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| Spence Rehabilitation Center |
| 1650 45th Ave. Suite 2C |
| Munster, IN 46321 |
| Visit our Porter County location! |
| 1620 Country Club Rd. Ste E |
| Valparaiso, IN 46383 |
| Phone |
: (219) 513-2267 |
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What are some possible causes of shoulder pain? |
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| 1. |
Heart problems: |
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Do you have a personal or family history of heart |
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disease. Does the pain get worse with exertion and |
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improve with rest? Does if feel like burning or a |
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pressure on your chest? If so, see your doctor to |
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rule out heart disease. |
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| 2. |
Cholecystitis: |
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Pain from gallbladder disease typically develops shortly |
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after eating a fatty meal and can be associated with |
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fevers, chills, and nausea. |
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| 3. |
Fractures: |
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Did the pain result from a fall on an outstretched arm? |
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Is there swelling or deformity? If so, see your doctor to |
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rule out fracture. |
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| 4. |
Rotator Cuff Tendinitis: |
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The rotator cuff consists of a series of muscles that hold |
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the humerus into the shoulder socket. Occasionally |
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trauma and repetitive use can result in inflammation |
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or degeneration of the tendons that attach these |
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muscles
to the shoulder socket. Symptoms typically are |
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aggrevated with raising your arm up or to your side. The |
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pain can be worse at night and sometimes interfere with |
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sleep. The shoulder can be tender when touched and |
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accompanied by weakness if severe. |
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| 5. |
Shoulder separation: |
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It is also known as acromial clavicular joint separation |
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and usually occurs after trauma such as a fall onto the |
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shoulder. The ligament that attaches the collar bone to |
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the shoulder gets torn. There is usually tenderness at |
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the junction between the collar bone and shoulder as |
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well as swelling. Severe shoulder separations can also |
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appear as a lump at the top of the shoulder and the |
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shoulder pain can improve when supported by the |
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other extremity. |
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| 6. |
Bursitis: |
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A fluid filled sac located in the shoulder that can get |
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inflamed and painful. |
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| 7. |
Shoulder dislocation: |
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The muscles and ligaments that hold the humerus into |
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the shoulder socket get torn and the shoulder can be |
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out of place. |
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| 8. |
Myofascial Pain: |
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Occasionally poor posture, stress, and neck strain can |
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result in pain and tightness in the shoulders. |
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| 9. |
Cervical Radiculopathy: |
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Some pinched nerves in the neck particularly C5 and C6 |
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can radiate or move into the shoulders. |
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What are some important factors to consider when |
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having shoulder pain? |
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| 1. |
Do you have any other associated symptoms: |
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Is it a pressure and associated with nausea, shortness |
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or breath, vomiting, sweating, fevers or chills, see |
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your doctor immediately. |
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| 2. |
Do you have Swelling, deformity, or recent |
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trauma: |
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Could indicate shoulder separation, dislocation, or |
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fracture. |
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| 3. |
Do you have worsening numbness or weakness: |
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See your doctor ASAP to rule out a pinched nerve. |
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What are some common tests to evaluate shoulder |
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pain? |
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Certain test can aid in diagnosis depending on the history |
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and physical exam findings. |
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| 1. |
Blood work: |
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Particularly helpful to rule out heart attack, infection, |
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or gallbladder disease. |
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| 2. |
EKG: |
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To rule out heart attack and evaluate for other cardiac |
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problems. |
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| 3. |
Xray of the shoulder and sometimes including |
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the neck: |
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Can look for fracture, a separated shoulder, and |
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calcium deposits associated with tendinitis. Also, the |
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humerus can be higher than normal if there is rotator |
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cuff problems. A neck film is usually checked to |
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ensure stability of the spine if the therapist is planning |
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to include traction and mobilization. |
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| 4. |
MRI: |
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This test is best to evaluate the soft tissues such as |
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the ligaments, tendons, and bursa but is usually |
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reserved for patients who are not responding to |
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medications and therapy. If there is associated neck |
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pain, numbness, or weakness, an MRI of the neck is |
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needed to evaluate for a pinched nerve. |
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| 5. |
CT: |
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Is more sensitive for fracture and can evaluate the |
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other organs such as the heart and lungs if they are |
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suspected. |
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What are some Treatment options for Shoulder Pain? |
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| 1. |
Rest: |
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Use your affected arm as tolerating for the first two |
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to three days. A sling may also be helpful if either |
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a shoulder dislocation or separation are present. |
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| 2. |
Cold: |
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Apply a cold pack for 15-20 minutes to limit pain and |
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swelling. This modality is most helpful after a recent |
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injury particularly the first 48 hours. |
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| 3. |
Elevation: |
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Keeping your arm above your heart the first 48 hours |
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can also help minimize swelling. |
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| 4. |
Tylenol |
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| 5. |
Nonsteroid anti-inflammatories: |
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Ibuprofen and naprosyn can be obtained. |
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| 6. |
Heat: |
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Can be used to loosen up tight, tender muscles but |
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should not be used the first week after injury because |
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it can make swelling worse. |
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| 7. |
Ultrasound: |
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High frequency sound waves are sent through body |
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tissues as means to provide deep heat to the site |
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of injury. This deep heat helps to decrease pain |
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and inflammation as well as loosen tight tissues. |
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| 8. |
Physical Therapy: |
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Typically starts out with range of motion passively |
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performed by a therapist progressing to actively |
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performed movements by the patient. Once range |
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of motion is achieved, the muscles that hold the |
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shoulder in place should be strengthened using a |
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large rubber band called a theraband. Specific |
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shoulder exercise will depend on the diagnosis and |
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symptoms.
For specific shoulder exercises, refer to |
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the links page. |
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| 9. |
Shoulder Cortisone injection: |
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Some shoulder conditions respond well to injections |
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containing steroids. Shoulder injections are |
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particularly helpful to relieve pain and inflammation |
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caused by tendinitis, bursitis, and joint arthritis. An |
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injection can be advantageous because a higher |
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dose of medication is placed at the site of injury |
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which helps to limit unwanted side effects. |
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| 10. |
Glucosamine: |
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An over-the-counter supplement that has been found |
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to help joint pain. It consists of a precursor molecule |
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that is used by the body to produce cartilage. The |
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studies supporting it’s efficacy are limited but the |
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supplement
has been found to be relatively safe. |
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| 11. |
Shoulder arthroscopy: |
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A small incision is made and a camera is used to |
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view inside the joint. This procedure can be used to |
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decompress and repair injured tissues surgically. |
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Common conditions treated using arthroscopy include |
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impingement syndrome, labral tears, frozen shoulder, |
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AC joint arthritis, biceps tendinitis. |
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| 12. |
Shoulder replacement surgery: |
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The arthritis shoulder joint is removed and replaced |
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with an artificial ball-and-socket implant. This |
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procedure is used to treat severe AC joint arthritis |
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that has not responded to conservative treatments. |
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