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(FAQs) Shoulder Pain & Shoulder Injury

Shoulder Pain Causes & Symptoms

Shoulder blade pain:

The shoulder blade, known as the scapula, is a common area to experience pain that Dr. Melander treats daily at North Shore Spine and Sport.  Many people sitting at desks for long hours experience pain in the upper back and shoulder blade area.  Most of the time these are not complicated pain conditions and are easily managed with therapy and exercise.

Shoulder pain in the front, Shoulder pain in the back:

Pain in the front or back of the shoulder is extremely common and treated frequently by Dr. Melander.  Many different activities contribute to pain experiences in these areas such as throwing, swimming, weight lifting, playing musical instruments, and using a keyboard/mouse.

Shoulder pain when lifting arm, Shoulder pain when lifting arm out to side, Shoulder pain when raising arm:

Dr. Melander treats shoulder pain related to lifting or raising the arm all the time.  Commonly these sorts of pains are related to strains that have occurred to muscle and connective tissue around the shoulder area and are easily managed with therapy and exercise.

Shoulder pain from sleeping, Shoulder pain from sleeping on side:

Perhaps the most common shoulder pain report that Dr. Melander hears at North Shore Spine and Sport, shoulder pain related to sleeping on your side is almost textbook diagnostic of shoulder bursitis.  We have many bursa throughout the body that function to reduce friction between muscle and bone, unfortunately, certain kinds of cumulative strain or trauma can cause irritation of the bursa resulting in bursitis.  Thankfully, most shoulder bursitis cases are very easy to treat.

Shoulder pain from lifting:

Chances are that any person who has spent even a small amount of time weightlifting has experienced some kind of discomfort in the their shoulder(s).  Most of the time these issues are “self-limiting” and will go away without intervention.  Occasionally a thoughtful evaluation with a healthcare provider is warranted to guide someone on a proper course of treatment and rehab.

Shoulder pain from neck:

There are a number of conditions involving the neck that may cause a referred pain experience into the shoulder.  In no particular order these conditions include cervical radiculitis/radiculopathy, nerve entrapments at the scalenes, cervical disc derangement, facet irritation, etc.  Dr. Melander is skilled at differentiating all of these conditions and crafting a care plan that is appropriate for all of them.

Shoulder pain at night:

Shoulder pain at night relief is predicated on the condition driving the pain experience.  Many people suffering from shoulder bursitis experience shoulder pain at night, and between some hands-on manual therapy with Dr. Melander and some homecare consisting of self-myofascial release, stretching, and heat, these conditions will usually respond favorably within a short period of time.

Shoulder pain causes arm numbness:

While certainly not the most common cause of arm numbness, some shoulder pain conditions may cause referred pain, numbness, or tingling into the arm if some of the nerve structures that pass through the shoulder are affected.  Dr. Melander can you help you identify if any nerve compromise is involved with the numbness you feel from shoulder pain.

Shoulder Pain Relief (Treatment and Therapy for Shoulder Pain)

Dr. Melander usually uses a combination of hands-on manual therapy like Active Release Techniques®, Functional Range Release®, Instrument-assisted soft tissue mobilization, and mobility or strength training to help get his patients shoulder pain relief.

Shoulder pain treatment exercises at North Shore Spine and Sport often involve first restoring adequate shoulder mobility with Functional Range Conditioning® principles like CARs, PAILs/RAILs, and other “end-range” exercises like lift-offs.

    Common Shoulder Pain Questions

    What can cause shoulder pain without injury?

    Its true, trauma/injury is not required to experience shoulder pain.  At North Shore Spine and Sport, the majority of shoulder pains are not related to a major trauma or injury event, rather, most shoulder pains are due to cumulative or repetitive strains inherent to a person’s lifestyle.  Fear not, these are usually easily managed.

    How do I get my shoulder to stop hurting?

    First step, don’t panic.  Second step, make notes of what activities seem to contribute to the pain.  Third step, attempt to modify any painful activity and see if within a few days or more your shoulder pain improves.  If not, consult with a trained healthcare provider who can assess your shoulder and guide you to recovery.

    Why does my shoulder hurt when I lift my arm?

    There are many reasons your shoulder may hurt when you lift your arm.  The best suggestion is to consult with a trained healthcare provider who can assess your shoulder and guide you to recovery.

