Imaging Tests To Diagnose Shoulder Pain
If youve already had X-rays or an MRI scan, your shoulder specialist will look at the images to help identify the cause of your pain. If not, he or she may order one or more of these tests:
X-RayAn X-ray lets the doctor see your bones and joints. It can help diagnose fractures, dislocations, and damage such as arthritis.;
What Is A Shoulder Specialist Called
Orthopedic surgeons are experts in ailments of the bones, tendons, joints, muscles, and ligaments. They work with patients in the diagnosis, prevention, and treatment of disorders. In the case of shoulder pain, you should be seeking out either a generalist orthopedic surgeon or one that specializes in shoulder surgery.
Rotator Cuff Injuries And Irritations
Your rotator cuff is a group of muscles and tendons that help tether your shoulder into the socket and allow you to move it in a circular motion. Some two million people visit a doctor each year for rotator cuffrelated issues, according to the American Academy of Orthopedic Surgery . Most problems with the rotator cuff fall into two categories: tears or inflammation. Suspect a rotator cuff problem if you have pain or stiffness in your shoulder when you lift your arm above your head to brush your hair or when you reach behind your back. “You won’t be able to do a lot of things you want to do, such as put dishes in an upper cabinet, play tennis, or do garden pruning,” says Dr. Ramappa.
Rotator cuff impingement.;A rotator cuff impingement happens when there is irritation, inflammation, or compression of the tendons or bursa in the shoulder. An impingement can be caused by an injury, but it can also just result from general wear and tear from daily life.
Rotator cuff tears.;A tear in the rotator cuff will produce pain that is similar to an impingement but has one additional differentiating feature. “If the pain is associated with weakness, it is likely caused by a tear, and if you just have pain, it may only be a rotator cuff impingement,” says Dr. Ramappa.
Performing simple stretches two to three days a week can help keep your muscles flexible and reduce pain, provided your doctor approves.
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Your Shoulder Becomes Weak
Shoulder weakness after obtaining injury may be due to a ruptured or torn rotator cuff. This is usually caused by a sudden force being exerted on to the shoulder. Having large tears on the rotator cuff usually causes weakness, especially when you are trying to lift your arm. If you are experiencing this, its time for you to see a doctor.
But How Did Those People Know What Kind Of Doctor To Go To For Shoulder Pain
Your family physician may be comfortable assessing and even treating your shoulder pain. However, they may refer you to a D.O. or M.D. with a specialty in Sports Medicine. A referral to an Orthopedic Surgeon may also be appropriate as they may order special tests to see why your shoulder is injured.;; If your shoulder can be treated conservatively, your physician may send you to a Physical Therapist for strengthening and pain control.
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Which Doctor To See For Shoulder Pain
If you are experiencing any of the warning signs of a shoulder injury, youll need to decide which doctor to see for shoulder pain. No matter the source of your shoulder pain, seeing an experienced orthopedic doctor as soon as possible is beneficial to prevent the issue from becoming more severe. Equipped with extensive knowledge regarding musculoskeletal issues, this type of medical professional will be able to diagnose your shoulder condition and advise you on the best course of treatment based on your symptoms. The doctor will most likely try treating your shoulder condition with more conservative methods, such as physical therapy and/or medication, before moving onto operative procedures.
What Causes Impingement Syndrome
Impingement syndrome can occur in athletes, active people and older adults. Its presence can also indicate a number of different-but-related problems, including:
- Rotator cuff injury: A tear in the tissues that connect muscle to bone around the shoulder joint
- Shoulder instability: A feeling of looseness in the shoulder
- Bone spurs: Projections that develop at the edges of bone
- Labral injury: A tear in the cartilage
- Disease of the tendon: Problems in the tissue that connects muscle to bone
- Osteoarthritis: Pain that occurs when tissue at the end of the bone wears down
Eventually, impingement syndrome can lead to other injuries, so its important to see a doctor for a proper diagnosis and care plan.
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Pinched Nerve In The Neck
A pinched nerve in the neck is also called cervical radiculopathy. It means that a nerve in the neck, at a point where it branches off from the spinal cord, is being compressed by the surrounding bones, muscles, or other tissues.
It can be caused by a traumatic injury, such as from sports or an automobile accident, especially if the injury results in a herniated disk. It may also arise from the normal wear and tear of aging.
Symptoms include sharp, burning pain with numbness and tingling from the neck to the shoulder, as well as weakness and numbness into the arm and hand.
Diagnosis is made through patient history, physical examination, and simple neurological tests to check the reflexes. Imaging such as x-ray, CT scan, or MRI may be done, as well as electromyography to measure nerve impulses in the muscles.
A pinched nerve in the neck often improves with simply a few days or weeks of rest. Physical therapy, nonsteroidal anti-inflammatory drugs, and steroid injections into the spine can all be very helpful.
Rarity: Common
Top Symptoms: pain in one shoulder, spontaneous shoulder pain, pain that radiates down arm, pain in the back of the neck, severe shoulder pain
Urgency: Primary care doctor
How Is Shoulder Pain Treated
The treatment recommended for shoulder pain will depend on the cause.
