Primary Spine & Rehab

10/24/2020

03/31/2020

We will begin seeing patients on a limited basis for medical, chiropractic and physical therapy treatment starting Monday April 6 2020. We can also offer telehealth services for all three provider types. Please call the office to see if your insurance covers this service.
Enfield: 860.763.2225
Hartford: 860.232.1576

We've done a lot to make sure our patients are as safe as possible from infection while in our care. Learn more at: http://primaryspinerehab.com/COVID-19-Announcement.htm

06/29/2019

02/27/2019

FDA Labels our Amnion Injections as “Regenerative Medicine Advanced Therapy”:
In March, the U.S. Food and Drug Administration awarded a treatment in use at Primary Spine & Rehab the “Regenerative Medicine Advanced Therapy” designation (RMAT). This is only the 15th time the FDA has awarded this designation since its creation. The treatment in question is trademarked AmnioFix®. We sometimes generically refer to this treatment as amnion injection. With this designation, the FDA is specifically recognizing AmnioFix’s potential role in the treatment of knee arthritis, which is one of its many uses.

Knee Osteoarthritis Approaching Endemic Levels
Amnion injections have been shown to improve even the most treatment-resistant tendon and ligament disorders with only one shot. The FDA is specifically looking at AmnioFix’s potential role in knee osteoarthritis (KOA), which is a different kind of pain complaint. While many people may consider knee arthritis just another nagging pain, KOA actually causes more disability in walking than any other disease. By some measures, 40% of people age 56-64 have it. With an aging population, increasing levels of obesity, and increasing levels of inactive lifestyles, some estimates have knee arthritis reaching endemic levels in the coming decades. “Endemic” is a description of a serious disease that has become too common. Endemic is like an epidemic – the difference being that an epidemic is unpredictable.

Preventing Osteoarthritis Disability
The healthcare profession has major untapped potential for helping patients with knee arthritis. Osteoarthritis of the knee often starts in a person’s 40s or earlier and progresses for a decade or more before becoming disabling for some. In the past, medical professionals have largely waited until joint failure to do anything other than cover the pain. However, regenerative medicine treatments delivered with exercise therapy and other physical therapy approaches have strong potential to slow the knee’s degeneration, preventing disability in future decades.

Federal Government Encourages Greater Use of Regenerative Medicine
The U.S. Congress created the RMAT to encourage advancement in the field of regenerative medicine. To be eligible, a treatment must have clinical evidence demonstrating it can provide solutions for serious conditions, especially conditions that are sometimes difficult to treat. Regenerative medicine refers to treatments that focus a patient’s own healing responses exactly where they are needed to accelerate healing or rebuild non-healing tissues. The FDA states, “Regenerative medicine is a rapidly expanding field that has the potential to treat serious conditions, particularly in patients with unmet medical needs.” In a setting such as Primary Spine & Rehab, a multi-specialty musculoskeletal pain relief center, AmnioFix can help in the treatment of conditions such as arthritis pain, back pain, tennis elbow, ACL strain, post-surgical ACL recovery, tendon tears, fasciitis, etc.

What is AmnioFix®?
AmnioFix is a product of dehydrated membrane suspended in an injectable solution. It promotes tissue healing better than any synthetic drug. The membrane used in the product is human amnion, the innermost layer of the placenta. AmnioFix contains 226 different growth factors. In addition to providing building blocks for tissue repair, the injection influences a patient’s own body to direct more of its healing response to the targeted area. Clinicians use ultrasound-guided injections to deliver the treatment to very targeted areas specific to each patient’s individual condition.

To learn more about regenerative medicine, visit the website of Primary Spine & Rehab or call 860.763.2225 to schedule an appointment.

More: https://enfieldhealth.nwsltr.info/2019/02/fda-labels-our-amnion-injections-as-regenerative-medicine-advanced-therapy/

