The Mystery About Shoulder Pain
Shoulder pain changes lives everyday. Today,
more than anytime in history, more people know something
about shoulder pain. Sports hero’s down for the
count due to any number of problems with shoulder
muscles, tendons, labral tears, spurs, arthritis… you
name it, they’ve got it! Go beyond that, right in
your own living room, more and more of us are suffering
from some type of shoulder pain, what type, you name it,
arthritis, rotator cuff tear, frozen shoulder,
impingement syndrome… Baby Boomers are now coming
of age and well into the ages that there are aches and
pains in many locations of the body. The shoulder
is definitely in the top five, somewhere behind; low
back pain, neck pain, and a close runner up to knee
pain.
How do we develop shoulder pain? Usually,
either by repetitive maneuvers with our shoulders and
arms or straight out…trauma.
This article is going to touch upon 4 major types of
shoulder pain, how we develop shoulder pain and some
ideas on how to treat it once we know what the problem
is.
Rotator Cuff Strain: The
term strain means that there is a muscle and or tendon
that is overstretched or, outright torn. There are 3
basic types of strain, a mild partial, a moderate and
severe total. The Rotator Cuff stands for 4
different muscles that comprise the cuff of the
shoulder. These muscles are mostly responsible for
rotating the shoulder both fast and slow. A tear
usually occurs with sports related occurrences, throwing
a ball, swinging a golf club or trauma such as falling
on the ice or climbing and straining the arm or
shoulder.
With Rotator cuff syndrome, pain and weakness of the
shoulder is common. Inability to raise the
shoulder from our side without help from the other arm,
difficulty raising arm in front of the body or putting
the wallet in your back pocket. This is usually
diagnosed by a proper examination. Orthopedic
surgeons, Physiatrist and Chiropractic physicians can
diagnose this problem. MRI testing may need to be
used in order to confirm the diagnosis. Treatment
can be as simple as range of motion stretching and light
exercise with elastic bands to gently strengthen the
shoulder. Gentle massage and manipulation by a
doctor is also an option.
Rotator Cuff syndrome also very often responds
remarkable well to electro-therapeutic modalities
including; Ultrasound, Interferential Current,
Electromuscle Stimulation and Microcurrent.
For more severe cases of strain and frank tear,,
Orthopedic Surgeons may advise arthoscopic surgical
repair or other surgical treatments.
Frozen Shoulder Syndrome:
Frozen Shoulder aka Adhesive Capsulitis, feels
almost exactly as it sounds. The shoulder feels glued
down to the side. In extreme cases, the arm can
not be moved from the side without some assistance from
the other arm, however even so, only a few degrees of
movement can be achieved in this way. When
diagnosing this condition, one critical sign is the
persons inability to move the shoulder blade naturally
without using the entire upper body to raise the
shoulder. The cause of this condition is often
unknown. Multiple tendons and muscles simply seem
to adhere to each other and the ultimate affect is
non-movement. Another characteristic is that this
condition is not terribly painful unless the shoulder is
forced. Treatment for this condition usually takes
a long time, 6 months to a year or more in some
cases. Complete recovery is often possible with
the help of a good therapy program. Orthopedic and
Chiropractic Physicians as well as Physical Therapists,
can provide good treatment. At home work is also a
must. Patients must exercise, stretch and perform
particular movement patterns consistently in order to
overcome this strange condition. Home
Therapeutics’ including the use of Electrotherapy
modalities can be very helpful. Ultrasound,
Interferential Electrostimulation therapy, Microcurrent
all can help to reduce restrictions, reduce scar tissue
and improve circulation are used. A Proper
Physical Therapy Home Program is essential.
In more severe and non-responsive cases, Orthopedic
Surgeons may recommend ‘Manipulation under Anesthesia’
which does exactly as it sounds.
Shoulder Impingement Syndrome:
That stabbing ice pick sensation when you lift your
shoulder over your head, the feeling of a ‘dead arm’
when you wake up in the morning, tingling and burning
pain from your shoulder to your elbow or from your
shoulder to your lower neck. These can all be the
tell-tale signs of Shoulder Impingement. The cause
is usually the development of bony spurs and scar tissue
in the outer clavicle (collar bone) region of the
shoulder known by doctors as the AC region. In
some instances, the AC has a different shape from birth
known as a Type II Acromian process. This means
that the bone slopes downward into the space below where
there are nerves that can be pinched or
‘Impinged’. Other structures in the area including
tendons, muscles and bursae can also become inflamed and
swollen, causing even more radiating pain, tingling and
numbness. Shoulder Impingement often responds
nicely to in office procedures including specific
exercises that improve shoulder stabilization. In
addition, Physical Therapy modalities including
Ultrasound, Interferential Electromuscle Stimulation,
Microcurrent and even TENS treatments can greatly
help. Once again, in office treatments supported
by guided home therapeutics’ and finally, more
home therapeutics’ with modalities and proper Physical
Therapy exercises can be the key to complete recovery
and ongoing relief.
If these more conservative measures fail to help
attain full relief, some Orthopedic Surgeons may
recommend Steroid injection and even surgery in more
severe cases.
Labral Tear:
Often times, the Labral tear is an elusive
diagnosis. This can occur in the shoulder that has
been dislocated or sustained other more serious
injury. Sporting injuries can often lead to Labral
tear. This is either by repetitive trauma or again
frank injury. Depending on the physical needs of
the patient, this often leads to surgery. If the
patient is more sedentary or even simply not a sports
enthusiast and not engaged in daily physically demanding
work, this condition is one that is often treated to
reduce pain, improve painless range of motion and joint
stabilization. Conservative treatment for Labral
tear can be very similar to that for rotator cuff strain
or tear. A proper Orthopedic examination by the
Surgeon , Physiatrist, Chiropractic or other
Physician. MRI or other imaging tests including
contrast MRI or arthrogram may be necessary.
Restoring proper painless range of motion is a
priority. Stabilization exercise both in office
and at home through Physical Therapy Exercise treatment
manuals are key to recovery. Modalities
including Ultrasound, Interferential Electrostimulation,
Microcurrent, TENS and even Electromuscle Stimulation
can all be very helpful both in office and properly
managed at home programs.
In more severe cases, Surgery may be required for
proper treatment and increased stabilization.
No matter what the injury, malady, pain or
dysfunction, the more you know, the better off you
are. More and more doctors today appreciate a
patient who is interested in their condition. In
most cases, the more the patient does to help
themselves, the more easily their condition will
respond to treatment. Most doctors also would
rather less invasive approaches to helping patients
recover. Home Therapeutics’ are becoming more and
more important these days than ever before in the
history of modern medicine. Cost containment is
one of the driving forces behind this movement.
The use of less medication and more therapy and exercise
play a very important role.
Here’s top wishing you all the Best to attaining your
goal to improve your Health!
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