But how do you tell what is causing your shoulder pain? This article addresses some common ways that the various pain generators of the shoulder are diagnosed from the perspective of an experienced Physical Therapist.
Shoulder pain is a common problem that affects the majority of the population. Most people will experience some degree of pain in their shoulder at some point. The causes of the pain and the degree of the intensity of the symptoms will vary from person to person. The recovery and return to normal function will also vary from person to person for a variety of reasons. But how do you tell what is causing your shoulder pain? This article addresses some common ways that the various pain generators of the shoulder are diagnosed from the perspective of an experienced Physical Therapist.
Three common pain generators of the shoulder are the rotator cuff muscles and tendons, the bursa and the shoulder capsule. The purpose of the rotator cuff muscles and tendons is to move our shoulder in a rotating fashion (hence their name) and to help up elevate our arms over our head. The purpose of the bursa or bursal sac is to protect the muscle from scraping on the edge of the bone. So the bursa sits between the muscle and the bone and acts like a cushion. Without it the rotator cuff muscles would repeatedly scrape on the edge of the bone and become easily irritated. The shoulder capsule offers added stability to the shoulder joint. Any one of these structures can become a pain generator if they are inflamed or injured. Often times they will be inflamed in conjunction with each other.
It can sometimes be tricky to diagnose the exact pain generator because the symptoms that are experienced by people with these pathologies are typically very similar to each other. More often than not these pathologies will cause symptoms of pain, weakness, and loss of motion. The pain is typically felt in the shoulder region and is often felt in the upper arm above the elbow. People with shoulder pain will commonly feel an increase in pain when they are trying to raise their arm overhead or out to the side. So if these pathologies are so similar in nature how can we tell them apart?
Well, in physical therapy there are some simple tests that can be performed that will help distinguish between the different pathologies described above. I will describe them here briefly.
If the symptoms of these pathologies can be so similar then why do we need to be so specific in the diagnosis? The reason is that although symptoms are similar the treatments for these conditions can vary slightly from each other. Some things that I may do for an adhesive capsulitis I might not do to treat a tendonitis and so forth. So a specific diagnosis can help guide the Physical Therapist toward a specific plan of treatment for the pathology in question. A well-rounded treatment plan will lead to positive results in improving your painful shoulder.
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