That Nagging Shoulder Pain

A Word from Dr. Gary Arthur on Relieving Shoulder Pain

One of the things that has given me the most joy as a doctor over the past 30 years is fixing people’s shoulder problems, allowing them to return to an active lifestyle. I am overjoyed when they can once again engage in the activities they love. What a sense of accomplishment it is to have someone report that they are no longer in pain!

I’ve had my own share of shoulder injuries. One occurred when I lost my footing on some very slippery waterfall rocks, and fell, slamming all my weight on my shoulder. As a result, I dislocated my shoulder, separating my acromioclavicular joint. After having several serious shoulder injuries, I’ve learned how to heal the injury from experience.

Enduring a shoulder injury is not fun. Shoulder pain can be debilitating and severely limit one’s capacity to function and be active. So what can be done?

In order to move towards healing, the first step is to decide that you want change! You must determine that you want to do what needs to be done in order to relieve the pain and experience healing. My team and I are here to help you on that journey!

The first step we take is to figure out what is causing the shoulder pain. To determine this, we start with a history of injury: What happened to your shoulder when it first started hurting? Was it a dislocation, a shoulder separation, a fall, a sports injury? We want to get a sense better sense of the circumstance surrounding the injury. Second, there is an examination comprised of a series of orthopedic tests. This includes a range of motion assessment, a kinesiological muscle test to determine function, and palpation by the doctor to determine where the pain lies and which structures are involved. Then we look for scar tissue and adhesion patterns that are restricting normal movement and function. An X-Ray helps to further develop the diagnosis, determining if there is fracture, separation, or degeneration within or around the joint. In some cases, an MRI is needed to determine if we will need the involvement of an orthopedic surgeon. On the other hand, we commonly get referrals from Orthopedists that would like to try conservative care before undergoing surgical intervention. Thus, the care for the shoulder depends on the seriousness of the injury, and we always seek to prevent surgery if possible.

As we further the diagnosis, we look into the nerve function. The electrical nerve supply from the neck to the shoulder is very important. There is energy generated in the brain that flows down through the spinal cord and out through the nerves from the neck to the shoulder. This supply often times gets diminished with an injury, and it is important to restore the normal flow. It is like a dimmer switch! If you want your lights in your home or office to burn bright, you turn the dimmer switch all the way up. Similarly, if you want your shoulder to heal quickly and work correctly, you need all the energy and nerve supply possible to reach the shoulder. So, we must take a closer look to see if nerve function is affected. We perform several tests to determine the state of one’s nerve function in the shoulder area, and we provide several treatments for improvement when needed.

The diagnosis of the shoulder pain could reveal a wide variety of causes. Common injuries include dislocation, AC joint separation, labral tear, torn rotator cuff muscle, torn bicep, or injury to another muscle in the joint.

 

***The shoulder is the most complex joint in the body with many tendons, muscles, and bones all working along side eachother.

Once the diagnosis is complete and we determine all the tissues involved, we create a plan of care to relieve the pain and restore normal function. This care can include a combination of services including in-office therapies, kinesiological treatments, ART (active release technique), graston technique to help remove adhesions and scar tissue, kinesiological muscle balancing, deep muscle stimulation with the DMS machine, pulsed electromagnetic field therapy, magnetic therapy on acupuncture points, kinesiotaping, gentle adjustments when indicated and home-care exercises. For degenerative shoulders, we have several types of injections in order to aid in the process of regeneration. We have the option of Supartz injections as well as Amniotic Membrane Therapy and Stem Cell Therapy. We also provide a nutritional protocol to help with inflammation and this includes blueberries and other supplements to help tendons and ligaments heal quickly. That’s right, blueberries- a great anti-inflammatory food! Depending on your specific needs, we combine these therapies and healing aids to create a plan of care that is right for you.

The healing process is a group effort. It involves both the doctor, the healthcare team, and the patient. We put together the plan of care and the patient determines why they want to get better and commits to care. Then treatment begins. As the care continues, it has cumulative effects, and just like at a standard physical therapy center, the patient’s progress is evaluated after 12 visits to make sure that the patient is making progress and the treatment is a worthwhile investment of time and resources. Our goal is to relieve the shoulder pain and correct the root issue as quickly and effectively as possible.

Whether you have an acute injury or a chronic  nagging shoulder pain, there is hope for improvement! I look forward to checking out your shoulder to see what we can do to help you get well. We want you to be able to return to a pain-free, active lifestyle.