What causes shoulder pain?
Shoulder pain is an extremely common complaint, and there are many causes of this problem. The cause of many instances of shoulder or arm pain is obvious. You do something to injure the arm or shoulder and immediately feel pain. Or you begin feeling the pain a day or so later. You may have broken a bone or dislocated your shoulder.
Perhaps you strained tendons or ligaments by carrying too much weight for too long, by lifting something that was too heavy, overreaching or overexerting your arm--as when playing sports when you're out of shape--or by keeping your arm in an awkward position, or even by sleeping on the shoulder. The resulting pain may range from an annoying ache to acute pain that makes it hard for you to use the injured arm. Fortunately, the majority of such injuries are seldom critical.
Here is a list of some of the most common causes for shoulder pain:
- Referred pain from neck - When the structures in the neck are painful, the pain is often felt over the shoulder. It is important to remember this and your chiropractor will always examine your neck when you come in for shoulder pain.
- Bursitis / Rotator Cuff Tendinitis = Impingement Syndrome - The most common diagnosis in patients with shoulder pain is bursitis and tendinitis of the rotator cuff musculature causing impingement syndrome.
- Rotator Cuff Tear - Different degrees of rotator cuff tears can occur. If the tendons of the rotator cuff separate from the bone, surgery is sometimes necessary.
- Frozen Shoulder Syndrome - Also called 'adhesive capsulitis,' this is a common condition that leads to severely restricted movement of the shoulder.
- Calcific Tendinitis - Calcific tendinitis is a condition of calcium deposits within a tendon - most commonly within the rotator cuff tendons. Treatment of calcific tendinitis depends on the extent of symptoms.
- Shoulder Instability - Instability is a problem that causes a loose joint. Instability can be caused by a traumatic injury (dislocation), or may be a developed condition.
- Shoulder Dislocation - A dislocation is an injury that occurs when the ball-part of the shoulder joint (top of the arm bone) slips out of the socket (part of the shoulder blade).
- Ligament Injury (Acromio-Clavicular Tear) - Also called an A/C separation, these injuries are the result of a disruption of the acromio-clavicular joint. This is a very different injury from a gleno-humeral dislocation.
- Labral Tear - There are several patterns of a torn labrum and the type of treatment depends on the specific injury.
- Arthritis (Osteoarthritis) - Shoulder arthritis is less common than knee and hip arthritis, but when severe may require a joint replacement surgery. However, arthritic changes are more common in the acromio-clavicular joint between the collarbone and the shoulder blade.
- Biceps Tendon Rupture - The upper part of the biceps tendon can rupture and cause shoulder pain.
- Referred pain from internal organs - It is important to remember that pain from the gall bladder can be felt over the right shoulder and pain from the pancreas can be felt over the left shoulder, and most importantly, heart attacks can refer pain into the left shoulder and arm.
When do you need to call your Chiropractor about your shoulder pain?
Like any other pain condition, the sooner you get appropriate care the quicker the pain will go and allow you to go back to normal activities, the sooner you get appropriate care the less likely you are to get a recurrent and chronic problem.
If you are unsure of the cause of your shoulder pain, or if you do not know the specific treatment recommendations for your condition, you should seek Chiropractic help. Treatment of these conditions must be directed at the specific cause of your problem to be effective.
Some signs that you should be seen by a Chiropractor include:
- Inability to carry objects or use the arm
- Injury that causes deformity of the joint
- Shoulder pain that occurs at night or while resting
- Shoulder pain that persists beyond a few days
- Inability to raise the arm
- Swelling or significant bruising around the joint or arm
- Signs of an infection, including fever, redness, warmth
- Any other unusual symptoms
What are the best treatments for shoulder pain?
The treatment of shoulder pain depends entirely on the cause of the problem. Therefore, it is important for the chiropractor to accurate diagnose the problem before any treatment can start. If you are unsure of your diagnosis, or the severity of your condition, you should seek advice before beginning any self-treatment. Not all treatments listed here are appropriate for every condition, but may be helpful in your situation. Just remember, resting and taking painkillers only, is not a treatment that is likely to help your shoulder in the long term. But may well be part of what you need to do when the treatment start.
- Rest - The first treatment for many common conditions that cause shoulder pain is to rest the joint, and allow the acute inflammation to subside. It is important, however, to use caution when resting the joint, because prolonged immobilization can cause a "frozen shoulder".
- Ice and Heat Application - Ice packs and heat pads are among the most commonly used treatments for shoulder pain. Dr. Pisarek will advise when and how to use ice and heat therapy.
- Chiropractic Treatment - Once swelling and pain has somewhat subsided, mobilizing manipulations to increase active, passive and resisted ranges of motion (ROMs) can be instituted (see below).
- Low-level Laser Therapy (LLLT) - provides excellent results in treating all types of joint conditions. Click here for further information on this type of treatment modality.
- Physiotherapy - Various modalities such as ultrasound and interferential frequencies provide great benefit in shoulder rehabilitation.
- Stretching - Stretching the muscles and tendons that surround the joint can help with some causes of shoulder pain. A good routine should be established, and following some specific suggestions will help you on your way.
- Strengthening Exercises - Once the pain has substantially reduced and there is improved shoulder range of motion, a structured self-administered strengthening routine can be institute.
- Anti-Inflammatory Medication - Non-steroidal anti-inflammatory pain medications, commonly referred to as NSAID's, are some of the most commonly prescribed medications, especially for patients with shoulder pain caused by problems such as arthritis, bursitis, and tendinitis. There are of course some natural alternatives that your chiropractor can recommend.
- Cortisone injections - Cortisone is a powerful medication that treats inflammation, and inflammation is a common problem in patients with shoulder pain. Discuss with your doctor the possible benefits of a cortisone injection for your shoulder condition. It can be a useful adjunct to chiropractic treatment, but should not be relied on as a treatment on its own. It is used as a last resort prior to surgical consideration, and is quite an invasive approach and not without adverse-effects.
What can chiropractic do?
Chiropractors are trained in medical diagnosis and one of the priorities in the examination is to rule out more serious medical conditions before any treatment can start.
Your chiropractor will examine you and conduct diagnostic tests to determine exactly what is causing your shoulder or arm pain. Because the causes and the seriousness of different conditions are so varied, it is important to pinpoint the cause and begin the most appropriate treatment. He or she will discover if your problem is mild and transitory, or serious and likely to trouble you for a long time. A broken bone, which requires a referral to hospital, cannot be treated in the same manner as bursitis or tendonitis. Arthritis and gout call for different care than pain originating in nerves supplying the shoulder and arm. Your chiropractor will decide which treatment will be best for you and if referral to a specialist will be necessary.
Chiropractic can be successfully employed to deal with so-called frozen shoulder, a severe inflammation technically known as adhesive capsulitis. Chiropractors are accustomed to relieving painful trigger points between the spine and shoulder. Many chiropractors, especially those with additional training in sports medicine, are experienced in the care and rehabilitation of professional and amateur athletes who have injured their shoulders or arms. And all chiropractors can help you modify your habits and lifestyle to protect yourself from arm and shoulder injuries and ailments.
Call Advanced Healthcare today for your appointment with Dr. Pisarek
and let him help you overcome your shoulder pain and restore it's function.