A person's skull, neck and shoulders are linked together by muscle and connective tissue. Pain in these areas may be caused by numerous factors, including a traumatic injury, muscle strains and deep referred pain from trigger points--hyperirritable nodules in a tight band of muscle--in other parts of the body. Pain in one these areas may be focal and unrelated to the function and health of the others, or it may be diffuse and directly related to musculoskeletal problems in one of the other areas 4.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Traumatic injury can cause headaches, neck pain and shoulder pain. According to the Mayo Clinic, almost 1/2 the United States' troops assessed for chronic headaches after a tour of duty have a history of mild head trauma, often caused by exposure to blasts. The Mayo Clinic notes that headaches caused by trauma typically resolve within several weeks, although some may continue for months or even years.
The Spine Universe website states that trauma-related neck pain, especially whiplash-induced neck pain, damages the neck's soft tissues and is usually caused by rapid extension and flexion movements of the head and neck 14. Whiplash injuries often occur to a person who has been rear-ended while driving. Pain from severe whiplash-related neck injuries may result from damage to the following structures: intervertebral joints, discs, ligaments, cervical muscles and nerve roots.
According to the American Academy of Orthopaedic Surgeons, trauma-related shoulder pain is common and may be caused by fractures, shoulder joint dislocations and tears to the ligaments and capsule surrounding the shoulder 2. Common sources of shoulder trauma include falls and motor vehicle accidents.
- Traumatic injury can cause headaches, neck pain and shoulder pain.
- According to the American Academy of Orthopaedic Surgeons, trauma-related shoulder pain is common and may be caused by fractures, shoulder joint dislocations and tears to the ligaments and capsule surrounding the shoulder 2.
Causes of Pain on the Right Side Under the Arm
Muscle strains may cause headaches, neck pain and shoulder pain. According to The University Health Center at the University of Georgia, tension headaches may develop from neck muscle strains, and sometimes--especially in children--incorrectly fitted glasses can cause a tension headache due to eye or ocular muscle strain 34.
The Spine Health website states that neck muscle strains--which involve muscle fiber micro-tears--can be painful and may be caused by a sudden force, an inappropriate sleeping position or poor posture 4. The website notes that while many episodes of neck pain have no identifiable anatomical cause, neck muscle strains are due to a specific soft-tissue injury involving one or more of the neck's muscles.
Muscle strains also affect the shoulder and can cause shoulder pain. Shoulder muscles strains--especially strains of the rotator cuff muscles, which stabilize and protect the shoulder joint--are common in athletes who perform whipping motions of the arm, such as baseball players, water polo players and volleyball players.
- Muscle strains may cause headaches, neck pain and shoulder pain.
- The Spine Health website states that neck muscle strains--which involve muscle fiber micro-tears--can be painful and may be caused by a sudden force, an inappropriate sleeping position or poor posture 4.
Trigger Point Pain
Trigger points can cause headaches, neck pain and shoulder pain. According to Dr. Devin Starlanyl at the FibroDoc.org website, the most common cause of headaches is referred pain from myofascial trigger points. There are numerous scalp and skull muscles in which trigger points may develop, including the frontalis, occipitalis, temporalis and the extrinsic eye muscles.
Trigger points are common in patients with musculoskeletal pain in the cervical spine. Trigger points are often located in the following neck muscles: the suboccipital group, upper trapezius, levator scapulae and splenius capitis and cervicis. Trigger points in the neck may develop and cause pain due to poor posture, stress and other factors.
Shoulder muscle trigger points can be painful and cause shoulder dysfunction. Trigger points in the shoulder muscles may refer or cause pain to appear in other parts of the body. According to the Sports Injury Bulletin website, trigger points in the subscapularis muscle--which acts on the arm to rotate it inward--could lead to satellite or remote trigger points in the muscles around the elbow and cause pain in the elbow, in addition to the shoulder.
- Trigger points can cause headaches, neck pain and shoulder pain.
- According to the Sports Injury Bulletin website, trigger points in the subscapularis muscle--which acts on the arm to rotate it inward--could lead to satellite or remote trigger points in the muscles around the elbow and cause pain in the elbow, in addition to the shoulder.
Causes of Pain on the Right Side Under the Arm
What Are the Causes of Upper Leg & Back Pain?
Tennis Balls to Reduce Neck Tension
Causes of Pain on the Right Side of the Neck Down to the Shoulder
What Are the Causes of Pain in the Back of the Arm?
Inflamed Trigger Points in the Forearm
What Are the Causes of Neck Pain at Base of Skull?
Common Rear Shoulder Injuries
Causes of Left Shoulder Blade Pain
What Are the Causes of Muscle Spasms in the Neck?
- Spine Universe: Whiplash: Neck Trauma and Treatment
- American Academy of Orthopaedic Surgeons: Shoulder Trauma
- University of Georgia: Tension Headaches
- Spine Health: Types of Neck Pain
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- Cleveland Clinic. Salivary Gland Cancer. Updated October 13, 2018.
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- Cleveland Clinic. Cervical (Carotid or Vertebral) Artery Dissection. Updated May 24, 2019.
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- American Academy of Orthopedic Surgeons. Cervical Radiculopathy: Surgical Treatment Options. Updated June 2015.
- American Academy of Orthopedic Surgeons. Cervical Fracture (Broken Neck). Reviewed December 2013.
- Chow AW. (2018). Deep neck space infections in adults. Durand MJ, ed. UpToDate. Waltham, MA: UpToDate Inc.
- Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clinc Proc. 2015 Feb;90(2):284-99. doi:10.1016/j.mayocp.2014.09.008
- Isaac Z, Kelly HR. (2018). Evaluation of the adult patients with neck pain. Atlas SJ, ed. UpToDate. Waltham, MA: UpToDate Inc.
- Martinez-Perez R, Fuentes F, Alemany VS. Subaxial cervical spine injury classification system: is it most appropriate for classifying cervical injury? Neural Regen Res. 2015 Sep;10(9):1416-7. doi:10.4103/1673-5374.165508
Martin Hughes is a chiropractic physician, health writer and the co-owner of a website devoted to natural footgear. He writes about health, fitness, diet and lifestyle. Hughes earned his Bachelor of Science in kinesiology at the University of Waterloo and his doctoral degree from Western States Chiropractic College in Portland, Ore.