Shoulder Pain

Shoulder pain is a common condition that affects many patients with or without neck and back pain. It ranges from muscle tension and stiffness to a complete inability to move the arm. Whatever the degree of shoulder pain you are experiencing at the very least you would probably rather live without it.

Fortunately, you can take measures to prevent or relieve most episodes. If prevention fails, safe and effective treatment along with guidance will allow your shoulder to heal within a few weeks. In most cases early treatment intervention often leads to the best outcomes. Surgery is often not needed to treat shoulder pain.

If you suffer from mild to severe shoulder pain in Collingwood, then seeking treatment earlier than later is always a good move. The information below is meant to help inform you, but we highly recommend that you seek a professional opinion to properly diagnose these issues.

Symptoms

Shoulder pain can build up slowly from slouching too often or it can come on all of a sudden from a fall or after throwing and other overhead activities. The pain can be a dull ache experienced when sitting, working or sleeping then worsen or become sharp with movement such as raising the arm, reaching backwards or with simple neck movements. The pain can be over top, in the front, or in the back of the shoulder and even radiate into the neck, back, chest or down the arm. It is not uncommon to experience the pain deep in the joint or a clicking sensation when moving the arm. It can make even the simplest of movements such as carrying groceries, reaching up to a shelf and picking up your child or grandchild excruciatingly difficult.

When to see a doctor

Most shoulder pain gradually improves within a few weeks. However, not addressing the cause often ends with incomplete healing and repeat episodes that occur with increasing frequency, severity and the time it takes to feel better. Early intervention is the key to a successful outcome so contact a doctor if you have any of the symptoms above or conditions listed below.

In rare cases, shoulder pain can signal a serious medical problem. Seek immediate care if you have tightness in the chest, trouble breathing, weakness in the arm, vomiting or have suffered a traumatic fall or blow to your shoulder.

Causes

Shoulder pain can be caused by one or several conditions involving injury to the shoulder joint or surrounding muscles. It can be isolated to the shoulder joint or it can be a manifestation of back pain or neck pain where the pain starts in the neck or back but travels into the shoulder. Pain that comes from the joint usually worsens with activities or movement of your arm or shoulder, whereas referred pain from the back or neck is aggravated from twisting, breathing or head turning movements, but it is not uncommon to have an issue with more than one area.

Problems within the shoulder joint itself tend to result in pain on the front or side of the shoulder. Pain over the top of the shoulder often involves the neck and upper ribs. Pain in the back of the shoulder under the shoulder blade often involves the spine and mid level ribs. Tightness in any of these areas can compress nerves and cause pain down the arm or even numbness or tingling into the hand mimicking or contributing to carpal tunnel syndrome. The following explains some of the most common conditions that cause shoulder pain.

Shoulder muscle or tendon strain

Sharp and sudden shoulder pain can result from a fall, heavy lifting, or throwing. Strains are injuries to the muscles and tendons and can be extremely painful accompanied by swelling, bruising and spasm. Tendinitis involves the tendon and can also cause a sharp pain, usually on the front or side of the shoulder after repetitive activities such as weight-lifting or repetitive overhead work. A group of muscles called the Rotator Cuff, which wrap around the shoulder, are commonly involved. A snapping sensation around the shoulder with certain movements in a common early symptom reported by many patients.

Holding certain postures such as sitting, sleeping on your side, or typing on a computer can overload the shoulder creating painful points in the muscles. These can be quite uncomfortable and even refer pain down the arm or into the upper back and neck, but improve when you move out of these postures. Without proper treatment any of these conditions can eventually stop you from performing activity, however they all respond extremely well to treatment.

Joint and ligament sprain

Deep joint pain, severe muscle spasms, a recent loss of shoulder range, and a catching or locking in the shoulder can all be signs of shoulder joint injury or sprain. A sudden blow or traumatic over-stretch to the arm can cause a new injury whereas repetitive activities such as throwing can damage the joint over time via small injuries that accumulate into significant pain. These injuries often cause pain during movements of the shoulder even when the muscles are not contracting.

The shoulder joint which looks like a ball in a socket is cushioned by cartilage between these surfaces while the ligaments hold the bones together and deepen the socket. Due to trauma the joint itself can become dislocated where the ball jumps out of the socket or other related shoulder joints can become separated when ligaments are torn and the joint is no longer held in alignment. The severity of injury affects how these injuries respond to treatment so a prompt and accurate diagnosis is essential to a positive outcome, but they can respond well to treatment.

