Shoulder or neck?
Pain felt in the shoulder and arm doesn’t always start there. Irritation in the lower neck can be felt over the shoulder blade and down the arm, sometimes with pins and needles or weakness. Pain that is clearly worse with shoulder movements, such as reaching overhead or behind your back, more often comes from the shoulder itself. The examination tests both. See also neck pain.
How shoulder pain usually presents
- Pain reaching overhead or behind your back
- Pain lying on the shoulder at night
- A shoulder that has become stiff in every direction
- Pain with lifting, pressing or throwing, often at the gym or in sport
- Pain, pins and needles or weakness running down the arm
Seek urgent medical care if
Shoulder, arm or jaw pain comes with chest pain, shortness of breath, sweating or nausea: call 000, as this can be a heart problem. Also seek prompt medical care for a visible deformity or loss of movement after a fall, sudden weakness in the arm, or a hot, swollen shoulder with a fever.
How we assess it
About 30 minutes: a history, then an examination of shoulder movement and strength, the rotator cuff and shoulder blade control, the neck and upper back, and neurological testing where symptoms run into the arm.
Where imaging, a medical opinion or an orthopaedic review is needed, we will say so and help you get to the right person.
What care might involve
- Peripheral joint adjustment of the shoulder, shoulder blade and elbow where movement has been lost, using the chiropractic peripheral joint techniques Dr Matthew Schmerl, chiropractor, trained in at Macquarie University
- Adjustment of the neck and upper back, which often contribute to shoulder and arm pain
- Crossover Symmetry shoulder rehabilitation: band-based exercises for the rotator cuff and the muscles that control the shoulder blade
- PowerPlate and strengthening, progressed as your shoulder tolerates it
- Cold laser therapy (Erchonia) where the area is irritable
Which of these suits you, if any, depends on what the examination shows, and you decide what goes ahead.
The realistic version
Many shoulder problems settle over weeks to months with the right loading and strengthening. A frozen shoulder can take considerably longer, and some tears need a surgical opinion. We will tell you which pathway fits.