Shoulder pain can make seemingly simple activities surprisingly difficult.
Reaching overhead, putting on a jacket, sleeping on your side, lifting weights, throwing a ball, or even reaching into the back seat of your car can become uncomfortable.
The challenge is that shoulder pain isn't one specific condition.
Several different structures can produce similar symptoms, which means the first step is figuring out what's actually contributing to the problem.
What Causes Shoulder Pain?
The shoulder is designed to provide a large amount of movement.
That mobility depends on several joints, muscles, tendons, and other structures working together.
Common causes of shoulder pain include:
- Rotator cuff tendinopathy
- Rotator cuff tears
- Biceps tendon problems
- Bursitis
- Frozen shoulder
- Arthritis
- Joint sprains
- Muscle strains
- Shoulder instability
- Injuries from falls or sports
- Repetitive overhead activity
Pain around the shoulder can also sometimes originate from the neck or cervical nerves rather than the shoulder itself.
That's one reason an appropriate examination matters.
What Does Rotator Cuff Pain Feel Like?
The rotator cuff is a group of muscles and tendons that helps move and stabilize your shoulder.
Rotator cuff-related pain commonly causes discomfort around the outside or front of the shoulder.
You may notice pain when:
- Reaching overhead
- Reaching behind your back
- Lifting an object
- Sleeping on the affected shoulder
- Throwing
- Performing pressing exercises
Some people also experience weakness.
Importantly, shoulder pain doesn't automatically mean you've torn your rotator cuff.
What About Biceps Tendon Pain?
The long head of the biceps tendon travels through the front of the shoulder.
When irritated, it can cause pain toward the front of the shoulder, particularly during lifting, reaching, pulling, or overhead movements.
Because rotator cuff and biceps problems can produce overlapping symptoms, examination findings are often more useful than simply identifying where the pain is located.
What Is Frozen Shoulder?
Frozen shoulder—or adhesive capsulitis—is different from simply having a stiff or painful shoulder.
It typically causes a substantial loss of shoulder movement.
Patients may have difficulty:
- Reaching overhead
- Reaching behind their back
- Putting on clothing
- Washing their hair
- Reaching across their body
Frozen shoulder can take considerable time to resolve, and treatment needs to account for the stage and severity of the condition.
Aggressively forcing a painful frozen shoulder isn't necessarily better.
Could Shoulder Pain Actually Be Coming From Your Neck?
Yes.
Nerves exiting the cervical spine travel into the shoulder, arm and hand.
A cervical nerve problem can sometimes produce:
- Shoulder or shoulder-blade pain
- Arm pain
- Numbness
- Tingling
- Weakness
If moving your neck changes your shoulder or arm symptoms—or you're experiencing neurological symptoms—the cervical spine should also be considered.
You can learn more on our neck pain page.
How Is Shoulder Pain Evaluated?
An evaluation should start with understanding:
- Where your pain is located
- How it started
- Which movements aggravate it
- Whether there was an injury
- Whether you have weakness
- Whether symptoms travel down your arm
- Your work and activity demands
- Your exercise or sports history
The physical examination may assess shoulder movement, strength, specific orthopedic tests, and potentially the neck and neurological system.
Imaging isn't automatically necessary for every shoulder complaint.
Depending on the injury and examination findings, X-ray, ultrasound, MRI, or referral may sometimes be appropriate.
Should You Rest a Painful Shoulder?
Sometimes modifying an aggravating activity is useful.
But complete rest isn't always the answer.
For many shoulder problems, the goal is to find movements and activities you can tolerate and then gradually rebuild from there.
For example, you might temporarily reduce:
- Heavy overhead pressing
- Throwing volume
- Certain repetitive work
- Painful exercises
That doesn't necessarily mean you need to stop using the shoulder completely.
Exercise Is Often an Important Part of Shoulder Recovery
Shoulder rehabilitation frequently involves progressively restoring both movement and strength.
Depending on the problem, rehabilitation and movement might include exercises targeting:
- Rotator cuff strength
- Shoulder-blade muscles
- Pressing strength
- Pulling strength
- Overhead movement
- Range of motion
- Gradual return to work or sports
There isn't one universal “best shoulder exercise.”
The exercises should match the problem and your goals.
Can Chiropractic Care Help With Shoulder Pain?
Depending on the cause, chiropractic care may be one part of managing a shoulder complaint.
Manual treatment may sometimes help with comfortable movement or symptoms involving the shoulder, upper back, or neck.
But shoulder treatment shouldn't simply consist of repeatedly adjusting the area.
If strength or activity tolerance has been lost, rehabilitation and progressive exercise may be an important part of recovery.
Can Massage Help Shoulder Pain?
[Massage therapy] may help some patients manage muscle soreness or tension around the shoulder, upper back, and neck.
That can be useful, particularly when muscle tension accompanies the primary shoulder problem.
However, massage can't repair a significant tendon tear or replace appropriate rehabilitation when strength needs to be rebuilt.
When Should Shoulder Pain Be Evaluated?
Consider having your shoulder evaluated if you have:
- Persistent or worsening pain
- Significant weakness
- Difficulty raising your arm
- Pain that repeatedly wakes you at night
- Numbness or tingling
- Symptoms extending down the arm
- Significant swelling or deformity
- Pain following a fall or traumatic injury
- Symptoms that aren't improving with reasonable activity modification
Sudden severe weakness following an injury may require more immediate evaluation.
Shoulder Pain Treatment in Maple Grove, MN
The goal isn't simply to label everything as “shoulder pain.”
We want to understand what appears to be causing your symptoms and what is limiting you.
At Northwood Chiropractic & Wellness, we'll evaluate your shoulder, movement, strength, and—when appropriate—your neck to determine what may be contributing to the problem.
Treatment may include chiropractic care, rehabilitation and exercise, massage therapy, activity modification, or referral for additional evaluation when necessary.
The goal is to help you move comfortably and get back to the activities that matter to you.
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Dr. Greg Beenken
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