Shoulder Pain

Shoulder pain is multifactorial.  It can be related to degenerative changes the shoulder joint proper or can be secondary to smaller joints or bursas that surround the shoulder joint.   Pain may also be related to muscle or ligament strains or ruptures that function to form and move the shoulder joint.

Some people can also have neck pain that radiates to the shoulder region, this is usually either to arthritic changes in the neck or secondary to a pinched nerve in the neck that supplies muscles in the shoulder region.

Thus, proper workup with history and physical exam is necessary to identify the exact etiology to formulate the proper treatment plan.  Workup may require imaging and/or electrodiagnostic studies (electromyography and nerve conduction studies).

Shoulder pain can result from degenerative changes over time, overuse related to work or sports and injury.

Potential symptoms that you may experience with this condition:

  • Shoulder joint (s) pain
  • Burning sensation
  • Limited range motion
  • Muscle spasms and stiffness
  • Pain made worse with shoulder movements
  • Numbness and tingling
  • Clinking sound of the joint
  • Swelling

Treatment options for this condition:

  1. Physical therapy and/or Occupational therapy
  2. Medications:
    1. Anti-inflammatory therapy
    2. Nerve pain medications: Neurontin, Lyrica, Amitriptyline, Nortriptyline
    3. Muscle relaxants
    4. Hot and Cold compressors
  3. Cognitive behavioral therapy
  4. Interventions
    1. Small or large joint injection
    2. Bursa injection
    3. Cervical epidural steroid injection
    4. Cervical medial branch or facet joint blocks
    5. Radiofrequency ablation of cervical facet joints
    6. Acupuncture
    7. TENS unit therapy
  5. Surgery: This is considered when less invasive therapy is not successful or when is considered to be the best option for the cause of your shoulder pain.