02/27/2019

FDA Labels our Amnion Injections as “Regenerative Medicine Advanced Therapy”:
In March, the U.S. Food and Drug Administration awarded a treatment in use at Primary Spine & Rehab the “Regenerative Medicine Advanced Therapy” designation (RMAT). This is only the 15th time the FDA has awarded this designation since its creation. The treatment in question is trademarked AmnioFix®. We sometimes generically refer to this treatment as amnion injection. With this designation, the FDA is specifically recognizing AmnioFix’s potential role in the treatment of knee arthritis, which is one of its many uses.
Knee Osteoarthritis Approaching Endemic Levels
Amnion injections have been shown to improve even the most treatment-resistant tendon and ligament disorders with only one shot. The FDA is specifically looking at AmnioFix’s potential role in knee osteoarthritis (KOA), which is a different kind of pain complaint. While many people may consider knee arthritis just another nagging pain, KOA actually causes more disability in walking than any other disease. By some measures, 40% of people age 56-64 have it. With an aging population, increasing levels of obesity, and increasing levels of inactive lifestyles, some estimates have knee arthritis reaching endemic levels in the coming decades. “Endemic” is a description of a serious disease that has become too common. Endemic is like an epidemic – the difference being that an epidemic is unpredictable.
Preventing Osteoarthritis Disability
The healthcare profession has major untapped potential for helping patients with knee arthritis. Osteoarthritis of the knee often starts in a person’s 40s or earlier and progresses for a decade or more before becoming disabling for some. In the past, medical professionals have largely waited until joint failure to do anything other than cover the pain. However, regenerative medicine treatments delivered with exercise therapy and other physical therapy approaches have strong potential to slow the knee’s degeneration, preventing disability in future decades.
Federal Government Encourages Greater Use of Regenerative Medicine
The U.S. Congress created the RMAT to encourage advancement in the field of regenerative medicine. To be eligible, a treatment must have clinical evidence demonstrating it can provide solutions for serious conditions, especially conditions that are sometimes difficult to treat. Regenerative medicine refers to treatments that focus a patient’s own healing responses exactly where they are needed to accelerate healing or rebuild non-healing tissues. The FDA states, “Regenerative medicine is a rapidly expanding field that has the potential to treat serious conditions, particularly in patients with unmet medical needs.” In a setting such as Primary Spine & Rehab, a multi-specialty musculoskeletal pain relief center, AmnioFix can help in the treatment of conditions such as arthritis pain, back pain, tennis elbow, ACL strain, post-surgical ACL recovery, tendon tears, fasciitis, etc.
What is AmnioFix®?
AmnioFix is a product of dehydrated membrane suspended in an injectable solution. It promotes tissue healing better than any synthetic drug. The membrane used in the product is human amnion, the innermost layer of the placenta. AmnioFix contains 226 different growth factors. In addition to providing building blocks for tissue repair, the injection influences a patient’s own body to direct more of its healing response to the targeted area. Clinicians use ultrasound-guided injections to deliver the treatment to very targeted areas specific to each patient’s individual condition.
To learn more about regenerative medicine, visit the website of Primary Spine & Rehab or call 860.763.2225 to schedule an appointment.

More: https://enfieldhealth.nwsltr.info/2019/02/fda-labels-our-amnion-injections-as-regenerative-medicine-advanced-therapy/

02/22/2019

Mindful Walking: A Good Stress Reliever:
Mindful walking, or walking meditation, can be a good way to boost mood. Not only does the exercise of walking help release feel-good hormones into the body, but the mindful part also helps with reducing stress. It can help people slow down their minds and reach a state of calm. Below are some things to keep in mind when walking.


Wear comfortable shoes and pants for movement.
Start out walking at a regular place. Keep track of how the body feels as it moves.
Once you’re used to that pace, slow down just a bit and begin to breathe deeply. Don’t strain while breathing though.
While keeping aware of surroundings, begin to focus more attention on one of your senses. For example, start thinking about the smells in the area. After a bit, move on to sight and then to hearing.
After a few minutes, think about the physical sensations you are feeling again while walking.
Return to a normal pace.


Try this for 5-20 minutes the next time you feel really stressed. It might just help calm you down.

More: https://enfieldhealth.nwsltr.info/2019/02/mindful-walking-a-good-stress-reliever/

02/08/2019

Tips for Better Bone Health:
Osteoporosis is a disease where the bones become less dense. The result is weakened and brittle bones. However, there are ways to help stop bone density from declining as much, such as:


Eating calcium-rich foods: Calcium helps keep bones strong and healthy. Besides milk and dairy, calcium can be found in a wide variety of foods ranging from salmon to dark leafy green vegetables.
Engaging weight-bearing exercise: This does not necessarily mean weight lifting, though that is a good exercise for improving bone density. Aerobic activity such as walking and running also qualify as weight-bearing.
Don’t neglect core strength: Exercises that strengthen the core can help preserve spinal bone strength.
Don’t use to***co: Studies have shown that to***co use is tied to loss of bone density.


