Pain localized to the right cervical spine and shoulder region can stem from various musculoskeletal, neurological, and other underlying medical conditions, based on our experience at Kaly.
This detailed guide discusses the potential reasons you may be experiencing pain on the right side of your neck and shoulders along with advice on finding relief through both self-care and medical treatments.
What are the causes of shoulder pain and neck pain on the right side?
The most common causes of right-sided neck and shoulder pain are strained muscles like the trapezius and levator scapulae, poor posture leading to muscle tightness, herniated discs or bone spurs irritating cervical nerve roots, and degenerative joint issues putting pressure on surrounding tissues.
To be specific, poor neck posture such as a forward head position, text neck, or a tilted neck can strain the sternocleidomastoid muscle that extends from behind the right ear to the clavicle. Based on Kaly’s specialists’ expertise, this places excessive tension through the muscle fibers, irritating surrounding nerve roots and contributing to one-sided neck and shoulder pain.
A study published in the National Center for Biotechnology Information (NCBI) found that changes in scapular posture and muscle activation patterns are potential risk factors for chronic neck pain. Subjects with chronic neck pain tend to have more protracted shoulders, and altered behaviors of muscles, such as the trapezius and levator scapula, can cause compression and shear forces on the neck area, leading to pain.
A systematic review and meta-analysis published in the NCBI found that forward head posture (FHP) is the most common cervical postural fault and is associated with neck pain. Greater FHP has been associated with greater deficits in cervical range of motion, particularly neck rotation and flexion.
Underlying joint pathologies such as a cervical herniated disc, bone spur formation, or degenerative changes from osteoarthritis can also irritate nerve roots along the cervical spine. This commonly results in radiating pain from the right side of the neck into the shoulder and upper back region.
What causes severe right-side neck and shoulder pain?
Severe right neck and shoulder pain often results from serious injuries like cervical fractures or dislocations, advanced degenerative disc disease or spinal stenosis, severe muscle spasms or sprains, compressed or inflamed cervical nerves, and conditions like tumors, infections, or vascular issues affecting the cervical spine.
An article on Medical News Today explains that neck pain can often result from a minor sprain or tear to the muscle tissue. This type of pain is the most common neck pain and can sometimes be due to poor posture. Holding the neck out of alignment for extended periods can strain the muscles, leading to spasms or sprains
Another study on the NCBI Bookshelf discusses cervical degenerative disc disease, which typically develops in the aging population. This condition can cause pain in the neck and shoulder areas. The degenerative process of the cervical spine is classified into three distinct stages: dysfunction, instability, and stabilization.
As the disease progresses, it can lead to spinal stenosis, a narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine
Acute injuries such as fractures or dislocations of the cervical vertebrae from traumatic falls or accidents can drastically disrupt the neck’s structure. This frequently produces intense localized pain through the neck and shoulder secondary to instability and neurological compression.
Based on our research, other potential sources of severe right-side neck and shoulder pain include cancerous tumors affecting cervical vertebrae, spinal infections, aneurysms, blood clots, and fibrocartilaginous embolism associated with spinal cord infarction.
What are the causes of right ear, neck, and shoulder pain?
Right ear, neck, and shoulder pain commonly arises from temporomandibular joint dysfunction and muscle tension, ear infections that spread inflammation to surrounding nerves, and issues with the stylohyoid ligament irritating neurovascular structures in the neck.
Additionally, ear infections and inflammation of the external or middle ear structures can potentially spread to surrounding regions. The vagus and spinal accessory nerves provide sensory innervation to these areas, and neuralgia resulting from inflammation can generate referred pain signals.
- A study conducted among dental students found that stress-induced TMD was prevalent, with symptoms including pain and tenderness in the masticatory muscles or TMJ, clicking or crepitation of the TMJ during condylar movement, and limitation on mandibular movement. This pain can often be referred to the face, head, or jaw.
- A study conducted in Gorgan, Iran, found that of 770 patients with otalgia, 12.2% had referred to otalgia, with the most common cause being dental problems.
Another potential source includes acute dysfunction of the stylohyoid ligament that extends from the base of the skull to the hyoid bone. This structure runs adjacent to the internal and external carotid arteries, and any instability can irritate these critical neurovascular structures.
