Shoulder Pain

Symptoms

Symptoms of shoulder pain can be anywhere surrounding the shoulder and may extend to the shoulder blade or down the arm. The pain may feel deep within the joint or on the surface. The pain may be dull and achy or sharp and shooting. Symptoms, such as numbness, tingling and pins/needles may occur. The inability to move the shoulder through a full range of motion can also accompany the shoulder pain.

Causes

Shoulder pain can be caused by overexertion or repetitive overuse. Trying to lift a heavy object with improper form can strain the shoulder and cause pain. A traumatic injury, such as a fall, can also cause shoulder pain. Arthritic changes in the shoulder can also lead to pain. For most patients, wear and tear occurs from improper bodily mechanics, poor posture and lack of flexibility. The bone extending out from your collar bone can pinch the rotator cuff muscle (muscle that supports the joint deeply) and fray or tear and cause pain.

man with should painBackground

The shoulder is a complex joint, so it is important for a practitioner to identify the exact cause of pain. The skeletal structure of the shoulder joint is inherently unstable, a consequence to having a great range of motion in any direction, so constant support from the soft tissue structures (muscles and ligaments) is necessary to maintain stability. To maintain stability and support, the soft tissues must work in close coordination with each other. If any aspect of the supportive soft tissue becomes damaged, it places increased demand on the other non-damaged tissues, which can lead to overuse of these still-healthy tissues. This can lead to pain in or around the shoulder girdle.

The specific location of pain can shed light on what exactly is causing the pain. Pain in the front of the shoulder can indicate general impingement (pinching of muscle, tendon or bursae), biceps tendonitis, subscapularis tendonitis or a bursitis. Pain located on the outside of the shoulder can point to an injury to the supraspinatus, deltoid muscle injury, joint sprain or strain, or a neck injury that is referring pain to the outside of the shoulder. Pain on the top of the shoulder can signify arthritis of the acromioclavicular (AC) joint or if there was a traumatic injury, a shoulder separation at the AC joint. Pain located in the back of the shoulder can be a sign of infraspinatus, teres minor, posterior deltoid, or triceps injury. This is a generality and we keep in mind that most shoulder pain leads us to find at least 2 underlying problems because of the complexity of the joint.

Aligned Medical Group’s Approach

We perform a detailed examination, including orthopedic testing, range of motion assessments and muscle testing, to determine the exact cause of shoulder pain. Once the cause is identified, we prescribe a treatment plan that includes joint mobilization or manipulation, therapeutic stretching and strengthening exercises to improve range of motion and shoulder stability, and muscle stimulation. We do our best to correct postural abnormalities to maximize proper function and minimize further problems. Injections are sometimes recommended for reducing inflammation and pain, along with at-home TENS units to alleviate symptoms.