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“Shoulder Pain,” by Malcom E. Baxter, M.D.

Clinical Advances

“Shoulder Pain,” by Malcom E. Baxter, M.D.

“Man, my shoulder is killing me, and I haven’t done anything to injure it,” or, “Wow. I think I just tore something in my shoulder.” These are all too common complaints that physicians hear regarding shoulder pain.

The shoulder has the most motion of any joint in the body. Stabilizing this joint are many muscles, ligaments, and tendons—chief among these being the rotator cuff tendons.

The rotator cuff tendons are sandwiched between two bones in the shoulder, and herein lies the problem. With too much activity, especially overhead activity, the tendons are pinched and irritated resulting in a common condition called impingement syndrome. This pinching effect can eventually lead to a rotator cuff tear if left untreated.

Many painful shoulder conditions involve some form of rotator cuff inflammation in the form of tendinitis or bursitis. These conditions usually result from overuse.

Many times shoulder pain results from too much overhead activity. Weekend athletes and “yard warriors” often wind up with shoulder pain after overdoing it in a sport they have not played in a long time, or doing six months of yard work on a Saturday and Sunday. Rotator cuff tears often cause night pain and difficulty sleeping on the injured shoulder, as well as problems with outstretched or overhead movements.

Most of these painful shoulder conditions will respond to rest, anti-inflammatory medication, and occasionally necessitate physical therapy or Cortisone injections. Some painful shoulder conditions will need further evaluation in the form of x-rays or an MRI scan. MRI scans are very good at detecting torn rotator cuffs and ligament injuries.

Advanced technology now allows a minimally invasive approach to treating shoulder injuries. New arthroscopic techniques can be used to treat rotator cuff and ligament tears without a large incision. Outpatient arthroscopic repair facilitates faster recovery and is typically less painful.

Avoiding shoulder pain is not always possible. One day of overuse can sometimes equal six months of shoulder pain. It is recommended that you take the time to stretch and warm up, and to use moderation when it comes to activities you have not done in months or years.

The good news is that most shoulder pain will get better with non-operative treatment. The even better news is that technological advances with shoulder arthroscopy allows minimally invasive techniques to correct those shoulder injuries that do require surgery.