Brief Answer:
Very tricky.

Detailed Answer:
Several features of pain can be helpful in clarifying what is going on and the next steps for diagnosis and treatment.

Type of pain. Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain. Muscle spasms can be from the muscle or the nerve that goes to the muscle BUT if there aren't also nerve pains then, it's the muscle.

Location of pain. There is a lot to this. First, if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might be going on. Obviously if there was an injury to the area and then there was pain outward from it "hit a nerve" would be a possibility. Sick nerves are MULTIPLE areas and tends to be the TIPS of the nerve not the whole nerve

The neck is quite a common area for a pinched nerve. This shoots out and goes out of the shoulder and down the arm to the hands. Soft cervical collar, maybe local injections, maybe surgery can all sometimes be helpful. Also accupuncture is often helpful for nerve pain.

BUT, if it only a spasmed muscles there are several points:
first, some medicines help, but others cause this and lowering their dose or stopping them fixes this overnight. Any of the schizophrenia medicines also metoclopramide can cause severe neck spasm. Stopping the medicine helps overnight, benadryl is an antidote that usually helps in about an hour.

Muscle overuse and strain can trigger spasm. Heating pads and naproxen are often helpful in the immediate time frame and physical therapy is helpful in the long term.

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Brief Answer:
oh... supraspinatus

Detailed Answer:
well...good news and bad....
It isn't a common spot for problems. Pinched nerves in the neck, thoracic outlet syndrome, etc do not commonly hit that area. It's a local sore muscle. Other aspirin like drugs are worth a shot once. Massage/chiropracty is usually very helpful in the short term. For one isolated incident, I'm not sure of the role physical therapy would have UNLESS YOU ARE LIMITED IN ARM MOVEMENT in which case you NEED PHYSICAL THERAPY OR THE DYSFUNCTION GETS WORSE (called a "frozen shoulder", common with rotator cuff not common with shoulder pain that doesn't limit movement). I can't give a lot of likelihood of success to medical specialists in this case. About the only thing they can give are second opinions (useful to a point) and injection of steroids (not so useful if there isn't a joint space to inject). Oh, but they can prescribe muscle relaxants. As a clinical pharmacologist I know there are two groups of them even though this hasn't made it's way from the scientific literature to the medical textbooks. There are ones that work on muscles (cyclobenzaprine, skelaxin, baclofen) and ones that work on the spinal nerves (robaxin).

So, heat, rest, aspirin like drugs, thinking about what strains may have caused it, physical modalities like massage. Prescriptions might be another option.


This is general information not specific to your particular situation which cannot be done without actually being there. Other conditions can cause muscle pain such as lung cancer, stabbings, trichinosis; none are at all common and would be strongly expected to have many additional findings (weight loss, other pains, knife sticking out with bleeding, etc.)

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