Shoulder Arthritis

Morning stiffness and pain is a hallmark sign of arthritis caused by wear and tear over time or a previous injury to the joint. A progressive loss of range of motion is also characteristic of this disease. The cartilage of the joints wear thin while the joints thicken and may develop bone spurs which can create a pinching pain in certain positions. Symptoms are often managed well with treatment, but severe degenerative changes may require surgery so early intervention and prevention is best.

Frozen Shoulder

Frozen shoulder, also called Adhesive Capsulitis, is a progressive inflammatory condition that starts with intense pain, commonly after shoulder injury, that causes the shoulder capsule to shrink in on itself. Pain can subside, but leave the shoulder severely limited in movement which is followed by a long thawing stage as function gradually returns. While this condition can resolve on its own, prompt management will be essential to limiting the time and degree of shoulder disability experienced.

Rib sprain

Sudden and sharp pain in the behind the shoulder blade, or at the base of the neck and over the shoulder, from a twist, violent sneeze, chronic cough or for seemingly no reason at all. The pain limits twisting or turning movements while coughing, sneezing and even deep breathing can be excruciating making it impossible to find any relief. Often referred to as having a 'rib out' this condition's bark is worse than its bite in that despite the severe pain it is relatively harmless. However, seeking a professional diagnosis is recommended to rule out other causes. Symptoms often resolve gradually over a few weeks, but early treatment intervention can speed this up significantly.

Thoracic outlet syndrome

Pain and stiffness over the top of the shoulder and at the base of the neck that also radiates into the arm with numbness and tingling into the fingers are characteristic of this condition. Symptoms often worsen after prolonged desk work or sleeping on the affected shoulder due to compression of the nerve under the collarbone on top of the first rib. While it can have carpal tunnel like symptoms, it responds best to treatment that addresses the cause at the shoulder.

Fractures and dislocations

Sudden and sharp pain in the shoulder after a traumatic fall or blow can cause the arm bone, shoulder blade or ribs to fracture or the ball to tear out of the socket. These are serious medical conditions that require immediate medical care.

Chronic or acute medical conditions

Conditions affecting structures in your chest or abdomen, such as heart disease, diaphragm tightness and gallbladder disease, also can cause shoulder pain. Shoulder pain that arises from another structure is called referred pain. Referred shoulder pain usually doesn't worsen when you move your shoulder. These all need to be identified and treated at the cause to reduce pain and avoid long-term health issues. Even when these sources are treated medically the associated symptoms involving pain in the muscles and joints of the shoulder respond well to co-management.

Risk factors

Anyone can develop shoulder pain, even children and teens, but these factors put you at greater risk:

Age. Different conditions affect different age groups. Younger individuals are more prone to muscular injuries while elderly are prone to arthritis.
Lack of exercise. Weak, unused muscles around the shoulders.
Repetitive activities. Overuse of the muscles and joints of the shoulder, especially in the overhead position, can cause shoulder pain.
Poor sleeping position. Side sleeping can strain the shoulder muscle and ligaments.
Smoking. Smoking decreases blood flow to the joints.
History of injury. History of a traumatic fall or sports injury can lead to early degenerative changes.

"When I first went to Muscle and Spine to see Dr. Adam Martynuik, I was in intense pain. I had been dealing with shoulder pain for a very long time and had tried a bunch of different paths to find path relief. I was literally laying in bed in tears because of how much pain I was in that night when I stumbled across this practice. I booked an appointment online and was able to get in immediately. Over the last month and a bit, I have had so much progress with Dr. Martynuik's aide, which I hadn't been able to achieve in years. I highly recommend this place."

Cassy Wilson Patient

Diagnosis

Your doctor will collect information about your shoulder pain and lifestyle prior to your appointment and then use this to guide an assessment on how certain movements and positions affect your pain. Special orthopaedic tests and palpation help determine what is injured and painful. The doctor uses this information to help rule out more-serious causes.

The diagnosis identifies both where the pain comes from as well as the underlying cause. The best treatment approach is then determined and communicated to the patient along with the required dosage and the expected degree of recovery with and without treatment.

Advance diagnostic tests

Advanced diagnostic testing can provide some further insight. This testing alone however can sometimes be misleading when identifying the origin of the pain as many findings can also be found in individuals with no pain. Waiting for testing to be ordered and performed can delay essential treatment and often does not lead to better outcomes or change the prescribed treatment plan. Some patients become focused on testing and are either let down when it does not lead to an immediate solution or give up and accept pain choosing to do nothing about it when it could in fact respond very well to treatment.

