Shoulder pain symptoms and what they mean

Shoulder pain symptoms and what they mean

Jul 05

Had some great responses to my back and knee posts about this topic, so here goes for the shoulder.   There is a sea of problems that can arise in the shoulder, so this one is tough.  I’ll cover the more common things I see.   I’ll save shoulder dislocations, SLAP tears/labral tears for another post.

It hurts to raise your arm above shoulder level.  More than likely, it’s fairly sharp pain.  Usually only hurts to do that or reach in the back seat, fasten a bra, or maybe tuck in a shirt.  You may have done a lot of overhead work lately (painting, dusting high shelves) or work a job where your arms are overhead a lot.  Hurts to lay on that side as well.  You have some tenderness in the shoulder, most likely in front or on the side.  Washing your other armpit kills you.  You don’t have much pain at rest or when you aren’t doing anything.

Diagnosis:  Likely a bursitis or also what is known as “impingement.”  The bursa is a tiny, fluid filled sac that is in several joints.  Bursae can get irritated and inflamed.  In this case, the bursa lies between your rotator cuff and the collarbone.  When you elevate your arm, you are basically squeezing the bursa and it doesn’t like it.  You can fix this with anti-inflammatories, activity modification, ice, rest, and specific exercises in physical therapy.

You are likely a middle-aged female.  You may or may not be diabetic.  You have a sudden onset of shoulder pain that very sharp and painful, severely restricts your range of motion in all directions.  You could also get this condition after trauma or surgery.

Diagnosis:  Most likely, you have frozen shoulder.   Typically, there are varying degrees of it – “freezing” (getting worse), “frozen “(already there), and “thawing” (getting better). The evidence shows us that a “supervised home program” is very effective for this.  You don’t need injections or manipulations – the data on these isn’t that great.  Unfortunately, frozen shoulder has a mind of its own and clears up when it wants to.  Really.  You can take 10 people with it, lock them in a room, for 2 weeks to 2 years and just tell them to come out when it goes away.  It’s really a very bizarre condition.  Some exercises and stretches work moderately, but for the most part, a physical therapist can show you what to do to manage it and prevent it from worsening.

You are likely middle-aged.  You may or may not have had an incident where you felt a “pop” in your shoulder while lifting something.  Now, it hurts to raise your arm or it’s really hard to do it.  Hurts really bad to sleep on it.  Pain radiates down your arm a little.  If you are elderly, chances are this came on gradually and it’s just gotten worse.  Pain can be pretty sharp.

Diagnosis: You may have a rotator cuff tear.  Some people can manage without a repair.  Deciding to have surgery is a multi-factorial process – your age, activity level, overall health, quality of the tissue, extent of the tear, and many others.  Again, this is a whole other post!

You are likely a middle-aged female.  You are having unilateral neck and shoulder pain that seems to radiate from the neck down the arm, maybe to the elbow or even to the hand.  May or may not be associated with numbness and tingling.  Pain is achy most of the time, but can be sharp.  You tend to be worse at the end of the day, when sitting at the computer too long, after a long day of work, and better when resting or in the morning.

Diagnosis:  You might be dealing with cervical degenerative disc disease.  More than likely, you have fair posture which has caused a forward head/rounded shoulder position. Unfortunately, many doctors MRI and inject the shoulder and the problem is often not there – it’s the neck.  Any good physical therapist will screen your neck for pathology if you present with these symptoms.  If you have any pain past the elbow, rest assured it’s not only a shoulder problem – for sure, it’s neck too.  Usually, you can treat this successfully with posture retraining, manual traction, strengthening of the scapular muscles and deep cervical flexors (neck muscles), and manual therapy to restore mobility to stiff areas.

You can be a person in their 20’s or someone middle aged.  You complain of achiness in the whole arm.  Your arm may get purple/blue in color from time to time and you may get a “heavy” feeling in the arm with or without numbness.  Your arm might feel swollen.  You get relief raising your arm overhead and resting.  You can be male or female.  Male sufferers tend to be muscular guys who weight train a lot.  Females tend to be petite with poor posture and possibly with overdeveloped breast tissue.

Diagnosis:  You may be dealing with thoracic outlet syndrome.  Basically, the nerves that go from your neck to your hand are bundled together and have to squeeze through some tight spaces to get to their destinations. If you are tight or have poor posture, it compresses those structures and causes the symptoms above. This can be easily treated with exercises, stretching, and posture re-training in most cases.

Hope that helps.  If none of these describe you, give us a call!

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