Our shoulders are very susceptible to injury. It has a unique anatomy that makes it one of the most mobile joints in the body, but also one of the most unstable joints in the body. It is commonly injured during falls, but many people experience shoulder pain without any known trauma.
Some of the more common traumatic injuries occur as a result of falls, sports activities, heavy physical work, gardening and automobile accidents. Common traumatic injuries include:
- Sprains / Strains
- Tendinitis / Bursitis
- Shoulder Dislocation
- Separated Shoulder
- Tendon Tears (Rotator Cuff Tears)
- Cartilage Tears (Glenoid Labrum Tears)
Shoulder pain occurring without obvious trauma is also very common. Some of the more common non traumatic forms of shoulder pain include:
- Mechanical irritation of tendons and bursa as a result of poor posture and computer work with poor ergonomic set up
- Degenerative changes of the tendons (tendinosis)
- Arthritis (Osteoarthritis, Rheumatoid Arthritis, etc.)
- Calcium deposits (Calcific Tendonitis)
- Imbalance in the shoulder supporting musculature causing improper shoulder mechanical motion and abnormal movement patterns (Upper Cross Syndrome)
- Irritation of tendons and bursa from structural anomalies (Impingement Syndrome)
- Adhesive Capsulitis (Frozen Shoulder)
Non traumatic shoulder pain is particularly common in the age group 40 – 60. In this age range shoulder pain often results from degenerative changes in the rotator cuff tendons of the shoulder. The rotator cuff is a conglomerate of four important tendons which provide stability and movement of the shoulder. Without proper rotator cuff function normal pain free shoulder motion is not possible.
Diagnosis of shoulder pain depends upon a detailed history, chiropractic orthopedic and neurological examination, related physical examination, and sometimes diagnostic imaging (x-ray, MRI, CT, Diagnostic Ultrasound, etc.)
Treatment plans for shoulder pain depend upon an accurate diagnosis. Fortunately, most cases of shoulder pain resolve without surgical intervention once a properly designed rehabilitation program is initiated which is tailored to the specific needs of the shoulder. In some cases an interdisciplinary approach to care is necessary when severe pain and inflammation is present. When surgery is indicated the patient will be referred for surgical consultation.