Top 5 Shoulder Pain Conditions
Shoulder pain is a common complaint and can range from mild discomfort to severe, debilitating pain. It can result from a variety of causes, from injuries to degenerative diseases. Here are the top 5 most common conditions associated with shoulder pain:
Rotator Cuff Tendinitis (Impingement Syndrome)
The rotator cuff is a group of muscles and tendons that help stabilize the shoulder and allow for a wide range of motion. Rotator cuff tendinitis occurs when these tendons become irritated or inflamed, often due to overuse or repetitive overhead movements. This condition is common in athletes and individuals who perform repetitive shoulder motions, like swimmers, tennis players, and construction workers.
Symptoms:
- Pain when lifting the arm overhead
- Weakness in the shoulder
- Tenderness and swelling around the shoulder joint
- Pain at night, especially when lying on the affected side
Treatment: Rest, chiropractic care, massage therapy, physical therapy, anti-inflammatory medications, and sometimes corticosteroid injections. In more severe cases, surgery may be necessary.
Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder occurs when the connective tissue surrounding the shoulder joint becomes stiff and inflamed, leading to pain and limited range of motion. This condition often develops gradually and is more common in people between the ages of 40 and 60, especially women. It can also be linked to diabetes or after a period of shoulder immobilization following injury or surgery.
Symptoms:
- Pain and stiffness, especially when trying to move the shoulder
- Difficulty raising the arm or rotating it
- Pain that worsens at night
Treatment: Physical therapy, chiropractic care, massage therapy, stretching exercises, anti-inflammatory medications, and sometimes corticosteroid injections. In rare cases, surgery may be required.
Shoulder Bursitis
Bursitis occurs when the small, fluid-filled sacs (bursae) that cushion the bones, tendons, and muscles around the shoulder become inflamed. This condition is often caused by repetitive motions or pressure on the shoulder joint, and it can accompany other shoulder injuries like rotator cuff tendinitis.
Symptoms:
- Pain and swelling in the shoulder, especially with overhead movements
- Tenderness when pressing on the shoulder
- Limited mobility in the shoulder joint
Treatment: Rest, ice, anti-inflammatory medications, massage therapy, chiropractic care and physical therapy. In some cases, corticosteroid injections may be administered to reduce inflammation.
Shoulder Arthritis (Osteoarthritis)
Shoulder arthritis is a degenerative condition where the cartilage in the shoulder joint wears down over time, leading to pain, stiffness, and reduced mobility. This condition is more common in older adults but can also occur due to previous shoulder injuries or repetitive stress.
Symptoms:
- Pain that worsens with activity or at night
- Stiffness and swelling in the shoulder
- A grinding or popping sensation when moving the arm
Treatment: Medications for pain relief, chiropractic care, physical therapy, corticosteroid injections, and joint replacement surgery in severe cases.
Shoulder Dislocation and Instability
A shoulder dislocation occurs when the ball of the shoulder joint (humeral head) is forced out of its socket, often as a result of trauma or injury, such as a fall or sports-related accident. Once dislocated, the shoulder may become prone to repeated dislocations, leading to chronic instability. This condition can result in torn ligaments, tendons, and cartilage.
Symptoms:
- Severe pain, especially when the shoulder is moved
- Visible deformity of the shoulder
- Limited mobility and weakness after the dislocation
Treatment: Initial treatment focuses on reducing the dislocation and managing pain. Physical therapy is important for strengthening the shoulder and improving stability. Surgery may be required for recurrent dislocations or significant damage.
Treatment Options for Rotator Cuff Injury
Conservative Care
Platelet-Rich Plasma (PRP) Injections
Corticosteroid Injections
Success Rate: 60-80%
For many patients with mild to moderate rotator cuff injuries, chiropractic care or physical therapy is the first line of treatment. Conservative care focuses on strengthening the muscles around the shoulder, improving range of motion, and reducing inflammation. Conservative care can be especially effective for cases of rotator cuff tendinitis, partial tears, or impingement syndrome.
Effectiveness:
- Mild injuries: Patients with less severe tears or inflammation often see significant improvement in pain and mobility after a few weeks to months of chiropractic care or physical therapy.
- Moderate injuries: Even in cases with partial tears, chiropractic care or physical therapy can help many individuals return to normal activity levels without the need for surgery.
