Will I Need Surgery
If it is a subscapularis tear, most likely. Surgery is an effective solution for large and full thickness rotator cuff tears. Arthroscopic repairs are minimally invasive and single muscle/tendon repairs tend to go well. Problems do arise with tears larger than 5cm or where there is more than one tendon being repaired. A good therapist post-surgery is crucial to recovery and avoidance of re-injury, especially with complicating factors. My recommendation is avoid chain clinics you are looking for high quality, experienced and caring therapists, not fast food physical therapy.
There tends to be higher re-tear rates with larger size tears and the degree of muscle atrophy and fatty degeneration. It is important to keep as much motion as possible. Years after my second surgery and with residual iatrogenic tears in two tendons, I do shoulder stretching and specific exercises as well as the modified maneuver described here. This helps keep relief and function maximized even with two irreparable tears and a shoulder full of titanium screws. If I fail to do this, and sometimes I cannot, the pain and stiffness increases.
Here are some videos of the techniques: You can do some research or seek professional assistance, however, I do not like the seated version at all, so it is not presented here. Why? It may increase back pain and it seems to pose a reasonable risk of falling off the chair on your head.
Can Stress Cause Neck Pain And Tension In The Shoulders
When we experience high levels of anxiety or stress, our bodys natural reaction is to tense up. When this happens consistently over a long period of time, it can lead to muscle tension, which can cause stiffness, tightness, aching, and pain in your neck and shoulders. Stress-related pain in this region is typically the result of emotional or mental anxiety, which can directly affect the muscles and nerves that run through your shoulders, neck, and spine.
Aside from psychological and emotional stress, other issues that lead to feeling the physical symptoms of sore shoulders are overuse, poor posture, long periods of sitting, incorrect or poor sleeping positions, and of course, cases of injury.
What Can Cause Sharp Pain In Your Neck And Shoulder When Breathing
A couple of conditions can cause pain in the neck and/or shoulder when you take a deep breath, including:
- Pleurisy : Symptoms include sudden chest pain that may be felt only while coughing or breathing deeply, fever, cough, and shortness of breath.
- Pericarditis : Symptoms include rapid-onset stabbing chest pain, possibly pain in the shoulder, fever, weakness, and trouble breathing. It gets worse if you lie down or breathe deeply.
Pleurisy and pericarditis aren’t usually medical emergencies but you should treat any chest pain or breathing difficulty as an emergency until you know for sure what’s causing it.
Also Check: Nerve Pain Heat Or Ice
What Are The Symptoms Of Rotator Cuff Syndrome
Rotator cuff syndrome generally results in swelling and tenderness that can severely limit your movement. The early stages of RCS can show mild symptoms like sudden shoulder pain. But as your condition progresses, you may experience a significant loss of strength and difficulty lifting your arm.
Each specific rotator cuff condition typically presents its own signs and symptoms. But, if you have shoulder cuff syndrome, you can expect:
- Shoulder pain or soreness around your shoulder area
- Swelling at the side of your arm or in front of your shoulder
- Weakness in your arm
- Limited mobility in the affected arm, especially with arm lifting
- Interruption of sleep because of shoulder pain
- Difficulty in carrying out tasks that require overhead motions, such as brushing your hair or throwing a ball
Avoidance And Prevention Of Reoccurrence
Avoid excessive unusual activities with your hands above shoulder height, consider breaking tasks such as curtain hanging or decorating into short bite size periods of time
If you exercise, try and balance your programme to include strength work for all muscle groups
Take a break from heavy or repetitive shoulder movements/lifting
Recommended Reading: How Do You Tell If Your Wrist Is Broken
What Is Rotator Cuff Syndrome
Your shoulders are constantly in motion every day when youre reaching for something on a top shelf, engaging in sport, or simply stretching. Its a simple process that we often take advantage of. A complex interplay of muscles and tendons controls our shoulder function.
Rotator Cuff Syndrome is any injury, disease, or degenerative condition that affects the rotator cuff muscles and tendons of your shoulder. These muscles and tendons are vulnerable to damage because of repetitive use, and when this happens, your shoulder functions poorly.
To help understand better, lets take a look at a few conditions associated with rotator cuff syndrome:
Rotator cuff syndrome may even develop because of a single injury. The pain in your shoulder can start as a dull ache that worsens over time and with continual use of your arm.
Anatomy Of The Rotator Cuff
The rotator cuff comprises four tendons the supraspinatus, infraspinatus, teres minor, and subscapularis each of them attaches a muscle of the same name to the scapula and the humerus, or upper arm bone . The tendons work together to stabilize the joint, rotate the shoulder, and lift the arm above the head. Rotator cuff tendinitis usually starts with inflammation of the supraspinatus tendon and may involve the three other tendons as the condition progresses.
Read Also: Tramadol Sciatica
Inflammation Of The Shoulder Capsule
The synovial membrane of the shoulder may become inflamed this is called ‘synovitis’. Synovitis may occur as a result of another condition or it may happen as a result of an injury, or the cause may be unknown.