    How long can a sore shoulder last?

    The length of time shoulder soreness lasts depends on the cause of soreness.  From a hard workout….a couple days maybe.  From a fall or injury moment, maybe a few weeks or more.  From a gradual strain that built up over a long period of time, weeks or more without activity modification and treatment.

    What is the best exercise for shoulder pain?

    If Dr. Melander could pick one exercise variety for every human regardless of the type of pain they experience, he would pick CARs.  Deliberate movement of a joint through its largest non-painful range of motion is arguably the only way to maintain the health and integrity of a joint life-long.  Do your CARs.

    Does stress cause shoulder pain?

    Stress does not “cause” shoulder pain in so many words, but stress is a factor in just about every abnormal condition known to humankind.

    Rotator Cuff Injury

    Rotator cuff injury is extremely common and can be caused by trauma or repetitive strain circumstances.  The rotator cuff is comprised of 4 relatively small muscles that become continuous with the connective tissue capsule surround the glenohumeral (shoulder) joint.  

    While the rotator cuff muscles do contribute to rotation of the shoulder, arguably they are more impactful in providing a stabilizing effect on the shoulder joint.  Rotator cuff injury treatment at North Shore Spine and Sport usually consists of a combination of hands-on manual therapy like Active Release Techniques®, Functional Range Release®, Instrument-assisted soft tissue mobilization, and mobility or strength training.

    Rotator cuff injury exercises are varied based on the injury status and progression through a rehab cycle, but Dr. Melander usually advocates restoring adequate shoulder mobility with Functional Range Conditioning® principles like CARs, PAILs/RAILs, and other “end-range” exercises like lift-offs, then progressing to higher load exercises inherent to weightlifting.

    Many people ask what the difference is between a rotator cuff strain vs. tear, and the truth is, there is no difference.  Every strain is a tear, but the question is always “what is the degree of tearing?”.

    Low grade muscle strains cause microscopic tearing of a muscle and connective tissue (think soreness after lifting weights), whereas high grade strains are more associated with full-thickness rupture of an entire muscle (surgery often required).

    Rotator Cuff Tear

    Rotator cuff tears are an extremely common concern for people suffering from shoulder pain.  Interestingly, there is a great deal of evidence indicating that some rotator cuff tears are simply a product of age-related usage of the shoulder, and therefore, not all rotator cuff tears are relevant to shoulder pain.

    This idea has been confirmed with large population studies indicating that rotator cuff tears are just as likely to be seen with advanced imaging of the shoulder in a group of people with no pain as they are to be seen in a group of people with pain.  This is especially true over the age of 50.

    Common Rotator Cuff Injury Questions

    How do you know if you have a rotator cuff injury?

    It is best to consult with a trained healthcare provider who can assess your shoulder and determine what, and how badly, is anything compromised.

    Can a rotator cuff heal on its own?

    Absolutely, provided whatever activity is/had aggravated the shoulder in the first place is modified in a way that permits adequate healing.

    How long does rotator cuff injury take to heal?

    The time needed to heal a rotator cuff injury entirely depends on the severity of injury.  Low grade strains will likely heal without any intervention needed within a few days to few weeks, whereas high grade strains (ruptures) may require surgery and many months to heal.

    What kind of pain is associated with a rotator cuff injury?

    The pain associated with a rotator cuff injury is likely achy, but could be sharp/sudden during certain movements. 

    How can I tell if I tore my rotator cuff?

    Consult a trained healthcare practitioner, but remember, many rotator cuff tears are inherent to age and do NOT imply any compromise of the shoulder.

    our Chiropractic

    Dr. Melander has often described his work as new-school rehab, which is to say, an amalgamation of current best practices regarding pain or injury management, hands-on manual therapy or strength/mobility training, and endless advocacy and support for his patients.

    In Dr. Melander’s opinion, the best providers in the field of musculoskeletal injury are able to draw from multiple disciplines to create the most efficient and impactful care strategy for their patients.  If you are injured or hurting and not sure what to do, please reach out, it will be our greatest pleasure to help you. 

    Chiropractic FAQs

    We've compiled a list of common chiropractic questions to help you get all the answers you are looking for. If you have additional questions if our chiropractic and treatment services in North Shore would be a good fit for you, please contact our team. 

    How do I know if I should see a chiropractor?

