Why Does My Shoulder Hurt So Much?

Why does my shoulder always hurt? When will it ever get better? Do I need surgery? These are some of the questions you may be asking yourself; Shoulder injuries are in fact very common, but not as easily fixed all the time. This is because there are many underlying causes for a shoulder injury. I hope to answer some of your questions about shoulder and show you something that could help ease your pain.

The shoulder girdle consists of three joints: the glenohumeral joint, the acromioclavicular joint and the sternoclavicular joint. These joints shift together in an intricate pattern that can easily be disrupted. Alterations in the precision of movement can result in microtrauma, and if allowed to continue, macrotrauma in the shoulder.

There are many factors that can contribute to shoulder pain. Often, there is no obvious cause of the problem. However, the factors discussed in this article can also contribute to an overuse or a traumatic injury. Your physical therapist can work with your physician to determine what factors may be causing or contributing to your pain. This goes beyond what is noted in an x-ray or an MRI. There are usually many factors that contribute to shoulder pain that must be addressed to make sure that the pain will not only go away, but that it will not return. Each patient is assessed and given an individual plan of care based on their pathology, weaknesses and goals.

Altered configuration of the shoulders, scapula and/or spine can lead to shoulder pain. Your physical therapist can look for asymmetries that may contribute to abnormal lengthening/shortening of musculature or joint compression. Many factors can contribute to this aspect of your problem including sleeping position, ergonomic set-up at work/home, posture, exercise practices, stress and lifting mechanics. These factors must be addressed for optimal care.

The scapula could be the cause of shoulder pain. Even if the alignment is proper, if the scapula lacks stability, the patient will develop asymmetries and abnormal movement patterns contributing to pain. Sometimes, the pattern of muscle recruitment can lead to inefficient movements of the shoulder. Using muscles for which they were not designed can lead to overuse and pain. Your physical therapist can help determine which muscles are weak and which muscles are being overused. By learning to strengthen your weak muscles and relax your overused muscles, alignment and efficiency will improve.

Possible Treatments for Shoulder Pain:
· Strengthening weak shoulder/scapular muscles
· Working on postural stamina
· Manual techniques including joint mobilization to decrease stiffness and pain, soft tissue mobilization to improve flexibility and decrease pain
· Manual resistance techniques to get better muscle activation for functional movements
· Stretching shortened neck/shoulder/scapular muscles
· Body mechanics training for actions of daily living and lifting techniques
· Ergonomic recommendations for work and home
· Use of biofeedback or electric stimulation to develop muscle recruitment
· Use of modalities (ice, heat, laser light therapy, electric stimulation, TENS, interferential stimulation, or ultrasound) for pain control
· Taping techniques to reduce overused muscles and facilitate weak muscles

Although there are many great ways to treat your shoulder pain, there are just as many poor ways to treat yourself. Based on what you have learned you may be able to make some lifestyle changes that could help ease your pain, however, it is best to consult a doctor or physical therapist to discover all of the causes of your pain.


About The Author:

Amy Calhoun PT, DPT, NSCA-CPT, CSCS, is an expert on shoulder pain. Her treatment of Los Angeles Physical Therapy patients and expertise in manual orthopedic care through a post-professional residency at Kaiser Permanente has given her skill in successfully treating shoulder pain.