Shoulder Pain
and Injury

You may not have to live with shoulder pain...

A surprising number of chronic shoulder patients come in to this office misdiagnosed and that is why they continued to suffer for years. With proper diagnosis and treatment protocol, desired results may finally be achieved.

Years ago, if you went to a doctor with pain in your shoulder, you were likely to be diagnosed with a condition called bursitis. “Bursitis” is a fine diagnosis if that was what you actually had wrong with you. But there was often no differential diagnosis and examination to separate the cause of your pain with identifying a different reason such as a rotator cuff tear, tendonitis, subluxation of the shoulder joint, etc. Some time later, a common diagnosis would have been frozen shoulder. Nowadays, you are more than likely to be diagnosed with a rotator cuff injury just for walking in the door and pointing at your shoulder. Shoulder pain can only be resolved with the right diagnosis. For example, if you walk in pointing at your shoulder and you get a diagnosis of a rotator cuff tear and the examination did not rule out bicipital tendonitis or an acronio-clavicular separation which hurt in approximately the same area of your shoulder, you will be treated for the wrong thing and won't be getting the result you were looking for.

Although rotator cuff tears are a “fairly” common injury, an MRI will show “tears” in the rotator cuff of the average person. This can be true of just about anyone who has used their arms throughout their life, especially athletically, by the time they are twenty-five years old. Taking the time to orthopedically examine and differentiate the true cause of the shoulder pain and injury for a conservative solution will increase the chances of a more successful result with your very own shoulder. Although surgical procedures on the shoulder these days can be very beneficial under the right conditions, depending on the tear, if it is not completely torn, patients may be successfully treated without surgery. Health insurance protocols are making it increasingly difficult for doctors to specialize or refer to specialists. Consequently, the true nature of your chronic shoulder pain or shoulder injury may not be diagnosed accurately or treated with current or enough background knowledge. Too many doctors are being forced into treating many problems they may not have sufficient training in.

In a one-and-a-half inch space, there can be as many as twelve different things that could be wrong with your shoulder. They range from rotator cuff tears and bursitis to bicipital tendonitis to acromio-clavicular separation, to entrapment and thoracic outlet syndromes and so forth. It is very important for your doctor to avoid tunnel vision and look above and below the shoulder as well as at the site of pain! Conditions may exist that refer pain to the shoulder and give no outward sign of their source. For example, as many as twenty percent of my patients become symptom-free in their shoulder when I stabilize the elbow! In other cases, shoulder pain can come as a result of an elbow instability that refers pain into the shoulder and that is the only place you feel it and so the cause is missed again. Elbow pain can be caused from an unstable shoulder as well! Kinetic relationships surrounding the shoulder can interfere with healing as well as cause repetitive stress syndromes and need to be addressed.

Whether a patient needs to heal fast and get back in the game from a new injury or is just sick and tired of the pain and is looking for other options besides surgery, my patients know they are in the right place on the first visit

By: Dr. Nancy North

in the Care, Diagnosis and Treatment of Spinal and Extremity Injuries
throughout the United States, Europe and Asia.

Dr. Nancy North, DC, CCSP, CCEP
© 2005 - Present
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