In the first few days after an injury, putting a cold pack on the sore area can help to reduce inflammation. After that, a hot pack can be used to help relax the shoulder muscles.
Pain relievers or anti-inflammatory medications may also help control the pain.
But for persistent or intense pain, or if youre injured, you should see a doctor or physiotherapist, who may suggest:
- resting your shoulder for some time
- taping your shoulder for support, or resting your arm
- laser or ultrasound therapy
Steroid injections or surgery may be recommended for some injuries.
If the pain lasts for longer, you may get stronger pain relief medication from a specialist. This might include medication to relax the muscles or treat nerve pain. Sometimes, injections to block the pain may be recommended.
If the condition is severe, you may be advised to have nerve stimulation to the spinal cord. Sometimes surgery is needed to correct structural problems, such as an arthroscopy, stablisation surgery or a joint replacement.
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Ask Dr Warner: When Should I See A Doctor For Shoulder Pain
Our shoulder joint provides a wide range of motion, but injury or wear and tear can cause pain that limits mobility. Dr. Warner discusses the most common reasons for shoulder pain, and the treatments available.
We can thank our shoulder joints for the flexibility that lets us push back our hair, execute a perfect golf swing, or swim a few laps at the pool. But the bones, muscles, and tendons in our shoulders arent immune to overuse damage and injury. Summit Orthopedics sports medicine physician and orthopedic surgeon Dr. Brent Warner explains common shoulder injuries and discusses the treatment options available to treat shoulder pain.
I treat a variety of patients for shoulder pain, he explains. I certainly see young athletes with fractures or other acute injuries, but stiff painful shoulders caused by wear and tear as well as overuse injuries typically affect my middle-aged and more mature patients. Overuse issues can affect people who swam or golfed in their youth, but they arent necessarily triggered by athletics. These problems can also be the result of work, or everyday activities, for people who spend all day lifting heavy objects or reaching into the back seat of a mail truck.
Treatments for shoulder injuries cover a wide spectrum from conservative to surgical. In most cases, we begin with a nonoperative treatment, notes Dr. Warner. A lot of shoulder problems will improve with physical therapy over time. Injections can help decrease inflammation or pain.
What Is The Cervical Spine
The cervical spine is the neck region of your spinal column. It’s made up of seven;small, highly mobile bones, and their associated ligaments, muscles, and shock-absorbing discs.
Anything that aggravates or comes into contact with your spinal nerve roots can lead to radiculopathy, and that includes several common conditions in which growths or abnormalities cause something to invade the space of the nerve root.
- Herniated disc: The shock-absorbing discs between vertebrae can become damaged and may develop a bulge and/or leak fluid.
- Synovial cyst: These lumps are caused by a buildup of joint fluid that forms a sac.
- Bone spur: An extra bit of bone forms in response to damage or chronic inflammation.
- Cervical spondylosis : This condition involves the formation of bone spurs in the neck.
- Spinal stenosis: An advanced stage of spinal arthritis, stenosis occurs when the spaces in the spine become narrowed, usually due to excess bone growth.
- Degenerative disc disease : Discs between vertebrae erode and fray over time, which may cause a herniated disc. In cases of severe degeneration, bone-on-bone contact can cause bone spurs in the joint.
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Assessing Your Shoulder Health
Shoulder joint injuries can be head-scratchers. There are multiple articulations at the shoulders, making it a challenge to directly pinpoint an injury. But proper assessment and movement tests to determine specific pain can narrow it down to specific injury issues.
The aforementioned tests are simple protocol anyone can use to determine the possible cause of shoulder joint injuries. You may discover one specific issue or multiple issues .
Either way, multi-dimensional shoulder joint articulations can be problematic. It is imperative to strengthen all participating muscles and shoulder articulations to enhance shoulder joint health due to the vulnerability of the body part.
Your Shoulder Seems Unstable
If you lack stability in your shoulder after getting injured, it means that your shoulder is most likely dislocated. In some cases, a dislocated shoulder will slide back to its place immediately after getting up from the ground. Some will not this is when you need to be seen by an orthopedic doctor.
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If You Have To Go To The Doctor
If you talk with your doctor about right shoulder and arm pain, they may recommend the following, depending on the severity of your condition.
- Immobilization: In some cases, limiting the movement of your shoulder or arm may help it heal. This is often achieved using a sling, brace, or cast. Your doctor will let you know when it can be removed.
- Corticosteroid injections: This is a type of medication that your doctor can inject into the affected area to help reduce inflammation.
- Prescription medications: Prescription pain medications may be given for severe pain. Oral corticosteroids can help ease inflammation. If you have RA, your doctor will likely prescribe a disease-modifying drug.
- Physical therapy: Your doctor may give you a list of exercises to do that can help you regain strength, flexibility, and range of motion. In some cases, they may recommend that you work with a physical therapist.
- Surgery: Surgery may be recommended when other treatments havent been effective or when damage is severe. The specific procedure thats used can depend on whats causing your condition.
Pain Around The Upper Arm And Shoulder
This happens when the pain is localized predominantly in the area of your shoulder and upper part of your humerus. The conditions that cause this can include:
- Rotator cuff disease: Initially, pain is often felt at the front of the shoulder.