When advanced testing may be necessary

If shoulder pain is not responding to, or worsens despite, appropriate treatment or your doctor feels there is reason to suspect a more serious cause they may order one or more of the following tests:

X-ray. These images show the alignment of your bones and whether you have arthritis or broken bones. These images alone won't show problems with your cartilage, muscles, tendons or ligaments.
MRI or CT scans. These scans generate images that can reveal problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels.
Nerve studies. Electromyography (EMG) measures the electrical impulses produced by the nerves and the responses of your muscles. This test can confirm nerve compression caused by herniated discs or narrowing of your spinal canal (spinal stenosis).

Treatment

Early treatment intervention when symptoms are mild often leads to the best results with the least amount of suffering. The prevention and self care strategies learned during the course of treatment can reduce the occurrence or severity of future episodes and the risk of chronicity and long term disability.

Pre-treatment recommendations

While awaiting a consultation with a doctor there is some basic common sense advice that can ease shoulder pain:

Do not wait until the pain worsens or reaches extreme pain levels prior to seeking care, early intervention is the key to the best results.
Stop the offending cause. Sometimes this requires keeping a log of what seems to increase the pain.
Keep moving. Do not be afraid of activity severely limiting use may be making your pain worse.
Find positions of relief. Certain postures and positions likely increase your pain while others provide relief. Find those that relieve your pain and spend more time in them.

Conservative (non-surgical) treatment

There are many conservative treatment approaches backed by a substantial body of evidence, however it is never a one-size fits all approach that works for everybody. The mechanism of injury, degree of symptoms, patient age and other pre-existing conditions often guide your doctor's choice in the type of treatment they recommend. Treatment should aim to provide immediate pain relief within the comfort level of the patient and progress to addressing causative factors. Conservative treatment approaches often include one or a combination of the following:

Education. What activities and postures to stop to decrease your pain and allow healing.
Exercises. Designed first to relieve pain and increase your mobility then strengthen your shoulder muscles to provide protection and support.
Muscle Releases. Massage and hands-on stretches to relieve pain and relax the muscles surrounding the shoulder, back and neck.
Joint Releases. Stretches or adjustments of the joints in the shoulder, back and neck to relieve pain, restore motion and decrease tension.
Acupuncture. The insertion of ultra-thin needles in the muscles to relieve pain and stimulate healing.
Medications. Anti-inflammatories, muscle relaxants, oral and topical pain relievers, narcotics and anti-depressants as directed by a physician.

Treatment is delivered in a specific dosage based on the stage of healing and other factors. Adherence to the prescribed treatment plan is often as important as the treatment type.

Surgical and other procedures

If symptoms show no change or worsen despite sound conservative treatment approaches after several weeks, your doctor might suggest an alternative treatment approach, stronger medications, advanced imaging or other procedures including surgical consultation. More invasive procedures used to treat shoulder pain may include:

Cortisone injections. Injection of cortisone — a strong anti-inflammatory drug — plus a numbing medication into the joint space of the shoulder helps decrease inflammation, but the pain relief usually lasts only a month or two.
Surgery. If you have unrelenting shoulder pain, radiating arm pain or progressive muscle weakness and loss of range of motion you might benefit from surgery. These procedures are usually reserved for pain related to structural problems, such as severe arthritis or a torn shoulder labrum that fail to respond to other therapy.

Buyer beware

Because shoulder pain is so common, numerous products promise prevention or relief, but what works for one person may not work for another. There are many contributing factors that need to be addressed and you cannot buy your way out of making the necessary lifestyle changes.

Also, be wary of Dr. Google, I hear he got his medical degree online and attempting to self-treat without a proper diagnosis is often ineffective and potentially dangerous.

"Adam is a rock star who has worked with me on a couple ailments over the past year and a half. I had developed numbness in the fingers of my left hand which turned out to be carpal tunnel syndrome. Adam's quick identification of the issue led to effective treatment by him which has resulted in full feeling returning to my hand. More recently, over the past month a strong and sudden sneeze had me strain some soft tissue around my ribs. A few visits to Adam over the past few weeks has me feeling 100% again. I highly recommend him!"

Rob Knowles Patient

Visit our Location

Give us a Call

Send us a Message

Opening Hours