Neck pain, like almost all spinal pain, is caused by the common, slow, progressive, degenerative changes that happen to our spine as we age. It is a function of time, genetics, gravity, and traumas- micro- and macrotraumas. Most of the time, there is not a specific, significant, identifiable cause of the pain.
Doctors often send patients for x-rays or MRI scans and we all look for a variety of degenerative changes to the spine. We see, and identify, a variety of lesions on these images. But whatever we call them, they all represent compressive changes that are responsible for pain and disability.
Again, the most effective treatment I have found for neck-related pain, whether it is chronic or acute, including pain that radiates to the shoulder blades and mid-back and down the arm, is spinal decompression treatment. Most of the time this treatment will significantly improve, or resolve, someone’s pain in these regions. Exceptionally, I may need to refer somebody for pain management and even surgical treatment. However, neck surgery should be avoided whenever possible because the first neck surgery portends an increased risk of the need for subsequent neck surgeries.