Mobility & Flexibility

Understanding Shoulder Pain

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On my first visit, I automatically felt better but along came with soreness. I did continue treatment, I saw Dr. Jimenez maybe two or three times out of the week. Shortly after that I started noticing change. 

Denise

The shoulder consists of a number of joints that merge together with other complex structures, including muscles, tendons, and ligaments, to provide a wide range of movement in the arm, like scratching your back.

However, this increased range of motion can cause various health issues. It might lead to impingement problems or even instability on the bony structures or the soft tissues of the shoulder. Shoulder pain might be felt continuously or occur through shoulder movements. Moreover, shoulder pain can be temporary, or it might become chronic and require proper diagnosis and treatment.

The article below describes a few of the common causes of shoulder pain and discusses various treatment approaches to help improve shoulder pain. A qualified and experienced healthcare professional may be able to provide you with more information regarding your shoulder pain.

Anatomy of the Shoulder

The shoulder is a complex structure that is made up of three bones: the upper arm bone, also known as the humerus, the shoulder blade, also known as the scapula; along the collarbone, also known as the clavicle.

The head of the upper arm bone fits into a round socket on the shoulder blade, called the glenoid. Various ligaments, tendons, and muscles function by holding the upper arm bone. This collection of soft tissues is referred to as the rotator cuff. The main function of the rotator cuff is to both attach and cover the head of the upper arm bone in the shoulder.

Causes of Shoulder Pain

Most health issues that cause shoulder pain fall into four main categories:

  • Tendon inflammation, bursitis, and tendinitis, or a tendon tear
  • Instability
  • Arthritis
  • Fracture or broken bone

Other less common causes of shoulder pain include factors such as tumors, disease or aggravated conditions, and nerve-related problems. Below, we will discuss the common causes of shoulder pain in detail.

Bursitis

The bursae are small, fluid-filled sacs that are found between joints throughout the entire body, including the shoulder. These function by decreasing friction between the bone and the muscles and acting as cushions between the soft tissues and the bones.

Occasionally, excessive utilization of the shoulder can contribute to the swelling and inflammation of the bursa between the rotator cuff and a part of the shoulder blade called the acromion. The outcome measure of this health issue is a condition known as bursitis.

Bursitis often occurs in association with rotator cuff tendinitis, discussed below. The soft tissues in the shoulder can then become painful and inflamed. As a result, daily tasks, such as cleaning or brushing your hair and getting dressed, can become challenging to perform.

Tendinitis

A tendon is a cord that connects the muscles to the bones at different sites. Tendinitis is a consequence of inflammation in this soft tissue.

Ordinarily, tendinitis is frequently categorized as one of two types:

  • Acute. Overhead physical activities or ball projecting during a sports game or work may result in acute tendinitis.
  • Chronic. Degenerative diseases like arthritis or degenerative wear and tear due to age may lead to chronic tendinitis.

The joints in the shoulder most commonly affected with tendinitis include the four rotator cuff tendons, particularly the shoulder tendons. The rotator cuff consists of four muscles and their respective tendons, which keep the shoulder stable and protect the head of the upper arm bone. The rotator cuff provides equilibrium and shoulder movement.

Tendon Tears

The splitting and tearing of the tendons may be caused by severe damage or trauma from an injury and degenerative changes in the joints due to the normal aging process, long-term overuse, and the general wear and tear of the joints. These tears may divide the tendon completely out of its attachment, or they may only be partial. Normally in tears, the tendon is entirely separated from the bone. Rotator cuff and biceps tendon injuries are among the most common types of tendon tears.

Impingement

Shoulder impingement happens when the cap of the shoulder blade, known as the acromion, places pressure on the underlying soft tissues once the arm is raised away from the torso. When the arm is raised, the acromion rubs, or “impinges” on, the rotator cuff tendons and bursa. This may result in tendinitis and bursitis, restricting motion and causing pain.

Instability

Shoulder instability occurs when the head of the upper arm bone is forced out from the shoulder socket. This can occur as a consequence of a sudden injury or even due to excessive shoulder use.

Shoulder dislocations may only be partial, where only a part of the head of the upper arm may come out partially from the socket. This is also referred to as a subluxation. A complete dislocation usually means that the ball of the upper arm at the shoulder comes out all the ways from the socket.

When the ligaments, tendons, and muscles around the shoulder become torn or loose, dislocations can happen differently. Dislocations, which might be complete or partial, cause unsteadiness and pain when the arm is moved or lifted. Episodes of dislocations or subluxations increase the risk of developing arthritis in the shoulder joint, among others.

Arthritis

Health issues resulting in shoulder pain may also lead to arthritis. There are various kinds of arthritis. The most common kind of arthritis in the shoulder is osteoarthritis, also called “wear-and-tear” arthritis. Osteoarthritis symptoms can include pain, stiffness, and swelling, which may begin during the day and worsen throughout the day.

Osteoarthritis might also be associated with work or sports accidents and chronic wear-and-tear problems. Other kinds of arthritis could be linked to rotator cuff tears or joint lining inflammation.

