Shoulder Pain and its Different Causes
One of the most frequent diagnoses we treat here at Forward Motion Physical Therapy is shoulder pain. The types and causes of shoulder pain can vary, but they can all be very limiting for everyday function. Shoulder pain can be felt in the front, side, or back of the shoulder and can be a constant aching or a sharp pain only when moving the arm in a specific direction or a certain way. Shoulder pain can affect people of all ages, and depending on your age, you will have different causes of pain and symptoms. Here is a quick overview of some common shoulder conditions.
The shoulder is the most mobile joint in the body and is the most likely joint to dislocate. A dislocation occurs most often in younger people due to contact sports and adventure activities. Still, everyday accidents such as a fall can cause the joint to dislocate in people of all ages. The shoulder is immobilized in a sling, and then physical therapy treatment restores full range of motion, strength, and neuromuscular control.
What are some main causes?
Rotator Cuff Tears
The rotator cuff comprises four muscles and their tendons that hold the shoulder joint in place. They are compressed or rub against the bone with repetitive motions or everyday activities, such as washing and dressing, bringing our hands behind our backs, or overhead. Injuries to the rotator cuff are common and usually start out as irritation or impingement of the tendons. This irritation of the tendon can be treated successfully and a full pain-free range of motion restored. If left untreated, the risk can lead to rotator cuff tears later in life, as the tendon becomes frayed or damaged, and then a small motion such as lifting a gallon of milk can tear the tendon. If this happens, surgery is needed to reattach the tendon, and then PT is required to restore normal function.
Shoulder bursitis is a painful condition that affects people of all ages but tends to develop more in the middle-aged, elderly, and individuals who have muscle weakness. Shoulder bursitis can have many causes, but the most common is from repetitive activity, which creates friction in the upper shoulder area and inflammation. This can happen gradually or suddenly. It can also occur without any specific cause. Physical therapy can be a very effective treatment for shoulder bursitis to reduce pain, swelling, stiffness and to address the associated weakness in the shoulder, arm, neck, and upper back.
Shoulder Osteoarthritis or OA is typically seen in people over the age of 50 as we start to see the normal wear and tear on the two bones that make up the shoulder. We can see OA in younger people if they have had surgery or traumatized the shoulder at a younger age.
Shoulder pain can be constant, vary in the degree of intensity, or can be provoked with activity or positions. Fortunately, most shoulder pain can be treated conservatively. However, there are many misconceptions out there that you may not realize.
The most common mistake is in the diagnosis itself. Usually, when someone has nagging shoulder pain, they see their primary care physician. Unfortunately, standard care plans dictate that patients are either referred to an Orthopedist/Neurologist or the primary care physician orders scans of the shoulder. Now, there’s nothing wrong with ordering scans, especially if they are concerned about serious conditions such as cancers; however, shoulder conditions are of the soft tissues and cannot be seen on X-ray, and MRI’s are very expensive. Diagnosis needs to be done with proper questioning and a physical examination to determine the cause.
What do physical therapists do for shoulder pain?
The first thing a physical therapist does is ensure you are not having any referred pain from the cervical spine. Next, a series of movements and tests are done to pinpoint the painful structures to develop a successful treatment plan for you. If you are suffering from shoulder pain, you will be happy to know that current research consistently demonstrates improvement in symptoms with a well-structured and graduated exercise program. This improvement is equivalent to outcomes reported in surgical trials. So what does this mean? You can decrease your shoulder pain with physical therapy.
We can help!
If you, or someone you know, has shoulder pain, please give us a call and schedule a visit to see one of our therapists. If you would like to learn more about shoulder pain, come to one of our free Shoulder Pain Workshops that we host once a month. Call our office at (973) 400-3730 and ask to sign up for our workshop, as seating is limited. Check out our YouTube channel for shoulder exercises.