Frozen shoulder is a condition that occurs when the shoulder capsule thickens and becomes inflamed and tight. There may also be less synovial fluid to lubricate the joint. As a result, the shoulder becomes difficult to move.
Frozen shoulder may occur as a result of another condition if the shoulder has been immobilised . Sometimes the cause of shoulder pain may not be known.
Rotator Cuff Pain Symptoms
Sharp or aching pain and swelling from a rotator cuff tendinitis or tear are usually located over the front or lateral part of the shoulder and upper arm. People often complain of difficulty performing activities such as combing their hair, clasping a bra behind their back, reaching behind their back, or sleeping on the affected shoulder. Throbbing pain at night is also common in individuals with a rotator cuff tendinitis or tear. For some people, the shoulder pain may awaken them from sleep.
In addition, it’s not uncommon for the pain of a rotator cuff tendinitis or tear to be felt further down the arm from the shoulder. This has to do with the location of the nerves that pass by the deeper parts of the shoulder.
More specifically, with rotator cuff tears, deficits in strength are very common. For instance, many people noticed they have a hard time putting dishes away in upper cabinets or reaching into the refrigerator to lift a carton of milk.
With both a rotator cuff tendinitis and tear, a person often experiences pain over the shoulder that worsens with activities, such as reaching overhead or throwing.
Keep in mind, some people with rotator cuff tears do not experience any painand the severity of the tear does not correlate with the pain experience. In other words, a person with a partial tear may report severe pain while a person with a complete tear may report no pain at all.
You May Like: Can Belly Fat Cause Stomach Pain
When To See A Doctor
- Book appointment with a doctor if
- You have severe chest pain that radiates to shoulder
- You have difficulty breathing
- You have a feeling of nausea and vomiting
- You have a history of shoulder pain and heart disease
- You have shoulder pain along with chest tightness and shoulder pain and chest discomfort
- Any other symptoms that are the cause of your concern
Many people ask can shoulder pain causes chest pain. It may be possible. However, it is more important to identify the cause of simultaneous shoulder and chest pain.
Examining Neck And Shoulder Pain
Shoulder pain is frequently caused by problems in the neck. The cervical plexus is located in the neck, and people will experience pain when there is compression of these bones or tightness in the muscles that articulate with the neck vertebrae. There are many tests available to the clinician for examining the neck and shoulder in order to determine the location of the problem. Most professionals will begin by examining the neck for a nerve entrapment. If the source of the pain is in the shoulder, there will be no additional discomfort during movements of the neck.
Clinicians may also use magnetic resonance imagery, or MRI, to create a visual image of the soft tissues and bones in the affected areas. This can help the professional to determine whether the pain originates in the neck or the shoulder. The pain is also a symptom of some kind of problem. Acute pain occurs after a sudden injury. Accidents and other sudden impacts can cause an acute condition to develop.
You May Like: Is Heat Or Ice Better For Sciatica Pain
Maneuver For Rotator Cuff Pain Relief
The position is to make an equilateral triangle with the arms with the little finger side of the forearms and clasping the hands together. If you use the head, use the heels of the hands instead of the palms to contact the back of the head. Press down with your forearms to lift your shoulders away from your ears, raise and widen your shoulders and hold the position for 30 seconds. If you feel any sharp increase in pain, stop and consult your health care provider.
This method of rotator cuff pain relief is not a cure-all. It does not work for everyone. In the study, at almost 3 years after treatment, there were no new tears and all maintained their increases in range of motion and decrease in pain. It can be said that it appears to decrease pain and disability levels in a quick manner, permanently for some. The patients also had some conservative therapy, so I would also look at the other shoulder exercises.
A subsequent study using EMG revealed the subscapularis holding down the head of the humerus as the deltoid abducts the shaft of the bone. This successfully compensates for a torn supraspinatus and is learned rapidly.
Stretches For Neck And Shoulder Pain
Massage, yoga, and rotator cuff physical therapy are all great ways to improve proper body mechanics and relieve unwanted neck and shoulder tension. In addition, we like to suggest doing a few stretches to see if you can get your shoulders and neck muscles to relax a bit. Here are a few simple, yet effective stretches you can incorporate throughout your day.
Also Check: Is Heat Or Ice Good For Nerve Pain
Ways To Relieve Pain From A Shoulder Problem
If these measures fail to bring relief, you may need an MRI of your shoulder. If that shows a torn rotator cuff, then shoulder surgery may be necessary, says Dr. Ricchetti. If the physical exam and imaging indicate arthritis or a nerve-related pain in your neck, he recommends referral to a spine specialist. Spine specialists will conduct a thorough neurological examination, and do imaging and other tests. They will also begin with conservative care.
Shoulder And Neck Referred Pain
Because of the close connection of the nerves serving them, shoulder and neck pain are often mistaken for one another.
You may feel a pain in the shoulder thats actually coming from your neck, and vice versa. This is called referred pain.