While some loss of bone density comes with age, there is a lot one can do to help preserve and strengthen bones.

More: https://enfieldhealth.nwsltr.info/2019/02/tips-for-better-bone-health/

01/25/2019

Things to Consider When Starting a Fitness Program:
Exercise is important for overall health. Even just walking for half an hour each day can yield noticeable benefits. When people start a fitness program, they may fall into certain pitfalls. These snafus may discourage future activity. Below, we will outline some potential mistakes and ways to counter them.


Not knowing fitness goals: People know that exercise is good for them, but they may go into a program without any specific goals in mind. Having goals makes it easier to stick with a program. The goal doesn’t have to be extravagant, simple goals are just as effective and easier to manage.
Going too hard too fast: When starting a program, start slowly and build up to more strenuous activity. Going for the strenuous first before building up endurance can lead to pain and potential injury.
Not having a balanced routine: Some people make the mistake on over-focusing on one area. Working out the whole body is the best way to ensure overall fitness. Another common mistake is not to balance aerobic activity with strength training. Both are important.
Not allowing enough time for recovery: It’s important to allow the body time to recover between workout sessions. Without proper recovery, you could be putting yourself at risk of injury.


One tip is to discuss any new fitness plans with a professional such as a physical therapist. This is especially true if one has not exercised in a while. He or she will be able to help form an exercise plan appropriate for you.

More: https://enfieldhealth.nwsltr.info/2019/01/things-to-consider-when-starting-a-fitness-program/

01/14/2019

Early Physical Therapy Associated with Lower Overall Costs:
Lowering healthcare costs, personally and nationally is, of course, a high priority. A new study published in BMC Health Services Research shows that early intervention with a physical therapist reduces overall healthcare costs.

This study examined people with neck pain. Researchers sorted them into three groups, early, delayed, and late treatment. This was based on the amount of days it took for a person to see a physical therapist after a doctor’s visit for neck pain. Early treatment was within 14 days, delayed was from 15 to 90 days, and late was 91 to 364 days. When comparing these groups, researchers found:


The late group was 2.79 times more likely to receive an opioid prescription than the early group.
The delayed and late groups were 5.34 and 4.36 times more likely to receive spinal injections compared to the early group.
The delayed and late groups were four times more likely to receive a MRI compared to the early group.
Overall, the average health care cost for the early group was $1,853 compared to $2,917 and $4,026 for the delayed and late groups.


There were no significant differences among the three groups in terms of obesity, fibromyalgia, or other chronic issues. People who had neurological issues were excluded from all three groups.

As the data showed, earlier access to a physical therapist led to lower medical costs. Remember, if you or someone you know is having issues with neck pain, we are here to help. We can assess your neck to see what the problem is and plan treatment from there.

Source:

Horn, Maggie E, and Julie M Fritz. “Timing of Physical Therapy Consultation on 1-Year Healthcare Utilization and Costs in Patients Seeking Care for Neck Pain: a Retrospective Cohort.” BMC Health Services Research, BioMed Central, 26 Nov. 2018, bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3699-0.

More: https://enfieldhealth.nwsltr.info/2019/01/early-physical-therapy-associated-with-lower-overall-costs/

12/28/2018

Signs of a SLAP Tear:
Superior Labrum Anterior and Posterior (SLAP) tears are a common type of shoulder injury. Oftentimes, they are brought on by repetitive motion. Particularly, motions that involve lifting the arms overhead. Though trauma can cause SLAP tears as well. Regardless of what causes the injury, SLAP tears have common symptoms. We will outline them below.


Decreased range of motion
A decrease in shoulder strength
Sensations of locking, popping, or grinding
Pain with movement of the shoulder
Pain when holding the shoulder in specific positions
Feeling like the shoulder is going to pop out of joint


The treatment options for SLAP tears vary depending on how severe the tear is. If you or someone you know is having issues with shoulder pain, remember we are here to help. We can examine your shoulder and prescribe a course of treatment from there.

More: https://enfieldhealth.nwsltr.info/2018/12/signs-of-a-slap-tear/

12/14/2018

Tips for Avoiding Weight Gain Over the Holidays:
The holidays are a time of merriment and fun. It seems like there is almost no end to holiday goodies and treats out there. This can lead to unwanted weight gain. Maintaining a healthy weight is important for overall wellbeing. Here are some tips to keep the pounds off this holiday season.


