“Shoulder” means different things to different people. In medicine, we first distinguish this complaint between a shoulder joint problem, i.e. glenohumeral joint, vs. acromioclavicular joint, vs. neck problem. Shoulder joint problems are quite common, acromioclavicular joints problems are much less common, and neck problems are the most common cause of “shoulder” pain, as patients use the expression.
Neck problems, causing pain of the shoulder, is sometimes, very counterintuitive for patients to understand. And, in fact, many doctors and physical therapists, are sometimes tricked, diagnostically, and fail to identify the cause of shoulder pain in neck pathology. But clinicians must be thoroughly familiar with medically established pain referral patterns, and have long clinical experience, lest they fail to recognize, and treat, the causative pathology.
Fortunately, in this regard, I have seen more than 40,000 patients and after this many patients, even counterintuitive facts become appreciated.
Most patients are familiar with the referred pain phenomenon with regard to heart caused pain. Most know that a heart attack may cause pain of the chest, sternum, left arm, left neck and left jaw regions. Other organs/viscera of the body also cause typical referred pain patterns. The spine is similar in this regard.
So “shoulder” pain usually means pain on the top of the shoulder, the shoulder blade, the side of the shoulder, and the middle back, between the shoulder blades.
Shoulder pain arising from the shoulder joint, i.e. glenohumeral joint, is usually from a rotator cuff injury. This is usually a tear of the muscle and ligament underneath the boney part of the shoulder blade. Shoulder pain from an acromioclavicular joint problem is usually easier to figure out because most have a traumatic cause from a fall.
But shoulder pain from neck pathology is usually felt on the top of the shoulder, or shoulder blade, or between the shoulder blades, or down the arm. Neck pathology is, by far, the most common cause of shoulder pain.
I specialize in treating shoulder pain that is caused by neck pathology. If you have shoulder pain, and need effective diagnosis and treatment, please call my office at 404-558-4015.