Some of the symptoms of referred pain from your neck include:
- stabbing, burning, or electric-like tingling pain
- pain that radiates to your shoulder blade, elbow, and hand
- pain that radiates down your arm when you twist your neck
- pain thats relieved when you support your neck
Don’t Miss: Broken Wrist Symptoms Pictures
Can Physical Therapy Help With Stress Related Neck Pain Andshoulder Tension
Theres a multitude of evidence to support the effectiveness ofphysical therapy when it comes to reducing shoulder pain and decreased range of motion. Physical therapy treatment options for shoulder pain include manual therapy, joint mobilization, therapeutic exercises, stretching, therapeutic ultrasound, laser therapy, and modalities such as electrical stimulation/TENS, heat or ice.
Physical therapy can be a safe and effective option for managing the effects of severe stress. If your stress-induced shoulder and neck pain lasts for more than a few weeks, give us a call orrequest an appointment to discuss potential treatment options.
How Is Rotator Cuff Syndrome Diagnosed
Diagnosing a rotator cuff injury starts with a comprehensive review of your medical history and any sporting or daily activities that you had engaged in. Further investigation into your condition may include a series of physical examinations to assess the function of your rotator cuff:
If your orthopedist observes the following signs, your condition is most likely rotator cuff syndrome:
- You are unable to keep your arm outstretched to the side
- If you feel pain when your arm is lifted and moved forward more than 90 degrees
- You find it difficult to rotate your arm outward
Risk Factors Of Rotator Cuff Syndrome
Rotator cuff syndrome stems from repetitive activity and overhead movement for a prolonged period. Certain factors can promote these activities or put you at a greater risk for rotator cuff syndrome:
- Age – Rotator cuff injuries are most common in people over 60
- Family history – Rotator cuff injuries are apparent in certain families. It may involve a genetic component that allows rotator cuff syndrome to be passed down.
- Occupation – Rotator cuff syndrome is prevalent among construction jobs. The repetitive, often overhead motions like painting and carpentry can damage your rotator cuff.
- Athletes – Baseball players, basketball players, javelin throwers, and other athletes often experience rotator cuff injuries because of the constant stress on their rotator cuff muscles and tendons.
- Weightlifting – Overhead lifting and pressure from the weights can increase the chances of weightlifters developing rotator cuff syndrome. Shoulder pain when using dumbbells and lifting weights in shoulder and chest exercises is typical of rotator cuff syndrome.
Is Your Shoulder Pain Related To Your Numb Hands Or Fingers
n some people, shoulder pain may be a symptom of a nerve being pinched where it originates in the upper spine. ReadBlood and Nerve Supply of the Shoulder
Consider these conditions:
A pinched nerve, also called cervical radiculopathy, can result in shoulder pain, along with numbness and weakness in your arm and hand.1 Some patients describe the numbing sensation in their hands and fingers as pins and needles. A pinched nerve can occur when a nerve in the neck is squeezed or aggravated.1>
Brachial plexus injuries can cause shoulder pain and numbness and weakness in your arm and hand, among other symptoms.2 The brachial plexus refers to a web of nerves that starts in your neck. It controls feeling and movement in your hand and arm.3,4
Thoracic outlet syndrome is a condition that may cause shoulder and neck pain, as well as numbness in your fingers.5 It occurs when blood vessels or nerves in your collarbone and first rib are squeezed.5
Most of us experience minor instances of shoulder pain and numbness from time to time, and occasionally these symptoms are the result of a more serious medical condition. When it comes to shoulder pain and hand numbness, there are many causes for your doctor to consider.
Don’t Miss: How To Stop Stomach Pain From Eating Pineapple
How To Tell If Shoulder Pain Is Radiating Down Arm
Rotating your head slightly, look backwards over your shoulder and hold for a minute. Once complete, reperform the test on the painful side. If you feel any sort of pain radiating down your arm, an increase in numbing or tingling, move onto the final test. Turn your head to the side that is not painful and hold it there for a few seconds.
Conditions Of The Rotator Cuff
Injuries, poor posture, overuse, repetitive movements, and normal wear and tear of the shoulder joint and rotator cuff muscles can lead to symptoms like pain and weakness. This can make it difficult and painful to perform basic activities of daily living, such as reaching, lifting, carrying objects, getting dressed, and sleeping. Some of the common problems that affect the four rotator cuff muscles include:
Rotator cuff tear: When one or more of the tendons of the rotator cuff is injured or torn, it can cause pain and weakness. Rotator cuff tears are common in older individuals and can be treated with physical therapy, anti-inflammatory medications, and cortisone injections. In some patients, a rotator cuff tear may require surgery to repair the torn tendons.
Calcific tendonitis: In middle-aged individuals , small calcium deposits can form in the tendons of the rotator cuff, leading to inflammation and severe pain. The condition is called Calcific tendonitis and occurs more often in the right shoulder than the left for unknown reasons. People with endocrine disorders like diabetes or hypothyroidism are at greater risk of rotator cuff tendonitis. Conservative treatment consisting of rest, icing, pain medications, and physical therapy is usually effective. Occasionally, rotator cuff tendonitis may requiresurgical treatment.
Don’t Miss: Is Slitting Your Wrists A Painful Way To Die