Stay active: Oftentimes, holiday traditions involve sedentary activities. Try to incorporate new actives like a family walk or games that involve movement like charades.
Don’t skip protein: Many holiday favorites are rich in carbs but lack protein. Try to get protein in with every meal. It will leave you feeling fuller and less likely to overindulge.
Control portion sizes: This is what often gets people, eating too large portions. A neat trick is to use smaller plates. They allow less food to be put on them and clearing off a whole smaller plate can help us feel fuller.
Serve meals restaurant style: Keep the food in the kitchen and only bring what can fit on a plate to the dinner table. Not having the food directly in front of you can reduce the urge to eat more of it.
Wait before taking seconds: Wait a few minutes after clearing a plate before deciding to go back for more. It often takes a few minutes or so for the body to start registering the food that’s already been eaten. Try chatting with friends or go for a walk before getting that second helping.


The holidays do not have to lead to weight gain. Taking some simple steps and eating everything in moderation can help keep excess weight off.

More: https://enfieldhealth.nwsltr.info/2018/12/tips-for-avoiding-weight-gain-over-the-holidays/

11/30/2018

How Often Should One Stretch for Hamstring Flexibility:

There has been much talk about stretching as it relates to fitness lately. Stretching’s main purpose is to help with flexibility. If that is an issue, stretching can help improve range of motion. However, just how often and for how long does one need to stretch to show improvements? We’ll discuss that below.

One study has shown that stretching as little as three times a week can improve flexibility. Stretching six times a week was shown to be optimal, but the differences were not significant. This is based on data examining participants doing static hamstring stretches.

Other studies have shown that typically 30-60 seconds of stretching per muscle yielded significant results. Stretching for longer did not show drastic improvements in flexibility.

Remember, static stretching proves most effective after exercise. Be sure to talk to a physical therapist or doctor before adopting any new stretching regimen.

Source:
Cipriani, Daniel J, et al. “Effect of Stretch Frequency and S*x on the Rate of Gain and Rate of Loss in Muscle Flexibility During a Hamstring-Stretching Program: A Randomized Single-Blind Longitudinal Study” The Journal of Strength & Conditioning Research. LWW, Oxford University Press, 2012, journals.lww.com/nscajscr/Fulltext/2012/08000/Effect_of_Stretch_Frequency_and_S*x_on_the_Rate_of.15.aspx.

Related

More: https://enfieldhealth.nwsltr.info/2018/11/how-often-should-one-stretch-for-hamstring-flexibility/

11/16/2018

What is Text Neck and How Serious Is It?:
Text neck is a modern spine ailment. It refers to pain and damage in the neck caused by looking down at devices for too long. Turning our heads down puts pressure on the neck. Depending on the angle, we are adding 27-60 pounds of pressure to our spines. This pressure can lead to permanent damage.

There are ways to text and prevent this from happening:


Hold the cell phone or device at eye level as much as possible.
Take frequent breaks from your device. Every 20 to 30 minutes is a good rule of thumb.
For office workers, make sure your screen is set up to where it is at eye level when you work.


Younger people are more vulnerable to this as they tend to spend more time on their devices. The pain associated with text neck is usually located in the upper back and shoulders. It can range from a chronic pain to severe back spasms. If you have issues with upper back pain, remember we are here to help. A physical therapy assessment can identify the source of your pain, and an individually tailored plan can get you back in motion.

More: https://enfieldhealth.nwsltr.info/2018/11/what-is-text-neck-and-how-serious-is-it/

11/02/2018

How to Properly Cool Down After a Workout:
The importance of a good warm up before exercise is well known. The importance of a good cool down, however, is less discussed. Cool down sessions allow the heart rate to return to normal and blood to recirculate properly. Cool downs also help prevent dizziness and fainting. Below are two major aspects of any proper cool down session.

First, prepare your body for rest by exercising at a lower intensity for 3-5 minutes. During this time, focus on deep breathing to get your heart rate back to normal.

Second, five minutes of stretching. Target the muscles you used during the workout to relieve tightness, stress, and tension.

Overall, aim for 8-10 minutes. It might not seem like much, but a cool down session can make a big difference in terms of recovery from a workout. Cool downs can also help with flexibility, build muscle, and prevent injury.

