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Shoulder Pain


How Common Are Shoulder Problems?

Shoulder pain is a common complaint that is often associated with neck pain and upper back pain.  The only complaint we see more frequently in our office is low back pain.

“According to the Centers for Disease Control and Prevention, about 13.7 million people in the United States sought medical care in 2003 for shoulder problems.”

When you think of shoulder injuries, you probably think of sports-related injuries seen in baseball or tennis.   However, shoulder injuries can be easily caused by many normal everyday activities. The shoulder is so  susceptible to injury because it has the greatest range of motion of all the joints of the body.  And with increased motion, you have less stability.

To appreciate the incredible design of the shoulder itself and to understand the complexities in caring for shoulder problems we have to first take a look at the basic anatomy of the shoulder.  The shoulder consists of three major bones and over twenty different muscles.

Basic Shoulder Anatomy


The two main bones of the shoulder are the humerus and the scapula (shoulder blade).  The joint cavity us cushioned by articular cartilage covering the head of the humerus and face of the glenoid.  The scapula extends up around the shoulder joint at the rear to form the roof called the acromion, and around the shoulder joint at the front to form the coracoid process.  The end of the scapula, called the glenoid, meets the head of the humerus to form a glenohumeral cavity that acts as a flexible ball-and-socket joint.  A ring of fibrous cartilage surrounding the glenoid is called the labrum, which stabilizes the joint.  Ligaments connect bones of the shoulder and tendons join the bones to the surrounding muscles.


Two major tendons of the shoulder are the biceps tendon, which attaches the biceps muscle to the shoulder and helps stabilize the joint, and the supraspinatus tendon, which helps form the rotator cuff.  Four short muscles originate on the scapula and pass around the shoulder where their tendons fuse together to form the rotator cuff.


Other major muscles that make up the shoulder girdle are the deltoids, the biceps, the triceps, the pectoralis, the rhomboid, the trapezius, the latisimus dorsi, the teres major, the levator scapula, and others.

All of these anatomical components, along with the muscles of your upper body, work together to manage the stress your shoulder receives as you lift, extend, flex, and throw.

Common Shoulder Problems

  • Tendonitis:  Inflammation of a tendon.  Commonly affecting the biceps tendon at the front of the shoulder.  Symptoms include painful shoulder motion and increased pain at night.
  • Rotator Cuff Strain or Rupture:  Injury to the muscle and tendon that covers, rotates, and raises the shoulder.  Symptoms include shoulder pain and difficulty raising the shoulder.
  • Impingement Syndrome: Rubbing and clicking of the shoulder on overhead motions.  The ball of the shoulder joint rubs against the ledge (the Acromium) over the shoulder.  It is frequently associated with tendonitis and rotator cuff problems.  Symptoms include pain during movement of shoulder and increased pain when raising shoulder approaching 90 degrees.
  • Subluxations: Bones shifting from their normal place and becoming “stuck”.  Symptoms include joint stiffness and weakness. Pain may or may not be present.
  • Bursitis: Inflamed bursa sack.  Symptoms include painful to the front or side of the shoulder and pain at night.
  • Myofascial Pain: Muscle inflammation involving any of the shoulder muscles.  Symptoms include local and/or referred pain in the shoulder, the upper back, the neck, the head, the shoulder blade area, or in the arm.
  • Nerve Irritation: Inflamed or irritated nerves originating from cervical spine or the brachial plexus.  Symptoms include shoulder pain, neck pain, arm pain, shooting or burning pain traveling from neck to shoulder, to arm, and to the hand.

Our Approach To Shoulder Problems

First we would start with a thorough case history, consultation, and examination.  I may recommend diagnostic studies (x-ray or MRI) if I need more information. At this point, if I determine that care is appropriate and you decide to begin care, I will design a treatment plan for you.  If at any time I discover something beyond the scope of my practice, I won’t hesitate to contact your primary care provider to discuss a possible referral to another healthcare provider.

We follow a very effective  treatment strategy based on the letters ASR.  They stand for:

My approach that works so well with the spine can be applied to other joints of the body. Virtually every articulation of your skeletal system is susceptible to fixations that can impair function and range of motion.  We have a variety of other treatment options to help you recover quickly and completely.  Some of our other treatment options could include:

  • Massage therapy
  • Laser therapy
  • Electrostimulation treatment
  • Home TENS unit
  • Therapeutic taping
  • Targeted rehabilitative exercises for the shoulder
  • Exercise modification
  • Home exercise program
  • Nutritional supplementation and dietary modification

We don’t want you to have to resort to dangerous medicines, injections, or surgery.  Our approach is to use chiropractic care and other natural therapies (such as massage or rehab exercises) to correct your shoulder problem quickly and  naturally.



1 Divyam { 01.26.13 at 3:43 am }

Hello Sir,
I met with an accident a week back , resulting in bruises all over my hands. Now a strange issue has come up, I hear clicking sound when I push my hands back ( bringing the chest forward ). Even m elbow seems to be loose as compared to the right arm. However, I feel pain only after the clicking sound. Otherwise I dont feel ay pain, but this is ver embarrasing. Please assist.

2 Dr. Ken { 03.12.13 at 11:32 am }

Get yourself to a chiropractic or orthopedic doctor to have a thorough examination.

3 Dr. Ken { 03.12.13 at 11:38 am }

Get to a chiropractic or orthopedic doctor for an examination.

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