However, if conservative care fails to provide relief within several months or if the injury is more severe, surgery might be considered. The success of conservative care is significantly higher if patients are diligent with exercises and follow their prescribed regimen.
Corticosteroid Injections
Platelet-Rich Plasma (PRP) Injections
Corticosteroid Injections
Success Rate: 50-70% for short-term relief
Corticosteroid injections are commonly used to manage inflammation and pain in the shoulder joint. These injections can provide relief from symptoms associated with rotator cuff injuries, particularly in cases of tendinitis or bursitis.
Effectiveness:
- Short-term relief: While corticosteroid injections can provide rapid, short-term pain relief (lasting weeks to months), they do not address the underlying problem, like tendon damage or impingement.
- Long-term success: Studies suggest that while these injections may improve symptoms temporarily, they may not prevent the need for further treatments, especially if a structural injury (like a full rotator cuff tear) is present.
Steroid injections should be used cautiously, as overuse can lead to weakened tendons and other complications.
Platelet-Rich Plasma (PRP) Injections
Platelet-Rich Plasma (PRP) Injections
Platelet-Rich Plasma (PRP) Injections
Success Rate: 70-80% in improving healing and reducing pain
PRP therapy involves drawing the patient's blood, concentrating the platelets, and injecting them into the injured shoulder to stimulate healing. The growth factors in the platelets promote tissue repair and can help reduce inflammation.
Effectiveness:
- Mild to moderate tears: PRP injections show promising results in reducing pain and improving function in patients with tendonitis, partial tears, or early degenerative changes in the rotator cuff.
- Chronic injuries: For more persistent or chronic injuries that don't respond well to physical therapy or steroids, PRP injections can be an effective alternative. Studies suggest that PRP may accelerate healing and improve outcomes compared to conventional treatments.
However, PRP injections are not universally effective and may not provide long-term relief for all patients.
Surgery (Arthroscopic or Open Repair)
Tendon Graft or Tendon Transfer (for Severe or Massive Tears)
Platelet-Rich Plasma (PRP) Injections
Success Rate: 80-95% (depending on the type of surgery and tear severity)
Surgery is typically reserved for patients with large or full-thickness rotator cuff tears that don’t respond to conservative treatments. Arthroscopic surgery (minimally invasive) is the most common approach, where small incisions are made to insert a camera and repair the torn tendons. In more complex cases, open surgery may be required.
Effectiveness:
- Full-thickness tears: The success rate for arthroscopic rotator cuff repair is generally high, ranging from 80% to 95%, with most patients experiencing significant improvement in shoulder strength, pain relief, and range of motion. Success rates may vary based on factors like age, tear size, and overall health.
- Re-tear rates: While surgery can lead to excellent functional outcomes, there is a risk of re-tearing the rotator cuff, particularly in older patients or those with large tears. Studies show that re-tear rates can range from 10% to 30%.
- Post-surgery rehabilitation: The success of the surgery is also influenced by the rehabilitation process. A diligent, well-structured physical therapy program after surgery is crucial for optimal recovery and long-term success.
Tendon Graft or Tendon Transfer (for Severe or Massive Tears)
Tendon Graft or Tendon Transfer (for Severe or Massive Tears)
Tendon Graft or Tendon Transfer (for Severe or Massive Tears)
Success Rate: 70-85%
In cases of large, irreparable rotator cuff tears where the tendon cannot be repaired directly, tendon grafting or tendon transfer may be performed. This involves taking tissue from another part of the body (such as a hamstring tendon) or using a donor tendon to replace or reinforce the damaged rotator cuff tendon.
Effectiveness:
- Massive tears: These procedures are typically considered for patients with significant rotator cuff damage that cannot be repaired with traditional methods.
- Success rate: Success rates range from 70% to 85%, and patients may experience substantial improvements in pain relief and shoulder function. However, recovery is more challenging and may require a longer rehabilitation period.
How Do You Decide?
Tendon Graft or Tendon Transfer (for Severe or Massive Tears)
Tendon Graft or Tendon Transfer (for Severe or Massive Tears)
The success rates for treating rotator cuff injuries vary depending on the severity of the injury, the chosen treatment, and individual factors such as age and activity level. Conservative treatments like physical therapy and chiropractic care are highly effective for many patients with mild to moderate injuries, while surgery offers the best long-term outcomes for those with severe tears. Tendon grafts or transfers can be successful in addressing massive, irreparable tears, though they come with a more complex recovery process.
