Shoulder Pain

This includes pain of the shoulder joint itself and of the shoulder blade. Most patients with shoulder pain are initially evaluated and treated by orthopedic surgeons. Pain clinics such as Newport Pain Management become involved if patients have a non-surgical problem, decline surgery, or find surgery had no benefit.

Rotator cuff problems

Rotator cuff problems are one of the single most common causes of shoulder pain. The rotator cuff is a collection of four muscles that surround the shoulder joint and, together with a piece of cartilage called the labrum, hold the joint together. Damage to any one of these muscles causes the shoulder to hurt and to not move very well. Typically, a patient with this injury has worse pain at night, with pain spreading down the outside of the upper arm, and may have difficulty lifting the arm from the side. This can occur from falling forward onto an outstretched hand or with a shoulder dislocation. Just as often, especially after age 50, the tendon wears and tears gradually without any single injury. Damage is usually done to the supraspinatus tendon. Cortisone or other injections do not cure the tear, and thus tend not to give any sustained pain relief.

Impingement

Impingement is another common cause of shoulder pain. Typically, parts of the shoulder joint get trapped between the arm bone and the area between the clavicle and the shoulder blade. This can lead to bursitis or even a rotator cuff tear. Again, pain is usually worse at night and limits moving the arm overhead. The diagnosis is usually made on physical examination, confirmed when needed with MRI or ultrasound.

Tendinitis and bursitis

This is an inflammation of the fluid-filled sacs called bursae, or of the fibrous strands of tissue surrounding the joint that attach to muscles, known as tendons. Pain from these causes tends to come on gradually, brought on by repeated minor trauma or activity. This type of pain usually responds well to local injections of corticosteroids such as cortisone.

Scapulocostal syndrome

Scapulocostal syndrome is an often-overlooked cause of pain in the head, neck, and shoulder blade areas. It is caused by bursitis of the scapulothoracic bursa under the shoulder blade. Patients commonly complain of pain in the neck and back of the head, the triceps muscle of the arm, the upper chest, and the forearm, including the fingers. Reaching across the body often causes the pain to intensify. Local injections of anti-inflammatory agents into the bursa can dramatically reduce pain.

Before your visit

While there are a vast number of disorders causing shoulder pain not listed here, it is important to know a few basics before your visit with your doctor. Don't walk away from your visit without a firm diagnosis or a plan to find one, as most shoulder problems can be improved with early and thoughtful physician intervention.

Call Newport Pain Management at (949) 759-8400.

This article is for general education and is not a substitute for individual medical advice.