Shoulder Pain

 What is Shoulder Pain? 

Shoulder pain is described as pain in the shoulder joint itself and or in the muscles of the upper back/neck . Shoulder pain can have a number of different causes. The shoulder joint itself is a multidimensional ball and socket joint . When we look at the Bio-mechanical origins of shoulder pain, the most common causes for pain we see originate in the lower cervical spine ( lower neck or upper back) . Starting with the lower portion of the cervical spine /upper parts of the thoracic region we look at the nerve roots coming out of the C5/C6 and the C6-T2 vertebral levels. Often times nerve irritation caused by a vertebral subluxation at these levels can lead to asymmetrical muscle contractions. The asymmetrical contractions lead to bio mechanical dysfunction of the joint muscles and tendons resulting in conditions such as rotator cuff tendonitis, bursitis and pain in the shoulder joint as well as further loss of function. The end point of chronic pain if left uncorrected is what is termed “Frozen Shoulder” which is a result of an individual who is experiencing pain and loss of function of the shoulder joint and as a result stops using that arm as a result of the pain and restriction of the biomechanics of that joint. As a result of this inability to use the shoulder, arm and hand the shoulder joint itself becomes further restricted and adhesions form within the muscles and tendons of the joint itself. This is termed “Frozen Shoulder” and becomes more difficult to treat over time.

What are different kinds of Pain?

Rotator cuff tears/Tendinitis, Bursitis, Impingement Syndrome, Frozen Shoulder. These are all effects of bio mechanical breakdown. Most common types of shoulder conditions are mentioned above. In more rare cases shoulder conditions can be a result of a pain referral caused by an organic cause such as Gall bladder, Liver or Pancreatic disease. For the purposes of this discussion, we are specifically talking about pain caused by a subluxation or other biomechanics related to the joint itself and not that of an organic origin. 

How do you treat and assess shoulder pain?

We need to first do a thorough examination including taking a history to ascertain how the pain might have been incurred. Was it a sporting injury? Was there other trauma such as a car accident? Is it work-related ( working on computers, heavy lifting, repetitive microtrauma)?  Next, we do a detailed set of tests including a range of motion, orthopedic and neurologic tests to determine the exact cause of the pain. Lastly,  we perform digital x-rays to determine if there is subluxation of the lower cervical joints upper thoracic joints, depending on the history and examination findings we may also x-ray the shoulder joint itself to look for any degenerative changes of the joints of the shoulder girdle.  Once we find the exact cause of the pain we would establish a specific treatment plan for the individual. This plan may include spinal adjustments, exercises, icing instruction, home care as well as instruction to modify ergonomics. Each care plan we design is specific to the actual condition and to the individual.  95% of our patients get better with adherence to our recommended treatment plans. We expect to see results.