- A case study reported a 4-year delay in diagnosing a combined carotid arterial and jugular venous styloid compression, which caused a range of symptoms including dull neck pain and severe incapacitating right-side headache.
What does right neck, shoulder, and chest pain indicate?
The combination of right neck, shoulder, and chest pain can indicate potentially serious cardiopulmonary or gastrointestinal conditions like heart attacks, blood clots in lungs, pneumonia, or esophageal disorders that require urgent medical evaluation.
While musculoskeletal pain can radiate across these regions, other red flag symptoms like shortness of breath, palpitations, or nausea should prompt immediate medical attention to rule out myocardial infarction, pulmonary embolism, pneumonia, and esophageal disorders.
Specifically, simultaneous right-sided neck, shoulder, and chest pain raises suspicion for the following potentially concerning scenarios:
- Myocardial infarction
Myocardial infarction, also known as a heart attack, can generate referred pain signals that radiate up into the right side of the neck and shoulder. Crushing, pressure-like chest pain, shortness of breath, nausea, and sweating are classic heart attack symptoms mandating emergency evaluation.
An electrocardiogram and cardiac enzymes blood tests help diagnose a heart attack requiring urgent intervention.
A case study analysis in the Archives of Physiotherapy discusses how patients with acute myocardial infarction commonly present with chest, upper limbs, or abdominal pain. The pain can also be referred to the shoulder. The symptoms of AMI include crushing, substernal chest pain, jaw pain, neck pain, and excessive sweating.
- Pulmonary embolism
Pulmonary embolism occurs when a blood clot breaks loose and travels to the lungs, blocking blood flow. The abrupt reduction in respiration can cause right-sided chest pain accompanied by neck and shoulder pain.
Vital signs may reveal low oxygen saturation levels and rapid heart rate and breathing. Diagnostic imaging like a CT angiogram confirms the presence of a pulmonary embolism.
A study titled “Neck-to-shoulder pain as an unusual presentation of pulmonary embolism in a patient with cervical spinal cord injury” reports a case where a patient with a cervical spinal cord injury experienced referred pain from the neck to the shoulder due to a pulmonary embolism.
The pain was not reduced after the administration of pain medication; however, it was completely relieved after the treatment of the pulmonary embolism.
- Esophageal disorders
Esophageal disorders like acid reflux, hiatal hernia, and esophagitis from heartburn can generate referred pain spreading up into the right neck and shoulder region. Nausea, difficulty swallowing, and worsening pain with eating can indicate an esophageal source warranting endoscopy.
The study “Cervical Radiculopathy as a Hidden Cause of Angina: Cervicogenic Angina” discusses how noncardiac chest pain (NCCP) can be caused by esophageal, musculoskeletal, or psychiatric diseases.
The study presents a case where a 56-year-old man experienced paroxysmal upper chest pain and chronic neck pain, which were later linked to cervical radiculopathy.
Why is pain radiating down my right arm from my neck?
Pain radiating down the right arm from the neck is typically caused by a pinched nerve or radiculopathy in the cervical spine, often from a herniated disc, bone spur, spinal stenosis, or rarely, a tumor or cyst compressing the cervical nerve roots.
Inflammation and disruption of the cervical nerve roots can also cause numbness, tingling, and weakness through the right upper extremity. Specifically, the following cervical spine issues often contribute to radiating right arm pain:
- Cervical disc herniations
Cervical disc herniations or bulges put pressure on nerve roots as they exit the spine. This most frequently occurs at the C5-C6 or C6-C7 levels, causing pain to radiate down the outer arm in a dermatomal pattern. Weakness or numbness in the biceps, triceps, or wrist may occur.
A study from the University of Virginia School of Medicine explains that cervical radiculopathy, commonly known as a “pinched nerve,” often results from a herniated disc. This condition can cause pain that radiates into the shoulder and down the arm, as well as muscle weakness and numbness in the hand. The pain is usually described as burning or sharp, and certain neck movements may increase the pain.
- Bone spurs
Bone spurs, also called cervical osteophytes, can gradually form along the margins of cervical vertebrae due to spondylosis. As these bony protrusions enlarge, they narrow the foramen and pinch neighboring nerve roots, triggering pain down the arm.
