Neck and shoulder pain: what causes it, how to ease it, and when physical therapy helps
Updated: 2 days ago
Reviewed by Joe Koloc, PT, MSPT, MBA · Last reviewed November 2026
Short answer: Most neck and shoulder pain comes from irritated muscles, joints or nerves, often stirred up by posture, sleep position, stress or a sudden strain. It usually eases within a few weeks with gentle movement. If it lasts longer, keeps coming back or spreads into your arm, a physical therapist can find what's driving it and treat it.
Why do my neck and shoulder hurt at the same time?
The neck and shoulder share muscles and nerves. The upper trapezius and levator scapulae run from the neck to the shoulder blade, and the nerves that supply the shoulder and arm leave the spine in the neck. So a neck problem can ache into the shoulder blade or send tingling down the arm. A shoulder problem can pull tension up into the neck.
Common causes include:
Muscle strain from long hours at a desk, looking down at a phone, or lifting.
Stiff neck joints, often worse in the morning.
An irritated nerve in the neck (cervical radiculopathy), which can cause pain, numbness or tingling in the arm.
Rotator cuff irritation or a stiff ("frozen") shoulder.
Stress and poor sleep, which keep the neck and shoulder muscles tense.
Jaw problems (TMJ), which can add to neck tension. TMJ therapy.
How can I relieve neck and shoulder pain at home?
For everyday neck and shoulder pain without warning signs, these steps help most people:
Keep moving gently. Slow neck turns, shoulder rolls and shoulder-blade squeezes, within a range that doesn't sharply increase pain. Holding your neck rigid tends to slow recovery.
Use heat for 15 to 20 minutes to ease tight muscles.
Change position often. Get up from the desk every 30 to 45 minutes. Raise your screen to eye level and keep your phone up rather than looking down.
Stay active. Walking keeps the whole spine moving and helps with stress.
Watch your sleep position (see below).
If the pain isn't easing after a couple of weeks, keeps coming back, or spreads into your arm, see a physical therapist.
How should I sleep with neck and shoulder pain?
Sleep on your back or side. Use a pillow that keeps your head level with your spine: thicker for side sleeping, thinner for back sleeping. Avoid sleeping on your stomach, which keeps the neck turned for hours. If one shoulder hurts, lie on the other side and hug a pillow so the sore arm rests supported in front of you.
When should neck or shoulder pain be checked by a doctor first?
Most neck and shoulder pain is safe to treat with physical therapy. Seek medical care first, and don't wait for a therapy visit, if you have:
Neck pain after a major fall, car accident or blow to the head.
Weakness, numbness or clumsiness in your hands or arms that's getting worse, or trouble walking.
Severe headache with a stiff neck and fever.
Dizziness, double vision, slurred speech or facial numbness with neck pain.
Chest pain or shortness of breath with left shoulder or arm pain. Call 911.
Fever, unexplained weight loss, a history of cancer, or pain that wakes you every night.
How does physical therapy treat neck and shoulder pain?
Physical therapy starts with an evaluation to find what's driving your pain: how your neck and shoulder move, which muscles are weak or guarding, and whether a nerve is involved. Treatment usually combines:
Exercise to restore movement and build strength in the neck, rotator cuff and shoulder-blade muscles.
Hands-on treatment (manual therapy) to ease stiff joints and tight muscles.
Nerve-calming techniques when pain or tingling runs into the arm.
Changes to your day: desk setup, sleep, lifting and how you load the area at work.
The 2017 neck pain clinical practice guideline from the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) supports exercise combined with manual therapy for most people with neck pain. See how we treat neck and shoulder pain and our orthopedic physical therapy.
How long does it take to feel better?
Most people with neck or shoulder pain notice a change within a few weeks of regular treatment and home exercise. Pain that has lasted months, or pain with nerve symptoms, can take longer. Results differ from person to person, and your therapist will tell you what's realistic for you.
Do I need a referral?
No. In Florida you can start physical therapy without a doctor's referral and be treated for up to 30 days. How direct access works. Your first visit is a 45–60 minute, one-on-one evaluation with a licensed physical therapist. What to expect at your first visit.
Frequently asked questions
What is the most common reason for neck and shoulder pain?
Muscle strain and stiff neck joints from posture, sleep position or stress are the most common causes. An irritated nerve in the neck and rotator cuff problems are also common.
Is heat or ice better for neck and shoulder pain?
Heat usually helps tight, achy muscles. Ice can help for the first day or two after a strain. Use whichever eases your pain more.
Can a pinched nerve in the neck cause shoulder pain?
Yes. An irritated nerve in the neck can cause pain in the shoulder blade and pain, numbness or tingling down the arm.
Can physical therapy help neck and shoulder pain?
Yes. Exercise combined with hands-on treatment is a recommended first-line treatment for most neck pain.
Neck and shoulder care in Polk County
Core Rehabilitation treats neck and shoulder pain at all three clinics:
Lake Wales: 2031 State Rd 60 East · 863-678-0705
Haines City: 50 Maxcy Plaza Circle · 863-421-2000
Winter Haven: 3017 Cypress Gardens Rd · 863-268-6523
Request an appointment and we'll call you back.
Ready to get started?
Request an appointment at the clinic nearest you. No referral needed to start.
This article is general information, not medical advice for your situation.
Sources: Blanpied PR et al. Neck Pain: Revision 2017, JOSPT clinical practice guideline.
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