Neck and Shoulder Problems 
A few months ago we had two patients with shoulder pain. They could not have been more similar yet they were very different, let me explain. “John” (not his real name) had pain in the right shoulder. He had fallen about 8 weeks ago on it and landed fairly hard. His pain was worsened with overhead reaching and also reaching behind his back. When I touched his shoulder he had pain in the front of the shoulder. When I pressed on the top of the arm bone it was tender. This indicated probable swelling and inflammation in the bursae which protects the space between the arm bone and the top of the socket in the shoulder. He did not have any pain at all beyond the shoulder. He had fallen on the shoulder and there was swelling in the shoulder area only. This is called a shoulder impingement syndrome. X-rays were also negative. His treatment consisted of moist heat, stretching, stabilization and strengthening of the shoulder as well as ultrasound with cortisone cream and electrical stimulation with an ice cryocuff to reduce inflammation. He responded fairly well. In about 7 ½ weeks he was able to do overhead activities. He was also able to get his arm behind his back. He no longer complained of aching in his shoulder and can do yard chores without pain. He was also able to sleep without pain. This is a pure shoulder muscle and bone problem. Another patient “Sally” (not her real name) had shoulder pain too, however she also complained of pain in her forearm. Her thumb and index finger were also numb and tingling, especially with lifting beyond 10 lbs. She had two children in diapers and had done some recent home renovation work. She had this problem for about two months. There was no known cause according to the patient. She was able to move her shoulder and arm without pain for the most part but when she looked up she complained of neck pain and pain down the right arm. She then remembered her arm and shoulder pain was preceded by neck pain and discomfort. We suspected a neck problem as the cause of her arm and shoulder pain and numbness. We did cervical traction and within a few weeks the pain slowly came out of the arm and shoulder as well as reduced numbness and tingling in her hand. In addition to neck traction we did joint mobilization of her neck, with neck and upper back stabilization and strengthening. Eventually she was able to lift her children and take care of them without symptoms. She also is doing some postural training to keep her shoulders back and sustain her endurance for activities. The key question in telling where shoulder pain is coming from is, ‘Does the pain go down the arm into the forearm and sometimes the hand?’ If it does, in almost all cases the neck must be suspected and examined. If the pain is in the shoulder and only radiates a little towards the elbow then the shoulder must be suspected and examined. If you have pain in your shoulder, neck or arm, give us a call at TriState Hand and Occupational Therapy. We will help you get to the cause of your problem and get some relief. Call 301-759-4263 and schedule a free screening or appointment. Try therapy first at TriState Hand and Occupational Therapy. We can help you get back into the swing of things so you can enjoy life and be yourself again. ****Tips**** -Try a memory foam cervical pillow to reduce stress on your neck at night. -Try to use a mechanical aid instead of carrying heavy materials such as a wheelbarrow, dolly or cart. -If you have difficulty reaching overhead or reaching behind your back, you may have a shoulder problem and need to have it examined. -Avoid swimming if it bothers your shoulder. -Instead of lifting your grandchildren, let them crawl up into your lap. |
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