Ultimately, the best treatment approach depends on the specific circumstances of the injury and should be determined in collaboration with a healthcare provider. Proper diagnosis and individualized care are key to maximizing recovery and achieving the best possible outcome.
If you've been struggling with a rotator cuff injury and would like another opinion, give us a call today and schedule an initial consult with Dr. Collin DeWitt. Through chiropractic care and the many manual therapies and therapeutic exercises that we implement into each treatment plan, we are confident that Dr. DeWitt will be able to help you solve your shoulder pain problem.
How Chiropractic Care Can Help Shoulder Pain
Can It Even Help Me?
Shoulder pain is a common condition that can significantly affect your quality of life, whether caused by injury, poor posture, or underlying conditions like rotator cuff issues or arthritis. While traditional treatments like physical therapy and medications are often used, chiropractic care and manual therapies offer effective alternative or complementary options for treating shoulder pain. These therapies focus on improving joint mobility, relieving pain, and restoring function.
Spinal Alignment and Posture Correction
A significant cause of shoulder pain is poor posture or misalignments in the spine. When the spine is out of alignment, it can affect the nervous system as well as the biomechanics of the body and lead to discomfort, including shoulder pain. For example, a misaligned upper back or neck (cervical spine) can contribute to referred pain in the shoulder due to nerve interference or muscle strain.
Chiropractic Care Approach:
- Proper spinal alignment improves posture and prevents unnecessary strain on the shoulder muscles, joints, nerves and ligaments.
- A chiropractor may also assess and adjust the position of the shoulder joint if it is out of alignment, addressing issues such as subluxations (partial dislocations) or shoulder impingement.
Joint Mobilization and Manipulation
Manual therapies such as joint mobilization and manipulation are integral parts of chiropractic care. Joint mobilization involves the gentle, controlled movement of the joints to improve their function, whereas manipulation involves more forceful adjustments to restore normal movement and alignment.
How Joint Mobilization Helps:
- Mobilizing the shoulder joint helps restore normal motion, especially if the joint has become stiff or restricted due to injury, overuse, or arthritis.
- These techniques target the soft tissues around the shoulder (muscles, ligaments, tendons) and improve their flexibility and mobility, allowing for better function and reduced pain.
- Joint manipulation can be used to treat conditions such as rotator cuff tendinitis, frozen shoulder, and shoulder impingement by improving the mechanics of the joint.
Soft Tissue Therapy
Chiropractors often use soft tissue techniques like myofascial release, trigger point therapy, cupping massage and Graston Technique to treat shoulder pain. These manual therapies focus on relaxing tight muscles, releasing tension, and promoting healing in the soft tissues.
How Soft Tissue Therapy Helps:
- Myofascial Release and Graston Technique target the fascia, which is the connective tissue surrounding muscles. Tightness in the fascia can lead to muscle pain and stiffness, contributing to shoulder discomfort. By releasing fascial adhesions, chiropractors can reduce irritation and improve mobility.
- Trigger Point Therapy and Cupping Massage focus on painful "knots" in the muscles that may radiate pain into the shoulder. Chiropractors apply pressure to these points to release muscle tension and reduce referred pain.
Improved Muscle Function and Strengthening
When shoulder pain limits your ability to move freely, the muscles around the joint may weaken due to disuse or compensation. Chiropractors use manual therapies not only to alleviate pain but also to help strengthen the muscles that support the shoulder joint, improving long-term function.
How Chiropractic Care Promotes Strengthening:
- Rehabilitation exercises: Chiropractors often prescribe specific exercises designed to improve shoulder strength and stability. Strengthening the muscles around the shoulder can prevent future injuries and help with recovery.
- Chiropractors work with patients to develop an individualized treatment plan that incorporates functional movements and exercises tailored to restore muscle balance and shoulder joint health.
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Whether you've been dealing with shoulder pain or discomfort for years, or just since this past weekend, we're here to help you find relief. Our shoulders give us so much more access to the world around us, being limited in your shoulder health limits how much you can interact with the world around you. So don't wait, start your journey toward shoulder pain relief today and give us a call at 605-782-9871 or click the button to schedule online.