ANKLE PAIN
CARPAL TUNNEL SYNDROME
CHRONIC PAIN
ELBOW PAIN
HIP PAIN
IMPAIRMENT & DISABILITY
KNEE PAIN
MUSCLE WEAKNESS
MYOFASCIAL PAIN
NECK & LOW BACK PAIN
NUMBNESS
SHOULDER PAIN
WRIST PAIN
Spence Rehabilitation Center
9305 Calumet Ave. Suite C-1
Munster, IN 46321
Phone : (219) 513-2267
Fax      : (219) 836-1276
     
 
What are some possible causes of shoulder pain?
 
1. Heart problems:
Do you have a personal or family history of heart
disease. Does the pain get worse with exertion and
improve with rest? Does if feel like burning or a
pressure on your chest? If so, see your doctor to
rule out heart disease.
2. Cholecystitis:
Pain from gallbladder disease typically develops shortly
after eating a fatty meal and can be associated with
fevers, chills, and nausea.
3. Fractures:
Did the pain result from a fall on an outstretched arm?
Is there swelling or deformity? If so, see your doctor to
rule out fracture.
4. Rotator Cuff Tendinitis:
The rotator cuff consists of a series of muscles that hold
the humerus into the shoulder socket. Occasionally
trauma and repetitive use can result in inflammation
or degeneration of the tendons that attach these
muscles to the shoulder socket. Symptoms typically are
aggrevated with raising your arm up or to your side. The
pain can be worse at night and sometimes interfere with
sleep. The shoulder can be tender when touched and
accompanied by weakness if severe.
5. Shoulder separation:
It is also known as acromial clavicular joint separation
and usually occurs after trauma such as a fall onto the
shoulder. The ligament that attaches the collar bone to
the shoulder gets torn. There is usually tenderness at
the junction between the collar bone and shoulder as
well as swelling. Severe shoulder separations can also
appear as a lump at the top of the shoulder and the
shoulder pain can improve when supported by the
other extremity.
6. Bursitis:
A fluid filled sac located in the shoulder that can get
inflamed and painful.
7. Shoulder dislocation:
The muscles and ligaments that hold the humerus into
the shoulder socket get torn and the shoulder can be
out of place.
8. Myofascial Pain:
Occasionally poor posture, stress, and neck strain can
result in pain and tightness in the shoulders.
9. Cervical Radiculopathy:
Some pinched nerves in the neck particularly C5 and C6
can radiate or move into the shoulders.
 
 
What are some important factors to consider when
having shoulder pain?
 
1. Do you have any other associated symptoms:
Is it a pressure and associated with nausea, shortness
or breath, vomiting, sweating, fevers or chills, see
your doctor immediately.
2. Do you have Swelling, deformity, or recent
trauma:
Could indicate shoulder separation, dislocation, or
fracture.
3. Do you have worsening numbness or weakness:
See your doctor ASAP to rule out a pinched nerve.
 
What are some common tests to evaluate shoulder
pain?
Certain test can aid in diagnosis depending on the history
and physical exam findings.
 
1. Blood work:
Particularly helpful to rule out heart attack, infection,
or gallbladder disease.
2. EKG:
To rule out heart attack and evaluate for other cardiac
problems.
3. Xray of the shoulder and sometimes including
the neck:
Can look for fracture, a separated shoulder, and
calcium deposits associated with tendinitis. Also, the
humerus can be higher than normal if there is rotator
cuff problems. A neck film is usually checked to
ensure stability of the spine if the therapist is planning
to include traction and mobilization.
4. MRI:
This test is best to evaluate the soft tissues such as
the ligaments, tendons, and bursa but is usually
reserved for patients who are not responding to
medications and therapy. If there is associated neck
pain, numbness, or weakness, an MRI of the neck is
needed to evaluate for a pinched nerve.
5. CT:
Is more sensitive for fracture and can evaluate the
other organs such as the heart and lungs if they are
suspected.
 
     
 
What are some Treatment options for Shoulder Pain?
 
1. Rest:
Use your affected arm as tolerating for the first two
to three days. A sling may also be helpful if either
a shoulder dislocation or separation are present.
2. Cold:
Apply a cold pack for 15-20 minutes to limit pain and
swelling. This modality is most helpful after a recent
injury particularly the first 48 hours.
3. Elevation:
Keeping your arm above your heart the first 48 hours
can also help minimize swelling.
4. Tylenol
5. Nonsteroid anti-inflammatories:
Ibuprofen and naprosyn can be obtained.
6. Heat:
Can be used to loosen up tight, tender muscles but
should not be used the first week after injury because
it can make swelling worse.
7. Ultrasound:
High frequency sound waves are sent through body
tissues as means to provide deep heat to the site
of injury. This deep heat helps to decrease pain
and inflammation as well as loosen tight tissues.
8. Physical Therapy:
Typically starts out with range of motion passively
performed by a therapist progressing to actively
performed movements by the patient. Once range
of motion is achieved, the muscles that hold the
shoulder in place should be strengthened using a
large rubber band called a theraband. Specific
shoulder exercise will depend on the diagnosis and
symptoms. For specific shoulder exercises, refer to
the links page.
 
 
 
9. Shoulder Cortisone injection:
Some shoulder conditions respond well to injections
containing steroids. Shoulder injections are
particularly helpful to relieve pain and inflammation
caused by tendinitis, bursitis, and joint arthritis. An
injection can be advantageous because a higher
dose of medication is placed at the site of injury
which helps to limit unwanted side effects.
10. Glucosamine:
An over-the-counter supplement that has been found
to help joint pain. It consists of a precursor molecule
that is used by the body to produce cartilage. The
studies supporting it’s efficacy are limited but the
supplement has been found to be relatively safe.
11. Shoulder arthroscopy:
A small incision is made and a camera is used to
view inside the joint. This procedure can be used to
decompress and repair injured tissues surgically.
Common conditions treated using arthroscopy include
impingement syndrome, labral tears, frozen shoulder,
AC joint arthritis, biceps tendinitis.
12. Shoulder replacement surgery:
The arthritis shoulder joint is removed and replaced
with an artificial ball-and-socket implant. This
procedure is used to treat severe AC joint arthritis
that has not responded to conservative treatments.
 
 
Disclaimer
"Nothing contained on this website should be interpreted to be medical advice. This website is for general information only.
Please consult a physician for medical advice regarding any medical condition."
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