Expert: J.R. Strecker, B.S., D.C. - 2/8/2009

Question
Dear Dr. I have pain in the left crook of my neck. It comes and goes every couple of months always in the same place. When I have it, it is severe. I am 50 years old and wonder if it could be a heart problem? I am otherwise very healthy with no heart related issues in my family background. I had read somewhere that pain in the shoulder for women could be something more. Thank-you

Answer
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Hello D.,

You asked a really great question!  Briefly, yes, it could be a heart condition referring pain to the area you described.  However, this does not mean it is or not.  The only way to find out is to see your doctor and get evaluated.

The heart is known for referring pain to the left shoulder, but it is not limited to only these areas.  It can also refer to the right shoulder and even the left arm and elbow.  Additionally, many types of heart conditions can cause the shoulder pain.  Sometimes pain from the heart can be caused by more serious conditions, such as narrowing of the coronary arteries that lead to an increased risk for heart attack, or non-serious conditions, such as spastic coronary arteries causing harmless, referred pain to the shoulder.  It’s impossible to say what your condition is, or if it’s even a heart condition at all.  For all we know, it’s truly a shoulder problem from using your arm or lifting too much.  

One of the most common ways to determine if shoulder pain is referred pain or musculoskeletal (eg-shoulder) is to notice if position and movement affect the pain.  If your shoulder pain increases or lessens with certain movements and positions, there is less concern that the shoulder pain is referred from the heart.  If the shoulder pain is constant and unaffected by any positions or treatments, and additionally, is hard to localize, then the likelihood the pain is referred from a visceral structure increases.

To reiterate, it is not possible for me to know what category your condition falls under or if even the above scenarios apply to your condition at all.  Consequently, do not fail to follow up with your doctor and ask your doctor.  It’s always better to be safer than sorry.  Additionally, your doctor’s evaluation may highlight important aspects I’m blind to that bring in other plausible scenarios.

Hopefully you find this helpful.  Best of luck!

Dr. JR Strecker, D.C.