More: https://enfieldhealth.nwsltr.info/2018/11/how-to-properly-cool-down-after-a-workout/

10/19/2018

Can Foot Issues Cause Knee Pain?:
Knee pain is a very common complaint. Interestingly, not all knee pain is caused by issues with the knee. Other areas of the body can sustain trauma and result in knee pain. The foot, particularly the ankle, can cause issues with the knee.
One example is over-pronation. Pronation refers to the mechanics of the ankle when one is walking. Over-pronation is when people roll their ankles inwards while walking or running. This can lead to an inward rotation of the lower leg. This inward rotation can cause excess stress on the knee, leading to pain.
Ankle injuries can also lead to knee issues, especially if they do not heal properly. When the ankle is injured, muscles called the peroneal muscles can get damaged. These muscles help with supporting the lower leg. If this support weakens, it can put extra strain on the knee. The nerves in the lower leg can also get damaged and lead to pain in the knee.
To find out if your knee pain is related to a foot issue, come and see us. We can examine your feet and see if any issues are present there that may be causing knee pain.

More: http://enfieldhealth.nwsltr.info/2018/10/can-foot-issues-cause-knee-pain/

10/19/2018

Can Foot Issues Cause Knee Pain?:
Knee pain is a very common complaint. Interestingly, not all knee pain is caused by issues with the knee. Other areas of the body can sustain trauma and result in knee pain. The foot, particularly the ankle, can cause issues with the knee.
One example is over-pronation. Pronation refers to the mechanics of the ankle when one is walking. Over-pronation is when people roll their ankles inwards while walking or running. This can lead to an inward rotation of the lower leg. This inward rotation can cause excess stress on the knee, leading to pain.
Ankle injuries can also lead to knee issues, especially if they do not heal properly. When the ankle is injured, muscles called the peroneal muscles can get damaged. These muscles help with supporting the lower leg. If this support weakens, it can put extra strain on the knee. The nerves in the lower leg can also get damaged and lead to pain in the knee.
To find out if your knee pain is related to a foot issue, come and see us. We can examine your feet and see if any issues are present there that may be causing knee pain.

More: http://primaryspinerehab.nwsltr.info/2018/10/can-foot-issues-cause-knee-pain/

10/05/2018

Avulsion Fractures Explained:
Avulsion fracture means a tendon or ligament has pulled a piece of the bone off. These fractures tend to be more common in children, athletes, and dancers, but, anyone could have an avulsion fracture. It’s important to recognize one, because it’s easy to confuse them for sprains. Without proper treatment, avulsion fractures can lead to serious complications.
Symptoms of avulsion fractures include:
• Swelling
• Bruising
• Intense and sudden pain where the trauma occurred
• Trouble moving the bone or joint
• Pain when trying to move
The consequences of a misdiagnosis can lead to nerve irritation, issues with walking, and chronic pain. Treatment usually involves rest, icing the area, and certain exercises.

More: http://enfieldhealth.nwsltr.info/2018/10/avulsion-fractures-explained/

09/21/2018

Causes of Muscle Soreness/Stiffness:
Everyone has dealt with a sore or stiff muscle at some point. Usually, sore muscles are not much to worry about and can be treated with home remedies. Sometimes, that is not the case. Sore and stiff muscles could be a symptom of an underlying issue.
Possible reasons for sore and stiff muscles include:
• Exercise: Starting a new exercise routine or upping the intensity on an existing one can lead to muscle soreness
• Sprains and strains
• Lack of exercise: Leads to muscle weakness thus making it more likely for someone to have sprains and strains
• Poor nutrition
• Arthritis
Most of the time, muscle soreness and stiffness will go away on their own, or with the aide of home remedies. These home remedies include rest, icing or heating the affected areas, stretching, massages, and warm baths/showers.
If pain is prolonged or frequent, then it might mean something more serious. A physical therapist can help you find the cause and solution.

More: http://enfieldhealth.nwsltr.info/2018/09/causes-of-muscle-sorenessstiffness/

09/07/2018

Progressive Muscle Relaxation: A Good Way to Unwind:
Progressive Muscle Relaxation (PMR) has been used in treatments for a variety of ailments ranging from anxiety to insomnia to chronic pain. It has been found to be a great stress reliever. PMR is simple in concept. Here is a basic rundown.
1. While inhaling, contract one muscle group for five to ten seconds. While exhaling, stop contracting that muscle groups.
2. Relax for about 10-20 seconds, move on to another muscle group, and repeat step one.
3. When you stop contracting the muscles, focus on the changes you feel when you relax that muscle. Mental imagery may be helpful. Imagine all the negative energy in your life draining out of you as you relax your muscles.
Those are the basics of PMR. There are some who advise to work your way up the body with the muscle contractions, while others say work down the body. If you’ve had a history of injury or conditions that may cause muscle pain, you should speak with your therapist or doctor before starting PMR. If done correctly and safely, progressive muscle relaxation can yield a variety of health benefits.
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More: http://enfieldhealth.nwsltr.info/2018/09/progressive-muscle-relaxation-a-good-way-to-unwind/