A case report published in the National Center for Biotechnology Information (NCBI) also discusses a patient who developed neurological symptoms due to osteophyte formation after undergoing anterior cervical discectomy and fusion (ACDF), a surgical procedure to treat spinal problems.
- Spinal stenosis
Spinal stenosis refers to abnormal narrowing of the cervical canal, often from arthritis or degenerative changes. This compresses the spinal cord and nerve roots traveling through the neck, potentially producing neuropathic arm pain, numbness, and tingling.
- Cervical tumor
Based on our experience, a cervical tumor or cyst can sometimes apply direct pressure on nerve roots or prompt abnormal bony growths impacting nerve impingement. Though rare, these types of lesions must be evaluated.
- Cervical radiculopathy
Cervical radiculopathy involves inflammation, irritation, or injury to a cervical nerve root. In addition to radiating arm pain, this often causes segmental weakness, numbness, or diminished reflexes that can help pinpoint the affected nerve root(s).
A study published in the NCBI explains that the clinical manifestations of cervical radiculopathy are broad and may include pain, sensory deficits, motor deficits, diminished reflexes, or any combination of the above.
What treatments are available for pain in the neck and shoulder on the right side?
Treatments for right neck and shoulder pain include physical therapy, massage, chiropractic adjustments, bracing, medications, heat/ice therapy, and if conservative measures fail, steroid injections or surgery based on the specific diagnosed condition.
Kaly specialists advise utilizing a combination of conservative treatment approaches to alleviate common right side neck and shoulder pain, including:
- Physical therapy – Targeted stretches and exercises help strengthen the musculoskeletal support system and improve range of motion and flexibility. Proper posture retraining is also beneficial.
- Massage therapy – Deep tissue techniques applied to tight musculature can relieve trigger points and release stored tension.
- Chiropractic – Gentle joint mobilization and manipulation can improve segmental motion of the cervical facets and thoracic spine.
- Bracing – Structured cervical collars can provide external support and limit painful motion.
- Over-the-counter medications – Anti-inflammatories like NSAIDs temporarily alleviate pain and swelling.
- Heat/ice therapy – Alternating heat and ice helps relieve muscular tightness and spinal joint irritation.
Based on our experience at Kaly, when conservative measures fail to provide adequate pain relief, options like steroid injections or surgical intervention may be warranted based on the diagnosed condition. This is why obtaining an accurate diagnosis is critical.
What are the best pillows for relieving right-side neck and shoulder pain?
The best pillows for right neck and shoulder pain are cervical and contour pillows that support the natural curvature of the neck, adjustable memory foam or buckwheat pillows that conform to the neck’s shape, and orthopedic pillows with proper ergonomic design to maintain neck alignment.
Kaly specialists recommend the following pillow types to help reduce nighttime aggravation of right-sided neck and shoulder pain:
- Contour pillows are molded into an orthopedic shape with indented sides that gently support the head and neck. This also helps keep the spine straight.
One study published on PubMed found that the design of an orthopedic pillow, which conforms to orthopedic guidelines to ensure the right support of the cervical curve, plays a crucial role in cervical curve, pillow temperature, and pillow comfort. The study concluded that an orthopedic pillow may be an optimal pillow for sleep quality
- Memory foam conforms to the contours of the head and neck. It also responds to pressure and warmth to provide customized support.
A systematic review and meta-analysis conducted by researchers found that pillow designs significantly impact neck pain, waking symptoms, and neck disability. The study found that rubber pillows (which have similar properties to memory foam) were effective in reducing neck pain and enhancing pillow satisfaction in patients with chronic neck pain.
The study also noted that the alignment of the cervical spine in the side-lying position may be significantly impacted by the shape and height of the pillow.
Moreover, WebMD supports the use of memory foam pillows, stating that they can provide extra head and neck support, helping to maintain the natural curve of the cervical spine. The article also mentions that contoured memory foam pillows can help support the chin in the correct posture for side sleepers, which can prevent pain.
Try different pillows and thicknesses to find the option that feels most comfortable and allows you to rest in a neutral spinal position without excessive bending or rotation of the neck. Proper nighttime support helps reduce stress on the cervical spine and surrounding musculature.
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