Shoulder Pain

Shoulder Pain

Shoulder pain may occur as a result of direct injury to the shoulder joint or its surrounding structures. Because shoulder pain may actually originate in the neck or other adjacent area, a thorough consultation and examination is performed prior to the development of a treatment plan. In many cases, imaging is ordered as a way to assist in the most accurate diagnosis of shoulder pain.

Causes of Shoulder Pain

Rotator Cuff Injury

The rotator cuff, which surrounds the shoulder joint, is comprised of several tendons and muscles. These structures are responsible for stabilizing the bone of the upper arm within the shoulder socket. When the rotator cuff is injured, a persistent, dull ache may develop. Pain usually worsens with pressure, such as sleeping on the affected side. The primary risk for rotator cuff injuries is repeated overhead lifting. A direct injury may also damage the rotator cuff. This type of injury may result in an actual tear of the rotator cuff, which would require prompt medical attention. Physical therapy exercises have been proven effective at restoring comfort and range of motion in patients affected by a rotator cuff injury.


Bursitis is the inflammation of the bursae that are situated around the bones near the shoulder joint. These fluid-filled sacs provide necessary cushioning to the muscles, tendons, and bones around the joint. The bursae may become inflamed as a result of repetitive motion. As an example, a baseball player may develop bursitis in the shoulder due to the frequency and velocity of throwing the ball. To reduce inflammation, treatment may revolve around hot and cold therapy. Physical therapy exercises are also valuable in the prevention of recurrence.

Thoracic Outlet Syndrome

Thoracic Outlet Syndrome describes a handful of disorders that may indirectly cause shoulder pain. These conditions occur in the area between the first rib and the collarbone, referred to as the thoracic outlet. Pain stems from nerve or blood vessel compression within this space. In a majority of cases, it is nerve compression that needs to be addressed in order for pain to resolve.

Nerve-related Thoracic Outlet Syndrome (neurogenic) may cause symptoms such as pain and aching in the neck, shoulder, and hand. The grip may become weak, and numbness may be felt in the arm and fingers of the affected side of the body. In some instances, noticeable atrophy of the muscle at the base of the thumb may occur.

Individuals diagnosed with neurogenic thoracic outlet syndrome are typically referred to a physical therapist. Treatment protocols revolve around improving the flexibility and strength of the muscles around the shoulder. This opens the space within the thoracic outlet so nerve endings are relieved of compression. Physical therapy can also correct poor posture, which exacerbates nerve impingement, and it can improve range of motion.

Brachial Plexus Injury

Sensations in the body stem from nerves that travel from the brain stem, through the spinal column, and to various points, such as the hands and fingers. The brachial plexus is a matrix of nerves that travel through the shoulder and arm. Injury to this network may occur during sports, vaginal birth, a motor vehicle accident, or other circumstance. The injury relates to the stretching and / or compression of these nerves.

There are various modalities that may assist in the recovery from a brachial plexus injury. Chiropractic evaluation may be performed to identify the area of the cervical spine that is involved in nerve impingement. Chiropractic adjustments to the affects spinal segment relieves pressure on the nerves, allowing for full comfort and range of motion. Acupuncture is a reliable therapy that is often used to minimize inflammation and encourage faster healing. Finally, physical therapy may be recommended for the treatment of brachial plexus injury. Prescribed exercises and stretches focus on maximizing the strength and flexibility of the structures around the affected joints.

Advanced Physical Medicine & Rehabilitation provides friendly care in Lake Como, Brick, Edison, Red Bank, and other cities of Monmouth County. To locate an office near you or learn more about the services provided by our experienced therapists, Contact us today.

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