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When Diagnosing Shoulder Pain and Discomfort, Location is Key

Shoulder pain is one of the most common medical complaints among patients of all ages, making even simple tasks painful and worrisome. Unless your pain stems from a very recent injury, diagnosing the cause of shoulder pain isn’t always straightforward. That’s mainly due to two reasons: First, the shoulder is a complex joint, and it’s not always easy to determine which structures are causing symptoms. And second, there are many problems that cause pain in and around the shoulder.

As a leading orthopedic doctor in the greater Chicago area (with offices conveniently located in Rockford and Elgin), Dr. Van Thiel is skilled in diagnosing shoulder pain, so patients can feel confident they’ll receive optimal care for their needs.

Types of shoulder pain

Diagnosing shoulder pain starts with determining where the symptoms are located.

Front of the shoulder

Pain located along the front part of your shoulder is most often associated with the biceps tendon or the labrum, the soft cartilage “cup” that helps hold the shoulder joint in place.

  • Biceps tendonitis is an inflammation of the tendon. Pain tends to be worse when you use your upper arm for lifting, carrying heavy objects, or lifting something over your head.
  • Superior labrum anterior posterior tears or SLAP tears typically follow a fall on an outstretched arm. They’re also common in people who use their arms repetitively overhead. Most SLAP tears cause deep shoulder pain along with pain that extends in the front of the joint.
  • Shoulder arthritis is another cause of pain in the front of the shoulder. Typically, pain is accompanied by some stiffness in the joint, along with a deep ache inside the shoulder.

Top of the shoulder

If your pain is focused primarily along the top of your shoulder, it may be caused by the acromioclavicular (AC) joint.

  • AC separation usually follows a fall onto the shoulder or arm. It occurs when the collarbone (clavicle) separates from the shoulder blade (scapula).
  • AC arthritis causes deep aching and a loss of range of motion in the shoulder. You might feel a grinding sensation when you lift your arm or cross your arm over your chest.
  • Distal clavicle osteolysis is a relatively uncommon cause of shoulder pain near the end of the collarbone, occurring in people who do a lot of repetitive heavy lifting.

Surrounding your shoulder
If you have pain all around your shoulder, it may be related to your rotator cuff. The rotator cuff is a group of tendons and muscles that work together to keep all the parts of the shoulder joint together and stable. The rotator cuff also helps your shoulder move and function. Three common rotator cuff problems are tendonitis, bursitis and tendon tears.

  • Rotator cuff tendonitis happens when one or more of the tendons surrounding the shoulder joint become irritated and inflamed.
  • Bursitis is caused by inflammation in tiny sacs of fluid called bursa.
  • Rotator cuff tears happen when the tendons become frayed or partially or completely torn away from the bone.

Rotator cuff problems often cause a lot of pain at night when you’re trying to sleep. They’re also associated with reduced range of motion and increased pain or stiffness when you raise your arm or try to lift heavy objects.

Other causes of “all over” shoulder pain include adhesive capsulitis (or frozen shoulder), shoulder instability and shoulder dislocation.

  • Adhesive capsulitis causes the connective tissue that surrounds the joint to become stiff and inflamed. It’s a relatively common problem that’s associated with both pain and stiffness in the joint, especially when you raise your arm — and even when someone else raises it for you.
  • Shoulder instability happens when your joint is loose and unstable. Most often, instability develops after a dislocation injury or from repetitive use.
  • Shoulder impingement (also called swimmer’s shoulder) happens when the connective tissues inside your shoulder swell and rub against the joint’s bones.

How do I know if my shoulder pain is serious?

Any type of shoulder pain should be taken seriously. Pain in a joint is your body’s way of letting you know that something is not right. Some shoulder pain will resolve on its own with a few days of rest. But how can you tell when you need to see the doctor? Here are some general guidelines to follow:

  • The joint is deformed
  • Pain follows a significant injury, like a fall or car accident
  • Shoulder movement is limited or restricted
  • You have pain when lifting or carrying objects
  • The joint is swollen
  • You have shoulder pain at night or while lying down
  • Pain persists for more than a few days
  • You have pain or numbness radiating into your arm or hand

Shoulder pain accompanied by chest tightness, belly pain or shortness of breath could be a sign of a heart attack, and you should seek immediate medical attention.

Best way to diagnose shoulder pain: Schedule an office visit

Diagnosing shoulder pain on your own is never a good idea. You should always call our office with any type of pain so we can determine if you need to come in for a visit. Ignoring pain means an underlying problem could wind up becoming a lot more serious. Scheduling an exam for shoulder pain is the best way to ensure you get the right treatment for a speedy recovery.

If you’re having shoulder pain or other shoulder symptoms, call OrthoIllinois at   or use our online system to request an appointment with Dr. Van Thiel at his Rockford office today.

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