08/24/2018

When Knee Pain Is Not Caused by the Knees:
Many people report problems with knee pain. However, often the problem is not with the knees. Knee pain can be a symptom of issues elsewhere. The usual culprits are the hips and ankles. Today, we will discuss when knee pain is caused by the hips.
The first thing to consider is the structure of the knee joint. It’s a simple hinge joint that moves in two directions (bending and straightening) and is supported by muscles above and below it. Imbalances in the muscles, in this case, the hip muscle, can cause extra strain on the knee leading to the pain one feels.
Red flags for knee pain caused by weakened hip muscles include:
• The knee pain started to occur after hip surgery
• When standing on that leg alone, the knee feels like it can’t provide sport and might cave in
• Walking up or down stairs is difficult because the leg feels like it won’t be able to provide support
• Tenderness in the thigh muscles
Remember, if you or someone you know is experiencing knee pain, we are here to help. We will meet with you and assess what is causing your knee pain. From there, we will plan a course of treatment based on the true source of your pain.

More: http://enfieldhealth.nwsltr.info/2018/08/when-knee-pain-is-not-caused-by-the-knees/

08/15/2018

Success Story - Prolotherapy (Elbow): “I had PRP Injections to my elbow. While it was being done it did not hurt, the next few days it was very sore but since then I have had no more pain at all. It feels perfect! ” Barbara 3/11/18

More: http://enfieldhealth.nwsltr.info/2018/08/success-story-prolotherapy-elbow/

08/10/2018

Five Common Workout Mistakes:
Exercise has numerous health benefits. It can help keep weight in a healthy range, it can help strengthen muscles, and it can even help with mental health. However, many people commit common mistakes that can limit the benefits of exercise or even cause harm. We’ll outline some of these mistakes below.
• No variety in exercise: Working out the same areas all the time is not good for overall health. It can lead to muscle imbalances that increase risk of injury. Keeping the same routine all the time also decreases the effectiveness of exercise.
• Not warming up: Going straight into a hard workout can leave oneself at risk of injury.
• Not feeding muscles after a workout: It’s recommended that eating a nutritious meal after a workout can help muscles heal and grow faster. Consuming protein is especially important. The time window for maximum effectiveness is within an hour after a workout.
• Using improper form: Exercises done improperly can lead to injury.
• Not resting enough: It’s important to get enough rest in between workout sessions. Over-training can lead to injury, fatigue, and insomnia. It also makes exercise less enjoyable.
These mistakes are common ones to make. If you’ve found yourself doing some of these, try changing it up and see what benefits happen.

More: http://enfieldhealth.nwsltr.info/2018/08/five-common-workout-mistakes/

07/27/2018

When Does Shoulder Pain Mean A Neck Problem?:
Pain can sometimes be deceiving. This is especially true in the case of the neck and shoulder area. Both share nerve pathways. This can lead to the brain incorrectly tracing pain signals. One could feel pain in the shoulder when it’s the neck that’s having the problem, and vice versa. Being able to correctly pinpoint the true cause of pain is important so that a correct course of treatment can occur. Below we’ll go over ways to tell the two pains apart.
• Does the pain end at the elbow? Shoulder problems cause pain that can leach into the upper arm, but rarely does it go past the elbow. Neck problems, on the other hand, can cause pain to course down past the elbow and even into the hand.
• Is the pain dull and aching, or is it more like a burning/stabbing? The former is associated with shoulder issues while the latter is common with neck problems.
• Does it improve with rest? True shoulder pain improves when the arm is at rest. Neck pain persists at rest and only gets better when the neck is supported.
• What actions cause the pain? Reaching overhead or behind your back commonly trigger shoulder pain. If the pain happens when moving your neck, it’s your neck that’s the issue.
Remember that we are here to help. We can assess you to pinpoint what is the exact cause of your pain. From there, we will devise a course of treatment to improve your condition.

More: http://enfieldhealth.nwsltr.info/2018/07/when-does-shoulder-pain-mean-a-neck-problem/