Shoulder pain can come from a tendon, the joint, a broken bone or somewhere else in the body, such as the neck. Crushing pain or sudden pressure in the shoulder, especially with shortness of breath, dizziness or sweating, means call 911. A severe injury belongs in the ER. Pain that lingers can be looked at in Towson.
Why the Shoulder Is Easy to Hurt
You notice it when you pull on a jacket, lift a bag into the car or roll onto that side at night. The shoulder moves more than any other joint in the body, and all that motion leaves it open to pinching, wear and instability.
Shoulder pain is one of the problems we see at our Towson clinic. What helps depends on whether the trouble is in a tendon, in the joint or somewhere else in the body.
How the Shoulder Works and What Goes Wrong
Shoulder pain means pain in the joint or in the tissue around it. The joint is a ball and socket formed by the upper arm bone, the shoulder blade and the collarbone. Four muscles and their tendons, called the rotator cuff, keep the ball centered and help the arm move.
It may hurt only when you move the arm or all the time, and it may clear up or stay until the cause is found.
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The arm lifts
As the arm rises, the top of the shoulder blade can press down on the rotator cuff tendons and on the small fluid-filled sac above them.
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The tissue swells
Repeated pressure can lead to inflamed tendons and an inflamed sac. Then lifting the arm, or moving it forward or behind your back, starts to hurt.
Who tends to have rotator cuff trouble
- Anyone over 50, the group where tears are most common
- Painters, carpenters and others who reach overhead all day
- People who play baseball or tennis, or who lift weights
- People whose relatives have had the same problem
When the pain starts somewhere else
- A problem in the neck
- A problem in the lungs
- A nerve injury that changes how the shoulder moves
- A heart attack, covered in the emergency section below
Pain from the neck or lungs usually hurts at rest and does not get worse when you move the shoulder.
Muscle or Rotator Cuff?
The rotator cuff is itself made of muscles and tendons, so the real question is which tissue is hurt and how badly.
What points toward the rotator cuff
A dull ache deep in the shoulder, pain that breaks up your sleep, trouble with a hairbrush and a weak arm are the common signs. Some rotator cuff injuries do not hurt at all, so a weak arm with little pain still counts.
What can hurt in a similar spot
An imbalance between the shoulder muscles can cause pain here. So can overuse of a nearby tendon, such as the biceps.
What an exam adds
A clinician may look for swelling and tender spots and test how far and how strongly the arm moves. X-rays show the bones, while MRI and ultrasound give better pictures of soft tissue.
Mayo Clinic's overview of rotator cuff injury says these injuries are most often caused by wear on the tendon tissue over time.
How Shoulder Trouble Tends to Feel
Most shoulder problems get worse with certain movements and ease with others, so it is worth noticing which ones.
- A dull ache deep in the shoulder
- Pain when you lift your arm overhead
- Pain when you reach behind your back
- Pain that wakes you at night
- Stiffness that makes moving the arm hard
- Weakness in the arm
- A feeling of unsteadiness when you raise your arm
- Swelling or bruising after a fall or hard hit
Common Causes of Shoulder Pain
Much less often, the cause is a tumor, an infection or a nerve problem.
Frozen shoulder
The soft tissue inside the joint stiffens, and moving the arm hurts and gets harder.
Arthritis
Osteoarthritis, the wear-and-tear type, tends to start in middle age and worsens slowly. Many people stop using the arm to avoid the pain, which can stiffen the joint further.
Tendinitis and bursitis
A tendon joins muscle to bone, and a bursa is a small sac that lets tissue glide. Too much throwing or overhead work can inflame either one.
Torn tendons
A rotator cuff or biceps tendon can split partway or pull fully away from the bone. It can happen in one injury or build up from years of wear.
Dislocation and instability
The ball of the upper arm can slip partly or fully out of its socket, usually after a sudden injury. Once the tissue around it is loose or torn, it can keep happening.
Broken bones
Older adults often break a shoulder bone in a fall from standing height. In younger people it tends to take a car crash or a hard tackle.
How We Treat Shoulder Pain in Towson
The next step follows from which part of the shoulder is involved and how much it limits you. Whether any of these is recommended depends on your condition and our comprehensive evaluation.
Chiropractic
A chiropractor may evaluate shoulder and arm pain and use non-invasive adjustments for shoulder joint injuries.
Class IV Laser Therapy
This handheld, noninvasive device applies light to the area being treated. It may be used for shoulder injuries, including the rotator cuff.
The chiropractor carefully evaluates each condition to determine if you are a candidate for gentle chiropractic treatment. If you have numbness, tingling or weakness, it is carefully screened with orthopedic and neurologic testing, to isolate the cause and how your symptoms present.
Common Options for a Painful Shoulder
These are common paths, not a full list. Ask your doctor or an orthopedic surgeon about the rest.
| Option | What it involves | Who provides it |
|---|---|---|
| Home care | A few days of rest, ice wrapped in cloth, then a slow return to your usual activities. | You, with advice from your doctor |
| Exercises | Stretching and strengthening for the rotator cuff and the muscles around it. | Ask your doctor about a program |
| Medicine | Anti-inflammatory drugs such as ibuprofen, taken as directed. | Your doctor or pharmacist |
| Chiropractic care | Adjustments and other hands-on work. | A chiropractor at this clinic, if recommended |
| Class IV laser therapy | Light from a handheld device. | This clinic, if recommended |
| Surgery | The American Academy of Orthopaedic Surgeons says some shoulder problems may need it. | An orthopedic surgeon |
When to See an Orthopedic Specialist
A family doctor or other primary care clinician can check short-term shoulder pain. Some problems call for a surgeon who treats bones and joints, and left untreated, rotator cuff problems may leave you with permanent weakness or lost motion.
Ask about an orthopedic surgeon for
- A shoulder that keeps dislocating
- A tendon tear from a single injury
- A broken bone in the shoulder
- Pain or weakness that stays after rest and other simple care
The American Academy of Orthopaedic Surgeons' guide to common shoulder problems says surgery may be recommended fairly early for recurring dislocations and some rotator cuff tears.
When the team cannot help with a problem, a referral to another provider may be the next step.
When Shoulder Pain Is an Emergency
Call 911 for crushing pain or sudden pressure in the shoulder, especially if it spreads from the chest into the left arm, jaw or neck, or comes with shortness of breath, dizziness or sweating. It can be a heart attack. Do not call the clinic first.
Shortness of breath counts on its own, with or without chest discomfort. A severe injury that leaves the shoulder very painful, swollen, bruised or bleeding needs the ER.
See your care team right away for
- Weakness in your arm immediately after an injury
Call your doctor for shoulder pain with
- A fever, swelling or redness
- Red or blue skin around the shoulder
- Bad pain even when someone else moves the arm for you
- Pain that lasts more than 2 to 4 weeks after home care
Sudden left shoulder pain can sometimes signal a heart attack, according to the MedlinePlus article on shoulder pain.
Shoulder Care at Our Towson Clinic
New patients may start with a detailed intake, and any care plan may be built around your own needs. If you also see your own doctor, chiropractic care can be combined with your other medical treatment.
Knettishall, Loch Raven Village and the Bus Stops Nearby
Knettishall is nearby, about 0.7 miles southeast. Loch Raven Village starts about 0.2 miles east of the clinic along E Joppa Rd. MTA LocalLink 53 stops at Joppa Rd and Mylander Ln, about 0.3 miles east.
Book a Shoulder Evaluation
A few notes make the visit easier: which movements hurt, how and when the pain started, whether it has happened before and what helped then. Questions about insurance or cost are best asked by phone.