Optimal shoulder function is essential to minimise the likelihood of injury during everyday use of the arm and for those involved in sports using the upper body such as racquet sports or the throwing athlete. One common clinical presentation is the patient suffering from sudden onset shoulder pain typically as a result of a lifting, pushing or pulling activity or a sudden movement (often with the arm in elevation or overhead), the cause of which is often a torn muscle or tendon, typically a Rotator Cuff Tear (figure 1). Below are some of the more common causes of pain in the shoulder with a brief description of each condition to aid shoulder pain diagnosis. Pain referred into the shoulder from another source such as the neck or upper back, frequently associated with symptoms above or below the shoulder (such as the neck, upper back, arm, elbow, forearm, wrist or fingers). Tearing of connective tissue surrounding the shoulder joint (figure 2) with subsequent displacement and separation of the bones forming the joint so they are no longer situated next to each other (i.e. Damage to the cartilage lining the shoulder joint (labrum - figure 3) often in association with a dislocated shoulder, or due to a fall onto the arm, heavy lifting, a pushing or pulling movement or a forceful throw. Tearing of the connective tissue and ligaments of the Acromio-Clavicular joint (AC Joint - figures 4 & 5) typically as a result of a direct impact to the point of the shoulder during a fall or collision. For a description of the common causes of Gradual Onset Shoulder Pain to aid shoulder pain diagnosis Become a Member. For a description of the less common causes of Gradual Onset Shoulder Pain to aid shoulder pain diagnosis Become a Member.
A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose the cause of shoulder pain.
Find a physiotherapist in your local area who can assist with shoulder pain diagnosis and can treat patients suffering from shoulder injury. Shoulder pain can have a number of different causes, ranging from an injury like a car accident, to a chronic problem like arthritis.


Patients who experience shoulder pain may be surprised by the intensity and duration of the pain. Some signs that shoulder pain needs immediate attention may include a decreased ability to hold objects, decreased functioning of the arm, shoulder pain that persists even while at rest, shoulder pain that lasts more than a day or two, and unusual twinges or aches in the shoulder area. Chiropractic care can be an extremely effective treatment for shoulder pain regardless of its cause. Care for an injured shoulder may include application of heat, application of ice packs, gentle manipulation from the chiropractor to help the shoulder return to its original state of functionality, and gentle stretching and strengthening exercises that the patient can perform at home. In patients with gradual onset shoulder pain due to repetitive or prolonged arm elevation, lifting, pushing or pulling activities, general housework or lying on the affected size, Rotator Cuff Tendonitis (figure 1) is the more likely diagnosis, which typically involves gradual degeneration and inflammation of the rotator cuff tendons.
Associated with pain in the shoulder that may radiate into the upper arm and sometimes pain on firmly touching the affected rotator cuff muscle or tendon (figure 1).
Causes pain at the top of the shoulder that may increase when lying on the affected side, moving the arm across the body and during other shoulder movements.
Associated with severe shoulder pain, swelling, tenderness on firmly touching the affected region of the bone and sometimes bony deformity.
Associated with pain in the front of the shoulder, upper arm or elbow and often a snapping or tearing sensation at the time of injury. Associated with pain in the front of the shoulder or chest and often pain on firmly touching the affected muscle.
Associated with severe pain in the shoulder blade region, swelling, tenderness on firmly touching the affected region of the bone, markedly reduced shoulder function and sometimes bony deformity. Associated with severe pain in the shoulder, upper arm or elbow, swelling, tenderness on firmly touching the affected region of the bone, markedly reduced shoulder and upper limb function and sometimes bony deformity.


Investigations such as an X-ray, ultrasound, MRI, CT scan or nerve conduction studies are often required to confirm shoulder pain diagnosis and rule out other injuries.
The shoulder area is so essential for completing daily activities that it makes sense that the shoulder pain injury should be taken seriously and treated to avoid worsening your condition. Pain may be caused by local structures within or around the shoulder or may be referred from other sources (such as the neck or upper back). In those patients with associated neck, upper back, elbow, forearm, wrist or hand pain, Referred Pain (frequently from the neck or upper back) is often the cause of symptoms. Pain may also increase during lifting activities (especially with the arm outstretched or above the head) and when lying on the affected side.
Typically occurs as a result of a fall onto an outstretched hand or a direct impact from an object or person and causes severe pain in the shoulder that may radiate down the arm, a feeling of the shoulder 'popping out', deformity of the shoulder joint, muscle spasm and sometimes pins and needles or numbness. Pain may also increase during pushing activities and when performing a pectoral stretch (figure 9). Whether the shoulder pain is connected to the neck or is limited to the lower part of the shoulder, it can generally be treated with non-invasive methods of natural healing such as chiropractic care.
There are numerous other causes of shoulder pain, some of which present suddenly due to a specific incident, others which develop gradually over time.
Symptoms may increase with certain, often very specific movements or activities using the shoulder such as arm elevation and lifting (especially overhead), weight bearing through the affected arm (e.g.



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    17.06.2013

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    17.06.2013