- Torn rotator cuff: Tears in the rotator cuff can include pain that begins near the shoulder.
- Dislocated shoulder: Pain from a shoulder dislocation is most acutely felt near the shoulder.
- Broken collarbone: The pain from a broken collarbone can be felt close to the shoulder, particularly when you try to move your arm.
- Frozen shoulder: This type of pain typically comes on gradually and feels dull and deep.
- Calcific tendinitis: Pain due to calcific tendinitis can be severe and can come on suddenly, often in the morning.
- Shoulder sprain: You can feel pain from a shoulder sprain not only in your shoulder, but also in the area of your upper arm and collarbone.
- The pain due to a separated shoulder is felt around the shoulder and upper arm.
- Shoulder osteoarthritis and RA: People with arthritis in their shoulder often feel a deep ache in their shoulder and upper arm.
- Brachial neuritis: Pain from brachial neuritis is typically severe and most often happens in the area of the shoulder and upper arm.
- Brachial plexus injury: Pain from a brachial plexus injury can happen around the shoulder and upper arm. It may be long lasting.
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Shoulder Pain Treatment At Home
Unless there is an injury that clearly needs a doctors care, some shoulder pain can be managed at home. You can usually self-treat shoulder pain from repetitive use by stopping the activity. However, the longer you continue the activity, the worse the pain can be and the worse the damage may be to the shoulder structure. The most common home care recommendations for shoulder pain include:
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Rest. Reduce your activity, taking a break from the repetitive motions that may have caused your pain. If your shoulder pain is from an athletic or training injury, talk to the coach or an for alternate training.
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Ice. Apply ice to your shoulder for about 20 minutes a few times a day. Do not apply ice to bare skin.
- Heat. Warm packs are good for sore muscles, tendons and ligaments and mild injuries that do not cause significant swelling. Heat will increase blood flow to the area, which helps with healing and relaxes tension. For acute or very painful injuries, start with ice and alternate with heat after 48 hours .
; If you can take over-the-counter pain relievers, these may help as well by reducing inflammation and pain.
You may also want to protect your shoulder with a brace or support to prevent further injury. If the weight of your arm pulls down on your shoulder and increases the pain, a sling may be helpful. However, immobilizing your shoulder could lead to other issues, such as . If the pain is bad enough to require immobilizing, you should see a doctor for a diagnosis.
What To Do If Your Shoulder Hurts
If you do experience shoulder pain, it’s not always possible to figure out the cause. Sometimes problems in other parts of the body are actually the source of the pain, which then radiates to your shoulder. This can happen with certain neck problems, including arthritis and disc herniations, says Dr. Arun Ramappa, associate professor of orthopedic surgery at Harvard Medical School.
In general, if you are experiencing a lot of pain or know you injured yourself, it’s best to see a doctor right away to have your shoulder condition diagnosed.
But if you have general, mild shoulder pain, try adjusting your activities, taking nonsteroidal anti-inflammatory drugs, and performing mild stretches to see if the pain improves on its own. However, if the pain doesn’t go away after a few weeks, you should consult your doctor.
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Common Causes Of Shoulder Pain
Considering the range of motion a shoulder has, its perhaps not too surprising how common shoulder pain really isits estimated about 7.5 million people a year see a doctor for shoulder pain, and many more manage the pain at home. Your shoulder allows you to move your arms from side to side, forward and backward, and up above your head. A painful shoulder injury can occur from repetitive motions or acute, sudden injuries; chronic illnesses like can damage the joint as well. Here are the most common reasons people experience shoulder pain:
Exercise Can Help And Hurt Your Shoulders
Staying strong and flexible are the best ways to keep your shoulders healthy and prevent injuries. However, it’s important to focus on good form; bad exercise techniques can wreak havoc on your shoulders.
“I see people at health clubs all the time doing exercises with their arms straight out, away from their bodies with their elbows straight,” says Nicholson. “That looks good and feels like it is working your shoulder muscles. But, if you have a vulnerable shoulder, that form puts tremendous stress and strain across the rotator cuff.”
Instead, Nicholson recommends using resistance bands instead of weights and keeping your elbows bent at 90 degrees for shoulder-strengthening workouts.
“We tell patients to imagine that they are upper-cutting someone in the chin while keeping their elbows bent at 90 degrees,” he says. “Using resistance bands and keeping your elbows at 90 degrees allows you to exercise your internal and external shoulder rotation for the front and back of the rotator cuff without putting strain on it.”
Try some of these;shoulder conditioning exercises;from the American Academy of Orthopaedic Surgeons.
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Common Causes For Shoulder Injuries
Although we often associate shoulder injuries with professional athletes or those with very active lifestyles, this type of injury can affect just about anyone. We do, however, see some common causes associated with shoulder injury, including:
- Sports involving overhead activity that put stress on the shoulder joint, such as swimming, baseball and tennis
- Activities requiring repetitive lifting or overhead motion, such as construction, painting or hanging curtains
- On-the-job repetitive stress injuries such as awkward postures, frequent lifting and carrying, using vibrating equipment, static loading, or holding awkward postures
- Unexpected accidents
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