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- January 04, 2018 -

Your Shoulder Pain Explained with Kurt Lee, PA-C

PA Kurt Lee discusses how shoulder pain presents itself and the options you have for treatment.

Kurt Lee: Hi, I'm Kurt Lee, one of the PAs here at Spine and Joint Pain Specialists. I was asked to speak today a little bit about a common complaint that we see in the clinic - shoulder pain. The shoulder is a complex ball and socket joint capable of a wide range of motion. As a result, it is susceptible to injury. Some of the common causes of shoulder pain include: shoulder osteoarthritis, bursitis, tendonitis, injured cervical nerve roots can manifest as shoulder pain. So, we're gonna briefly go through some of the different, ideologies of shoulder pain. Shoulder osteoarthritis could further be divided into two categories. Either the ball and socket joint itself, which is known as glenohumeral joint arthritis, or the AC joint which is where the collarbone meets with the shoulder.

Glenohumeral arthritis typically manifests as soreness and stiffness in the shoulder. Progresses slowly as we age. You may feel or hear some grinding sensations in your shoulder as you move it through a range of motion. AC joint, or acromioclavicular joint where your collarbone attaches to your shoulder, typically causes more pain on the front side of the shoulder.

Motions like moving your arm across your body will worsen that specific pain. Bursitis of the shoulder, or shoulder impingement syndrome, is another very common cause of shoulder pain. Bursitis presents as shoulder pain worsened with movement, typically worsening when the arm is extended away from the body. Patients will sometimes describe the pain as a pinching sensation inside the shoulder.

Tendonitis, the biceps tendon, is a common cause of injury or shoulder pain, or pain in the front side of the shoulder. Typically, an overuse injury worsened with forward flexion of the shoulder, with your arm out in front of you, or direct palpation, in the front of the shoulder where the biceps tendon lies in its groove.

It's important not to get stuck into thinking only about the shoulder when somebody comes in with a complaint of shoulder pain. Irritated cervical nerve roots due to disc bulges or bone spurs from arthritis can also present as shoulder pain. There are four cervical nerve roots that exit the cervical spine and travel down the arm, past the shoulder at C5, C6, C7, and C8.

C5 will present as pain, numbness, or tingling over the deltoid area and will exhibit deltoid weakness. C6 will present with pain or numbness further down the arm into the thumb side of the hand. And this nerve is also responsible for strength and reflexes of the biceps muscle. C7 and C8 are responsible for pain that passes through the shoulder into the posterior pinky side of the arm.

C7 is also responsible for triceps strength and reflexes, while C8 is responsible for the grip strength. As you can see, identifying and treating shoulder pain can be complex and requires a detailed history and physical examination. Most injuries can be resolved with conservative treatment, including rest, ice, anti-inflammatories, physical therapy.

For those that have symptoms that still persist, beyond the conservative measures, there may be different interventional procedures that we can offer to help treat these various ideologies of shoulder pain. Most injections involve these in combination of numbing medication with corticosteroid or strong anti-inflammatory.

Just recently, insurance companies have begun authorizing the treatment, using stem cell injections to treat specific causes of shoulder pain. If you're interested in learning about the different treatment options that may be available to you, don't hesitate to give our office a call and schedule a consultation at (210) 541-0700. And, we look forward to seeing you.