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Shoulder pain is both common and debilitating, with a reported annual incidence of 11.2 cases per 1000 patients in primary care and a lifetime prevalence of up to 67%. Furthermore, recovery from shoulder pain is often slow with high recurrence rates. Of those affected by shoulder pain, 25% report having a previous episode, and 40 to 50% report persisting pain or recurrence at 12-month follow-up. Fortunately, shoulder conditions can be managed conservatively and surgically, depending on the patient and the degree of injury.
Your shoulder is the most mobile joint in the body and affords a wide range of motion and versatility. However, you pay a price for mobility through instability and risk of injury.
I’ll cover common causes of shoulder pain along with general treatment options. See your doctor for detailed information about your specific shoulder pain.
Your shoulder is made of multiple joints between the humerus (upper arm), clavicle (collarbone), and scapula (shoulder blade). The head of your humerus fits into a bony socket in your shoulder blade. The supraspinatus, infraspinatus, teres minor, and subscapularis attach the humerus to the shoulder blade and stabilize the humeral head during overhead arm motions and assist in the elevation and rotation of the shoulder. These muscles are known as the rotator cuff.
These muscles can be pinched, become inflamed, or tear.
Tendons firmly adhere each end of a muscle to a bone. Bursae cushion and protect tendons as well as reduce wear and tear from gliding muscles and nearby bone. Excessive use and repetitive stress of your shoulder can lead to inflammation and swelling of both tissues.
Partial or complete tearing or splitting of a tendon can result from long-term wear and tear or sudden injury and trauma. In particular, rotator cuff tendon tears are common and sometimes elicit little or no pain.
Repeated overhead movements can compress the tissue between the top of the arm bone and the top of the shoulder blade and result in inflammation and swelling. The tissue can weaken or tear if the movement is continued despite pain and inflammation.
With subacromial bursitis, rotator cuff tendinitis, and partial rotator cuff tears pain is worse between 60° and 120° (painful arc of motion) of shoulder abduction or flexion and minimal or absent at < 60° or > 120°. Often pain is experienced as a dull ache that is hard to localize along with weakness into external rotation.
Activity Modification
Rest along with altering activities to avoid painful movements allow healing and insight into the root cause. NSAIDs such as aspirin and ibuprofen can be used for a limited time and are not meant to be lived on.
Improve Flexibility and Strength
Stretching is a simple and effective way to restore the muscular balance between the shoulder muscles. Strength training of the rotator cuff in conjunction with stretching can have a profoundly positive effect. The American Academy of Orthopaedic Surgeons shoulder conditioning program is a great place to start.
Conservative
When shoulder pain is nonresponsive or progressive professional care should be utilized. Conservative care such as Chiropractic, Physical Therapy, Acupuncture, and Massage Therapy can be wonderful in improving and resolving shoulder pain.
An additional step is to have these muscles evaluated by a practitioner that uses Advanced Muscle Integration Technique (AMIT). Such a practitioner identifies muscles that are unable to hold strong under stress and re-integrates those weak muscles back into their properly functioning group.
Surgery
The majority of shoulder pain responds well to simple treatment methods such as altering activities, rest, stretching and exercise. Chronic dislocations and some rotator cuff tears do not benefit from exercise. In these situations, surgery may be recommended to remove scar tissue or repair damaged tissues.
If you have unresolved shoulder pain sidelining you let us at Clear Point Wellness get you back in action.
Dr. Jeff
Your South Austin Chiropractor
