Shoulder pain can be at a minimum distracting and at its worst, disabling. But shoulder pain can be somewhat tricky to diagnose. Shoulder pain can be caused by inflammation or injuries to any of these components: the shoulder joint (involving the clavicle, scapula and humerus bones), the tendons, the surrounded ligaments, or a rotator cuff injury. In addition, shoulder pain can be caused by bursitis or arthritis, in addition to disease processes that affect bones and muscles.
To properly diagnose shoulder pain, a physician will examine and interview the patient, will gently touch around the area (called palpation) to try to determine what improves or exacerbates the pain and will often order x-rays. While interviewing the patient, the doctor will ask the following questions:
- Do you remember a specific injury occurring?
- Do you have any sort of history of shoulder pain or previous injuries?
- How much pain are you in now?
- How long have you been in pain?
- How is your shoulder or arm movement affected? (Do you have trouble lifting, cooking, etc.?)
- What is your exercise regimen and how is your shoulder pain affected? (Golf, tennis, swimming and baseball/softball are often repetitive motion sports that can cause shoulder ailments.)
- Do you have any weakness?
- Do you have stiffness?
- How is your flexibility?
- What treatments have you already tried?
- Do you notice anything that improves or worsens your pain level?
After this interview and ordering tests, doctors begin to narrow in on the cause of the shoulder injury in order to determine how to proceed with treatment. They will first exclude joint involvement, then determine the state of the rotator cuff (typically by ordering either MRI or ultrasound tests) and also try to figure out if “frozen shoulder” is present.
Eventual treatment can include splinting and immobilizing, physical therapy, chiropractic treatment, medication or in the most severe cases, surgery.