Many times, individuals who already have arthritis in the shoulder joints will attempt to prevent moving their shoulder in an effort to reduce arthritis pain and discomfort, However, this often contributes to the stiffening or the tightening of the soft tissues surrounding the shoulder joints, leading to a painful restriction of movement.

Fracture

Fractures are frequently referred to as broken bones. Shoulder fractures commonly involve the clavicle, or the collarbone, the humerus, or the upper arm bone, and the scapula, or the shoulder blade.

Shoulder fractures in elderly patients frequently result from falling from a standing height. The average person’s harm from a motor vehicle or a sports accident often causes shoulder fractures.

Fractures frequently cause acute pain, swelling, and bruising in the shoulder. If a shoulder fracture is suspected, it’s important for the person to seek immediate medical attention from a healthcare professional.

Diagnosis for Shoulder Pain

If any of the health issues mentioned above result in extreme shoulder pain, seek medical attention as soon as possible to receive a proper diagnosis. While many cases of shoulder pain may resolve independently, make sure to see a doctor if symptoms persist or worsen.

A healthcare professional will conduct a comprehensive evaluation to ascertain the cause of the patient’s shoulder pain before providing them with the appropriate treatment options for their health issues.

Medical History

The first step for diagnosis is a comprehensive look at the patient’s medical history. The doctor will ask how the problem has been previously treated and how the pain began if they know that information. Moreover, additional questions will help determine the causes of the patient’s shoulder pain. Since certain actions may improve or worsen symptoms, a record may be an important tool in discovering the origin of shoulder pain.

Physical Evaluation

A thorough examination will help to discover the source of a patient’s shoulder pain. A doctor will assess for tender places and try to find physical abnormalities, swelling, deformity, or muscular fatigue. They will also observe the shoulder’s strength, flexibility, and movement.

Tests

The healthcare professional may additionally order certain tests to help identify the reason for the patient’s shoulder pain and help determine if the symptoms are due to other health issues. The following list demonstrates the variety of tests that can help determine the diagnosis.

  • X-rays. These images will reveal bone injuries.
  • Magnetic resonance imaging, or MRI and ultrasound. These imaging studies produce images of soft tissues. MRI can help your doctor identify injuries to the ligaments and tendons.
  • Computed tomography, or CT, scan. This instrument joins computer technologies and x-rays to make a better, more detailed image of the bones in the shoulder region.
  • Electrical studies. To assess neural function, the doctor may order an evaluation, including an EMG or electromyogram.
  • Arthrogram. This study injects dye to show the joint and its surrounding soft tissues. It might be used together with an MRI.
  • Arthroscopy. During this procedure, a doctor looks inside the joint using a camera. Arthroscopy may reveal soft tissue injuries that aren’t apparent in evaluations and exams. Arthroscopy can be used to fix the problem and help find the reason for symptoms.

Dr. Alex Jimenez’s Insight

As the most mobile joint in the human body, the shoulder joint is often vulnerable to experience a variety of problems which can result in shoulder pain. Shoulder pain can tremendously affect an individual’s ability to perform everyday tasks and, if lest untreated, it can progress into neck and back pain as well as cause other severe symptoms. Understanding the cause of a patient’s shoulder pain can help diagnose their problem in order to recommend the best treatment option.

 

Shoulder Chiropractic Treatment


Treatment

Chiropractic Care

Chiropractic care is a safe and effective alternative treatment option that can help manage shoulder pain by relieving discomfort and swelling, among other painful symptoms. A chiropractor will utilize chiropractic adjustments and manual manipulations to reduce joint restrictions and correct spinal misalignments in an effort to improve function.

Lifestyle Modifications

Furthermore, a chiropractic doctor or chiropractor will recommend a series of lifestyle modifications to help promote a faster recovery process. Changing a patient’s actions through a balance of rest and physical therapeutics can help improve shoulder endurance. Avoiding overexertion can also help prevent further harm and shoulder pain. 

Drugs & Medications

A doctor may also prescribe drugs and/or medications to decrease shoulder pain and inflammation. It must be taken only as directed if the medicine is prescribed to ease the pain. A physician can also recommend shots of numbing steroids to alleviate pain.

Surgery

Surgical interventions can help treat the causes of shoulder pain; however, it should only be considered as a last resort. Most patients will react positively to alternative treatment options like chiropractic care and lifestyle modifications. 

For certain types of shoulder problems, like recurring dislocations and a few rotator cuff tears, alternative treatment options may not be recommended, and surgery may be considered in this instance. 

Additional Topics: Acute Back Pain

Back pain is one of the most prevalent causes of disability and missed days at work worldwide. As a matter of fact, back pain has been attributed as the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience some type of back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments, and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as herniated discs, eventually lead to back pain symptoms. Sports injuries or automobile accident injuries are often the most frequent cause of back pain; however, sometimes, the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.

Post Disclaimer

Professional Scope of Practice *

The information herein on "Understanding Shoulder Pain" is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional.

Blog Information & Scope Discussions

Our information scope is limited to Chiropractic, musculoskeletal, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez DC or contact us at 915-850-0900.

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Blessings

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

Dr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
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