Do you or someone you know have shoulder pain? Have you had shoulder treatment that hasn’t worked in the past? Was your pain labeled as having something like a rotator cuff tear or shoulder impingement? As a Doctor of Physical Therapy, I am here to say that while you might have shoulder pain, your shoulder might not be the source of your symptoms!
In the video below, Dr. Jacob Templar discusses why your shoulder pain may not be a shoulder problem.
If you don’t like the video or want more information, continue reading.
Impingement and shoulder pain
According to an evidence-based review in 2014, shoulder pain impacts 34% of new patients seen in clinics. Just like other topics I will talk about, impingement is often a catch-all diagnosis for shoulder pain. Additionally, conditions like rotator cuff tears are often non-limiting and do not cause pain in 40-80% of people.
Impingement is described as the pinching of muscles in your shoulder in a small space under the collarbone. However, just because a muscle is being “pinched” doesn’t mean it will hurt. Sure, trauma and swelling associated with impingement can create a change in pressure in the shoulder and create symptoms. Personally, I’d suggest screening the neck and middle back first before addressing the shoulder. In fact, many patients who see me with this type of pain are positive for signs of spine involvement.
Symptoms of shoulder pain
A large portion of symptoms that start in the neck are missed because of a poor history or lack of area-specific screening. Many people with shoulder pain even after previous treatment, and or surgery, are experiencing neck pain and don’t know it. Furthermore, when someone has altered feelings of sensation, you must be suspicious of the spine. These are not common findings when the shoulder is the cause.
Also, the history of your complaint can give away some spine clues. A few of these clues include pain while resting, feeling better with movement, pain that doesn’t get significantly worse with continued use of your shoulder, or an increase in symptoms with sitting or you looking down.
Lastly, a recent scientific article was published showing 29% of people with shoulder pain actually had symptoms starting in their neck! The bottom line is, regardless of what may be the obvious source of our symptoms, your spine should be cleared first. By no means do I want everyone to have a neck or spine issue. I just want to make sure you get the best care for the right area so you can recover optimally.
Next time you see a healthcare provider, make sure to ask them, “could the shoulder pain I’m experiencing be from my neck?” Besides, It’ll only take a few minutes to rule this out and you’ll have peace of mind knowing you’re receiving care in the right area.
- De Yang Tien J, Tan AHC. Shoulder impingement syndrome, a common affliction of the shoulder: a comprehensive review. Proc Singapore Healthcare 2014;23(4):297-305.
- Minagawa, H., Yamamoto, N., Abe, H., Fukuda, M., Seki, N., Kikuchi, K., … Itoi, E. (2013). Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. Journal of Orthopaedics, 10(1), 8–12. http://doi.org/10.1016/j.jor.2013.01.008