    Chiropractors are trained in the evaluation and management (IE: treatment) of issues affecting the neuromusculoskeletal system (muscles, joints, connective tissue, nerves).  Many people associate chiropractic care with the spine only, but this is an inaccurate reflection of many chiropractors in the 21st century who are experts in treating spinal issues AND extremity issues (arms and legs).  As a general rule of thumb, if you have a painful condition that does not get better given a few days of activity modification you may want to consult a professional like a chiropractor.  Your chiropractor should be able to evaluate your painful condition, offer you some perspective and guidance relative to the painful condition, and help you care for the painful condition if treatment is warranted.  Like any profession though, each chiropractor has different clinical experience and different post-graduate education that may lend their practice toward a focus on sports injuries or pregnancy/neonatal care or neurologic issues or nutritional issues to name just a few.  If you are considering seeing a chiropractor, make sure that their experience and skill set seems like a proper match for your complaint and your ultimate goals.

    How do I choose a good chiropractor?

    Choosing a good chiropractor does not have to be a complicated process.  To begin with, ask your friends or family if they know someone they trust and can vet for you.  Next, check online as most chiropractors should have fairly informative websites relative to their clinical interests and experience that may help indicate whether they are a good fit for your issue.  If you are still not sure who to see after taking those steps, call your prospective chiropractor’s office as either the staff or the chiropractor will be more than happy to answer any questions and tell you if your issue is something commonly treated in that office.  Many people also like to read online reviews and while some online reviews can be misleading, if the significant majority of a chiropractor’s reviews are super positive then chances are you can trust the expertise of that provider.  Lastly, and arguably the most important step in choosing a good chiropractor, remember that you are in total control of your healthcare decision making.  If you go to an initial or follow-up appointment and you are not absolutely confident in the assessment and plan your chiropractor has rendered, then seek a second opinion.

    What can a chiropractor fix?

    A chiropractor can help you fix a wide variety of painful conditions related to the neuromusculoskeletal system such as headaches, back/neck pain, shoulder/elbow/wrist/hand pains, hip/knee/ankle/foot pains to name just a few.  Injuries of actual orthopedic compromise like fractures are best handled by orthopedists, but chances are if your pain/injury is non-surgical in nature then a chiropractor may be a great option to help you.  The best chiropractors will explain what they can about your pain/injury, offer guidance and likely treatment as efficiently as possible (days to weeks, maybe months in extreme situations), and then remove themselves and let your brain/body do the rest.  A great deal of research these days indicates that in many healthcare interactions providers should try and limit their patient’s dependency on them, opting instead for interventions and language that fosters resiliency and self-efficacy (independence).

    What happens at your first chiropractic appointment?

    Your first chiropractic appointment should include a detailed discussion of your health history and presenting complaint(s), an examination of your complaint(s), a discussion regarding what is indicated by the examination relative to prognosis and treatment plan, and finally some form of treatment/intervention assuming time permits.  Many painful conditions can be evaluated thoroughly and completely in a matter of minutes and certain treatment interventions could yield immediate relief, while other conditions may require more complex evaluations and more lengthy treatment plans.  Above all, you should leave your first chiropractic appointment feeling confident that your chiropractor is the best option to help you with your problem and you should leave feeling confident that you are on the road to recovery.

    How often should you see a chiropractor?

    You should see a chiropractor as often as you want or need.  Perhaps the most common criticism of chiropractors is that chiropractors “need to see you for the rest of your life”, and while there are unfortunately examples of chiropractors who advocate for this kind of dependency, the significant majority of chiropractors today want to help you as quickly as possible with no long-term commitments of any kind.  The best chiropractor will see you the minimally necessary number of times to help you overcome your issue and suggest you follow-up if there are any residual issues or new complaints sometime in the future.  Many patients however recognize how good they feel after chiropractic care and therefore wish to see their chiropractor with some kind of recurring frequency (IE: once/month, twice/year, or more).  These examples though should be dictated by the patient based on their assessment of their body’s needs and absolutely not dictated by the chiropractor based on some kind of pseudoscientific reasoning.

    Does insurance pay for chiropractor?

    In many cases, yes, insurance will help pay for chiropractic care assuming the chiropractor is participating with your health insurer.  If your chiropractor is not participating with health insurance, then it is still possible you have an out-of-network benefit with your insurer and can seek reimbursement that way.

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