The Shoulder
Many patients enter our office complaining of shoulder pain, suggesting that they have torn their rotator cuff. In actuality, very few patients have a true Rotator Cuff Tear. There are several etiologies to shoulder pain besides a torn rotator cuff; Adhesive Capsulitis (frozen shoulder), Subacromial Bursitis, Tendinitis, Glenohumeral Instability, Chondrocalcinosis, Osteoarthritis, Gout, Lyme arthritis, and Ganglion Cysts are but a few possible causes of shoulder pain. When diagnosing shoulder pain, it is important to consider the method of injury as well as patient age and lifestyle to determine a patient’s actual condition.
Cause of Injury/Pain
Overuse
- Subacromial bursitis
- Supraspinatus tendinitis
- Bicipital tendinitis
- Impingement syndrome
Forceful Trauma
- Glenohumeral instability
- Adhesive capsulitis
- Fracture
- Rotator cuff tear
Insidious Onset
- Lyme Arthritis
- Adhesive capsulitis
- Ganglion cyst
- Tumor
Age
- Osteoarthritis
- Glenohumeral instability
- Subacromial bursitis
- Supraspinatus tendinitis
- Bicipital tendinitis
- Impingement syndrome
- Ganglion cyst
- Lyme Arthritis
- Adhesive capsulitis
- Chrondrocalcinosis
- Gout
- Rotator cuff tear
Diagnosing Shoulder Problems
The art of diagnosing shoulder problems involves correlating a patient’s history and the results from a series of comprehensive shoulder exams. Understanding not only the symptoms, but the method of injury and its effect on the joint’s strength, motion, and flexibility are vital to diagnosing any orthopedic condition.
As a result, there are over 50 shoulder exam techniques that can be performed by the examining physician without the use of x-ray, MRI, or arthrogram. While the latter imaging exams may be used to confirm clinical suspicion or to justify surgical procedure, a patient’s history and a good physical examination will usually suffice in making a diagnosis and treatment plan. Many of the problems we diagnose are approached in a conservative, non-operative manner, with medication, rest, ice, and physical therapy used in favor over surgery. In the event that surgery is necessary, most shoulder conditions are treated using arthroscopic (scope) techniques in outpatient settings. These techniques minimize surgical incisions, reducing irritation to the shoulder joint and allowing patients to return home immediately after surgery.
Initiating early treatment for shoulder problems is often the best course of action as conditions can be managed and treated before they worsen. If you injure your shoulder or recognize the symptoms of any of the aforementioned conditions, a prompt evaluation by a primary care physician or orthopaedic surgeon is in your best interest.
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