As well-seasoned doctors of Long Island Spine Rehabilitation Medicine, we have a history of treating shoulder pain successfully with noninvasive methods. Patients who come to us have chosen carefully, knowing that we are well-credentialed and well-respected physiatrists — doctors who specialize in pain management and rehabilitation. From our five conveniently located offices, we provide patients from all over Long Island and the New York City metropolitan area with superior shoulder pain treatment. As importantly, our clinicians are highly regarded for their ability to determine if a patient’s shoulder pain is in fact arising from the shoulder itself or perhaps is a radiating pain from the neck or a pinched spinal nerve.
While most people have experienced shoulder pain at some point in our lives, the majority of episodes subside relatively quickly with application of ice packs and/or warm packs, rest, and over-the-counter painkillers. When shoulder pain does not resolve with home care, however,
it is important to have its cause professionally diagnosed so it can be treated properly to avoid ongoing pain and further damage.
Common Causes of Shoulder Pain
Most frequently, shoulder pain results from one of the following causes:
Arthritis of the Shoulder
Arthritis is an inflammation of the shoulder joint. The most common type of arthritis is osteoarthritis which typically results from the normal wear and tear of aging, but may also occur due to repetitive overuse or injury. Osteoarthritis worsens as time passes, limiting range of motion in addition to causing pain. Other types of arthritis are autoimmune disorders, such as rheumatoid arthritis and psoriatic arthritis.
Bursitis of the Shoulder
Bursitis is an inflammation of the bursae, fluid-filled sacs that cushion joints like the shoulder. Normally, bursae reduce friction between muscles and bones during movement, but overuse causes them to swell between the bones and generate pain.
Frozen shoulder is characterized by pain, stiffness, and limited mobility. It is not uncommon in individuals of middle-age (40 to 60), occurring more often in women than men. Other risk factors for frozen shoulder include diabetes, thyroid disease, rheumatoid arthritis or Parkinson’s disease, or being in recovery from a stroke or mastectomy.
Rotator Cuff Injury
The muscles and tendons that surround the shoulder joint are known collectively as the rotator cuff. They keep the ball at the top of the upper arm bone firmly attached to the socket of the shoulder. Rotator cuff injuries result in a dull ache that worsens when the patient attempts to rest or sleep on the affected side, pain and weakness in arms, and crepitus, a crackling sensation during movement.
Shoulder dislocation occurs when the ball of the upper arm bone pops out of the shoulder socket. It can be manually repaired, but must then be immobilized for many weeks by the use of a sling so it can heal properly. Once healed, the surrounding muscles should be strengthened through shoulder pain physical therapy because once a dislocation has occurred, another is more likely.
Subluxation of the Shoulder
When, due to injury, the shoulder does not fully dislocate, but the ball of the ball-and-socket joint comes partially out of the socket, the shoulder joint becomes unstable. This is known as a subluxation.
When pressure is put on the acromion (shoulder blade) and its underlying soft tissues, patients experience pain when they lift their arms. As the shoulder blade impinges on the tendons and bursae of the rotator cuff, inflammation increases, resulting in more pain and greater restriction of movement. If the pressure continues, the rotator cuff can tear.
Tendonitis of the Shoulder
Shoulder tendonitis is an inflammation of the tendons, the fibrous bands of tissue attaching muscle to bone in the shoulder joint. As tendons wear during the aging process, they are more prone to inflammation. There are two types of tendonitis: acute and chronic. The former typically occurs as a result of a traumatic injury during an accident or sports activity. The latter is caused by repetitive overuse during the course of everyday activities. Tendonitis, left untreated, may result in a torn or ruptured tendon that requires surgical repair.
Fracture of the Shoulder
Shoulder fractures may involve any of the bones of the shoulder — the collarbone, the upper arm bone (humerus), or the scapula (shoulder blade). As with any bone fracture, a fracture of the shoulder causes severe pain that may radiate, as well as swelling and bruising. In general, the older the patient the more likely a fracture is to occur during a simple slip and fall accident, especially in those with osteoporosis. Younger individuals are more likely to suffer shoulder fractures in car accidents or falls from a height.
Atypical Reasons for Shoulder Pain
There are some cases in which shoulder pain may be referred pain from another part of the body (such as the heart, gallbladder or stomach); in the majority of such cases, the pain is not exacerbated by movement. Other atypical reasons for shoulder pain include tumors, infections, neurological disorder or autoimmune disease.
Diagnosis of Shoulder Pain
At Long Island Spine, we are extremely careful with diagnosis since we know how crucial it is to get it right. Beyond conducting a thorough physical exam to determine your strength, range of motion, and which movements cause you pain, we will take a full medical history and administer any necessary diagnostic tests, such as X-rays, CT or MRI scans. We may also administer diagnostic ultrasound-guided injections to show us precisely where your pain originates and perform electromyography (EMG) and nerve conduction studies.
How Long Island Spine Treats Shoulder Pain
We offer a number of conservative treatments for shoulder pain, all safe and all designed to relieve pain and increase mobility, strength, and flexibility. When you come to us, you can put your trust in our excellent physiatrists and physical therapists to address all of your shoulder pain issues with concern and compassion as well as consummate skill.
If you come to us with a condition that requires surgery, we will refer you to one of our esteemed surgical colleagues for the operation and be available to assist you with pain management and rehabilitation after the procedure.
All of our shoulder pain therapies are noninvasive and none require downtime. Because no two cases are identical, we customize our treatment for each patient. The shoulder pain treatment plan we devise for you may include any or all of the following:
- Shoulder pain physical therapy, including customized exercise routines
- Shoulder injections (corticosteroid and painkiller) under ultrasound guidance
- Platelet-rich plasma (PRP) to promote healing
- Pulsed electromagnetic field (PEMF) technology to decrease pain
- Acupuncture (in our Great Neck and East Meadow offices)
- Medication administration and monitoring for optimum pain relief and bone strengthening
Though we most often try to keep our patients comfortable with over-the-counter painkillers anti-inflammatories, we may also prescribe stronger pain medications short-term to relieve severe, acute pain, taking care to avoid interactions and side effects. We may also prescribe muscle relaxants to help diminish your level of discomfort as we work to resolve your shoulder issues.
Be Proactive — Contact Long Island Spine Promptly If You Have Shoulder Pain
It is not only unpleasant to be in pain; it is often dangerous. Because pain is your body’s way of letting you know something is wrong and requires attention, you should never ignore it. If your shoulder pain persists, make an appointment with one of our keen practitioners. We will diagnose your condition and put you on the path to wellness, ease of motion, and a pain-free future. Contact us for a consultation.