Symptoms
It is estimated that 70% of people will experience shoulder pain in their lifetime. Most often, people who experience shoulder pain report feeling a mild, dull pain around the shoulder with many reporting pain after activities such as lifting furniture, throwing a ball, reaching for something on the top shelf, swimming, or using a computer. Often, this type of dull pain can be due to a minor injury to the shoulder musculature or a strain of the soft tissue surrounding the shoulder joint. Less often, people who experience shoulder pain report feeling a sharp burning pain around the shoulder that may radiate down the arm and into the hands and fingers. Experiencing any type of sharp or burning pain in the shoulder or arm is either a sign of serious injury to the shoulder or a warning sign of a heart attack and requires immediate medical attention.
Diagnosis
Even though there are two different broad categories of shoulder pain, it can still be difficult to determine, without a thorough shoulder examination, what is causing the pain. This is because there are many different muscles and soft tissue structures surrounding the shoulder joint that, when injured, can manifest as the same type of pain. For instance, both a SLAP tear of the labrum and a sprain of the infraspinatus tendon can produce a painful sensation in the front of the shoulder. Here are more examples of what types of injuries can create certain types of shoulder pain.
1) Dull/Achy Pain: Rotator cuff injuries are the most common cause of dull, aching pain in the shoulder joint. When one or more rotator cuff muscles are injured, the pain can also cause the shoulder to feel restricted in certain motions. Labrum tears also cause people to experience a dull, aching pain around the shoulder. People with tears in the labrum typically feel the pain either in the front or back of the shoulder. Frozen shoulder causes aching pain around the shoulder and usually affects people between the ages of 40 and 60. Unlike other causes of achy pain, the pain around the shoulder will subside over time as the shoulder becomes less mobile (eventually the shoulder becomes “frozen”). Lastly, arthritis can develop within the shoulder joint and cause a dull pain deep in the shoulder joint. Commonly, glenohumeral osteoarthritis affects people over the age of 50, but it can also affect younger people if they have had a dislocated shoulder or fracture.
2) Sharp/Burning Pain: Shoulder pain that is sharp or burning often occurs after a traumatic event. In all cases, x-ray and MRI examination is needed to determine the extent of the injury and to determine the best course of treatment. Shoulder fractures are one cause of sharp pain in the shoulder and can occur as a result of a fall, sports injury, car accident or any other direct force to the shoulder. Bursitis can also cause sharp and burning pain in the shoulder and can occur as a result of repetitive motion activities, car accidents, a fall or any other physical injury to the shoulder. The inflamed bursa may also impinge on nerves and cause radiating pain down the affected arm. Traumatic injuries to the shoulder can also lead to rotator cuff tears, shoulder dislocation and/or damage to the labrum.
3) Referred pain to the shoulder: Although not frequently discussed, pain in the shoulder can also be caused by problems with internal organs. Since there are no pain receptors on internal organs, the body refers pain to other parts of the body to indicate something is wrong. Referred pain to the shoulder can be a sign of internal problems such as gallstones, pancreatitis, a ruptured ovarian cyst, blood vessel problems or lung problems. Heart attacks also refer pain to the shoulder. If you experience serious shoulder pain without a known injury, seek medical attention immediately.
Treatment
Just as there are many different types and causes of shoulder pain, there are many different treatment options for shoulder pain. And depending on the cause of the pain, different types of treatment are recommended. For traumatic injuries resulting in fractures, ligament tears or dislocations, surgical consultation and rehabilitation are standard. For other less serious injuries, conservative care is recommended first with surgical intervention seen as a last resort if symptoms worsen or don’t improve. At Kinesio Care Center, our Doctors of Chiropractic implement many different therapies in order to reduce or eliminate shoulder pain and each one has a specific purpose.
1) Joint Mobilization/Manual Manipulation – Providing a specific chiropractic adjustment to the shoulder joint can improve joint mobility and reduce or eliminate pain caused by irritation within the joint.
2) Manual Therapy/Graston Technique – Removing adhesions, scar tissue and tension from the muscles surrounding the shoulder allow for more range of motion and better neuromuscular coordination. This will help the shoulder to move better and feel stronger.
3) EMS – Electrical muscle stimulation is great for short term pain reduction and lymph stimulation to remove inflammation and swelling around the shoulder joint.
4) RockTape – RockTape, as with most kinesio tapes, reinforce the shoulder joint during the healing phase of care by aiding muscles during contraction and providing neurological cuing for proper joint movement.
5) Therapeutic Exercise – Therapeutic Exercises replace old pain-causing shoulder movements by educating and reinforcing new, healthy movements. Often, therapeutic exercises are geared toward strengthening the rotator cuff muscles to provide better stability to the shoulder joint.
6) Therapeutic Activity – Where therapeutic exercises teach and reinforce general movements of the shoulder, therapeutic activity is specific to certain activities that aggravate shoulder pain such as reaching, lifting, swimming, or throwing.
Prognosis
For more serious shoulder injuries that require surgery, it is common for people to need 6 weeks or more to recover. This is because of the level of tissue damage that occurs during the initial injury and during surgery. Bleeding, infection, scarring and shoulder stiffness can also occur after surgery. Shoulder surgery is a serious procedure and is only required to fix serious shoulder conditions.
For less serious shoulder conditions, such as those that cause dull or aching pain around the shoulder, conservative care is recommended. Chiropractic care, physical therapy, massage, and acupuncture are all great ways to reduce or eliminate stubborn shoulder pain. If you or someone you know has been suffering with shoulder pain, give Kinesio Care Center a call to set up an appointment today. There is no need to live with shoulder pain, take care of it and get back to moving, feeling and living better.