Diagnosing the Cause Of Shoulder Pain

By Daniel Thompson, MD

Your shoulder is the most mobile joint in your body. But that mobility comes with a price; an increased risk of pain and injury. Problems can result from overuse, injuries, wear and tear and arthritis, and can affect the bones, muscles, ligaments or tendons.

Some of the most common pain-causing conditions include

Rotator cuff disorders – Symptoms of tendonitis and bursitis are often relieved with conservative measures such as rest, over-the-counter pain medication, physical therapy or cortisone injections. If these don't work, minimally invasive arthroscopic surgery may be necessary. A torn rotator cuff tendon is more serious and may require surgery to restore strength and reduce pain.

Shoulder instability – Ligaments that are torn or loosened as the result of a shoulder dislocation or injury sometimes improve with rest, a sling, physical therapy or activity modification. Chronic instability requires surgery to reconstruct and tighten the ligaments. Sometimes surgery is necessary to repair a torn labrum, the ring of cartilage that surrounds and cushions the shoulder joint.

Shoulder fractures (broken bones) – Some shoulder fractures heal on their own with rest, a sling and physical therapy. Others require surgery to realign and stabilize the bone.

Osteoarthritis – Conservative treatment including exercise, physical therapy, over-the-counter medications and cortisone injections can alleviate pain and stiffness and slow progression of shoulder arthritis. Patients with advanced or worsening symptoms may need shoulder joint replac-

ement surgery.

If you have shoulder pain that limits your everyday activities, it's important to visit a qualified surgeon for an assessment that should include a physical exam, imaging tests such as x-rays and, if necessary, a referral for an MRI scan.

In addition, physical therapy can help you regain strength, flexibility and range of motion following a shoulder injury or surgical procedure.