Frozen Shoulder or Cervical Spondylosis? Telling Neck-Origin Arm Pain From Shoulder-Origin

Cervical spondylosis and frozen shoulder can cause similar symptoms and confuse their source, but if there is any hope of mitigating your parent's suffering, we must distinguish between the two. Pain that stems from the neck can travel to the shoulder and arm, and pain that stems from a frozen shoulder, which causes stiffness that worsens with movement, should never be mistaken for the same.

The location of the pain, the patterns it triggers, if there is neck involvement, and the extent of lost shoulder movement are all important considerations when trying to determine the best course of treatment. Distinguishing between a frozen shoulder and neck pain can be the difference between efficient treatment and pain management for your parents.

What Is Cervical Spondylosis and What Is Frozen Shoulder?

Both neck and shoulder conditions show similar symptoms, which may be difficult to differentiate. Neck pain can spread to the shoulder blade, upper arm, or hand, while shoulder pain may be felt around the upper arm. Therefore, parental complaints of pain may not clearly indicate the source of the pain.

Cervical spondylosis describes the degeneration of the bones, discs, or joints in the neck. Many people experience these changes without symptoms. However, people may experience neck pain, stiffness, headaches, or pain that radiates to the neck, shoulder, or arm. If the nerves are inflamed or squeezed, the symptoms could include weakness, tingling, numbness, and pain that radiates or burns to the arm or hand.

Frozen shoulder or adhesive capsulitis is different. In this condition, the connective tissues surrounding the shoulder joint become thick and tight, restricting the movement. Pain and stiffness develop gradually and are accompanied by reduced active and passive range of motion, both when the person moves the shoulder and when a clinician moves it.

Restriction of movement is the biggest differentiating factor.

Evidence the Pain Is in the Neck

Pay attention to whether arm pain is accompanied by neck pain or symptoms that seem to originate in the neck.

Moving the head, looking up, and stretching the neck can worsen the pain. Symptoms may spread to the shoulder, down the arm, to the hand or fingers. Numbness, tingling, burning pain, or weakness are the most important symptoms to note. These can indicate irritation of a cervical nerve.

Your parents may complain of arm pain, but may be able to describe it as tingling, sharp or burning, rather than just being sore. They may also notice that one arm is more affected than the other.

One useful indicator is hand function. Do not assume that your parent's weakness in the arm or hand, difficulty buttoning garments, dropping objects, or difficulty gripping objects are all signs of aging. Schedule a visit with the physician.

Cervical spondylosis can be common in people with aging. An X-ray or scan may not always show the cause of the pain. The results of the imaging should be matched with the symptoms and physical examination.

Signs the Problem May Be Frozen Shoulder

Frozen shoulder usually acts differently from a pain in the neck. The other signs could be:

• Restricted movement of the shoulder is the most obvious symptom.
• The shoulder may have loss of range of motion, and the patient may have difficulty reaching behind the back, putting a shirt on, combing hair, or reaching a high place.
• The stiffness in the shoulder is not simply caused by pain. A physician can distinguish this by checking active range of motion alongside passive range of motion.
• Your parents may experience pain disproportionately at night, feeling pain during sleep on the affected side. Shoulder pain tends to progress through different phases of pain, stiffness, and gradual improvement.

Shoulder pain that is not managed with treatment can actually get worse. Stiffness needs to be assessed and treated adequately.

A Simple Comparison for Families

This isn't a diagnostic test. A person can have multiple conditions at the same time, and other problems such as rotator cuff disorders, arthritis, nerve compression elsewhere, or referred pain can produce overlapping symptoms.

What a Doctor or Physiotherapist Will Look For

A good assessment doesn't begin with an X-ray. It begins with the history and physical examination.

The clinician will usually want to know the origin point of pain, whether it travels, what movements aggravate it, whether there is numbness or weakness, and how the symptoms affect daily activities.

They will test how far you can move your neck and shoulders, what your muscle strength is, sensation and reflexes. If they suspect cervical radiculopathy, this exam can help them find out the nerve root that is affected. X-rays, MRI, or other tests may be recommended when clinically indicated, particularly when symptoms are severe, persistent, progressive, or associated with neurological deficits or other red flags. Shoulder or neck pain of your parents may not warrant imaging.

For frozen shoulder, tests and examinations will focus on range of shoulder motion. X-rays can be used to help eliminate other causes of shoulder pain. In other cases of shoulder pain, ultrasound or MRI may be used.

Neck and shoulder pain may not have the same treatment, but may have the same symptoms. For cervical spondylosis that does not cause any serious issues to nerves or the spine, treatment may include pain management and physiotherapy when appropriate, along with posture correction, staying active, and gentle exercises.

If cervical spondylosis causes cervical radiculopathy, treatment includes pain management and physical therapy, along with the use of medications. For serious and long-term symptoms, neurological issues, or pain that is severe, surgery may be required.

Frozen shoulder is a case of loss of range of motion in the shoulder. Restoring shoulder movement is the goal for treatment. A physiotherapist may suggest exercises to improve shoulder range of motion, as well as pain management. The use of corticosteroids may be suggested by a clinician depending on how severe the frozen shoulder has become.

Caregivers should not try to impose an exercise program after a home diagnosis. One exercise that may be beneficial for one condition may not be beneficial for another.

Where Supportive Products Can Fit In

Though they are helpful, supportive products should not be a substitute for an assessment. For example, an AGEasy Cervical Collar may provide temporary neck support and comfort. Regular cervical collar use and long-term use pose neck muscle concerns, as discussed by the American Academy of Orthopaedic Surgeons. In the long term, soft neck collars can be used but are not recommended, as they weaken the muscles of the neck.

Easing neck pain for restful sleep is also important. An AGEasy Cervical Pillow may fit as part of a restful night's sleep, as it provides cervical support, but it should not be used as a treatment for cervical spondylosis or frozen shoulder. A pillow is not a treatment for arm pain.

When Arm Pain Means Prompt Medical Attention

There are symptoms which necessitate a shift from home care to medical evaluation.

If your parents are experiencing one or more of the following, contact their doctor immediately:

• The new onset of significant arm weakness, hand weakness, and/or severe neck pain; significant arm numbness.
• Severe neck pain that is rapidly worsening or persistent.
• New or worsening arm pain with pins and needles.

Severe symptoms of spinal issues can include a newly observed inability to walk normally, increased walking unsteadiness and imbalance, loss of hand coordination, urinary and/or bowel incontinence. It should all be evaluated medically without delay.

Arm weakness plus facial drooping, speech difficulty, and other sudden or new neurological symptoms warrant medical evaluation. They cannot be assumed to be symptoms of cervical spondylosis.

Symptoms that include chest pain, shortness of breath, sweating, nausea and arm pain travelling to the jaw, neck, back, and shoulder may indicate heart problems. Chest pain, even if it is not occurring in the chest region, may be a symptom of heart problems.

The Bottom Line for Caregivers

The most important question isn't whether your parents have frozen shoulder or cervical spondylosis. The real question is, where is the pain?

Pain caused by neck movement that travels down the arm and is experienced with or without signs like numbness, tingling, and weakness is indicative of problems with the cervical spine and nerves. A genuine limitation of movement in the shoulder that is painful and stiff in various directions is indicative of a frozen shoulder.

Older adults can have multiple conditions that can co-exist, and initially, they may have the same symptoms as well. So, the right diagnosis is important to treat the condition.