Patients come in quite commonly with shoulder pain, and the shoulder is a very complicated joint and can have a number of sources of pain. I find that there are 3 that are the most common and can be managed easily with in office treatment as well as with home therapy.
1. Biceps Tendon: the biceps tendon runs up and down in the front of the shoulder, click here for a picture, and can be felt by moving your finger across it back and forth from left to right. It will increase in pain with lifting objects with that arm, both light and heavy, and the pain will be a quick, strong sharp pain. Treatment will include ultrasound therapy in the office as well as icing at home.
2. Acromioclavicular joint: the AC joint is between the clavicle and the acromion process of the scapula. If you follow your clavicle towards the shoulder, it makes the joint at the tip of the shoulder. Click here for a picture. This will hurt with lifting the arm over head or with attempting to put your arm behind your back, but will be fine with working with the arms down and in front of you. It can be brought on by using the arm too much over head, such as with painting, or with falling on the shoulder or with the shoulder fully extended. Treatment will include ultrasound and muscle stim therapy, as well as icing at home.
3. Impingement Syndrome or Rotator Cuff: Click here for a picture to show where this occurs. This is pain on the outside of the shoulder just under the acromion process and is due to the tendon of the supraspinatus muscles becoming impinged under the acromion process, and in extreme cases, becoming torn partially or fully by the shearing process between the head of the humerus, or top of the arm bone, and the acromion process. Commonly known as a torn rotator cuff and brought on by the same as AC joint pain. Treatment will include ultrasound therapy in the office and icing at home.
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