Shoulder pain is a common complaint.

shoulder painOften patients complain of pain “in behind” the shoulder blade that comes on with psychological stress. It is often described when the neck is not functioning quite right.

The intervertebral discs of the cervical spine are a common source of pain in the shoulder. In a study by Cloward MD titled : Cervical Diskography , A Contribution to the Etiology and Mechanism of Neck, Shoulder and Arm Pain he performed an invasive procedure that pressurized the intervertebral discs in the neck and mapped out where the pain is. If you click on the link, you will see the article in its entirety. It is an important piece of literature and proves to be invaluable because of the inability to conduct this kind of research today because of ethics.

As you can see, the procedure was quite invasive. By using a technique called, diskography (disc-maping), they overinflated the disc with air and watched where the pain showed up.


shoulder pain - x-ray

But the sacrifice of this subject yielded some very important information. As each individual disc was pressurized, you can see below) the mapping of the pain presentation. You can also see the presentation into the shoulder blade area.


 shoulder pain - spine diagram

One of the common links to stress and shoulder pain is the way we breath when we are stressed. Normal relaxed breathing should occur through the diaphragm–alleviating any extra work to be done with the upper chest muscles. Leon Chaitow, a osteopath and naturopath from the UK, has written the most on this topic. I have spent some time studying his work. He has written many articles on the subject and has just released his newest book.


As we experience stress in our daily lives as humans, we often react in a psychological manner. Most of our stress in today’s society is psychological. When compared to our early ancestors, their stress was often physical in nature. Robert Sapolsky wrote a wonderful book on the stress response and explained that both animals and our forefathers experienced stress differently than what we experience today.


When human stress is mainly psychological it causes altered breathing through our upper chest muscles. This puts unwanted compression on the cervical spine discs. As the accessory muscles ( muscles that are used to fill the upper portion of the lungs) lift the upper ribs of the thoracic cage, this in turn causes increasing compression on the cervical spine. You can see in the diagram below how the scalene muscles attach the cervical vertebrae to the upper ribs.


shoulder pain - screen shot

If you find that stress tends to bother the areas Cloward showed above, you may be an upside down breather. Keeping your shoulders down will help with preventing extra cervical compression. Also, you may require some cervical treatment to help with restoring better mechanics and height to the discs of the neck. I often find reduced cervical curves as a precursor to these kind of problems. And of course, previous trauma does not help if that is part of the history.


If you experience pain in these regions, and it has not responded to other treatment, you may want to consider chiropractic treatment to the cervical intervertebral discs. Diaphragmatic breathing strategies will surely help as well.