From Our Experts, News + Insights  |  April 8, 2016  |  Russell (Rusty) C. Wilson, MD

Shoulder Pain: When You Can’t Shrug It Off

The shoulder is a complex joint of mythical strength (at least if your name is Atlas and you’re carrying the weight of the world on it). 

From baseball pitching and carrying little kids to paddling a kayak and lifting overhead, the shoulder gets quite the workout. It’s important to take care of this joint – especially if it’s been injured. One of the most common injuries is to the rotator cuff tendons. 

There are four tendons surrounding the shoulder that provide stability and assist in the normal range of motion. Pain and limited range are often the first indicators that something could be wrong with those tendons. They can be inflamed, partially torn or experience a complete, full-thickness tear. 

After an initial evaluation with your primary healthcare professional, you may be sent for imaging. There are several procedures that allow us to look inside the shoulder joint. Often, imaging is effective in diagnosing unexplained pain and in helping both patients and primary care providers understand the conditions that are causing shoulder pain symptoms.

WakeRad_ShoulderPain_WilsonBlogTypically, the shoulder area can be evaluated with MRI or an ultrasound. Some shoulder injuries are difficult to see without some fluid in the joint – this is when an MR arthrogram might be performed. MR arthrograms can evaluate partial tendon tears and provide an excellent evaluation of the labrum or cartilage lining the joint. Labral injuries may be seen in patients who have dislocated their shoulder joint as well as in athletes. 

Some of the rotator cuff tendons sit underneath the acromioclavicular joint (AC) – the smaller part of the joint on top of the shoulder. Changes in the acromioclavicular joint, either differences in the shape of the acromion or from degenerative arthritis, may predispose you to problems with the rotator cuff tendons, lead to chronic tendon irritation or push you to tears. 

The shoulder is a complex joint and vital to many daily functions we don’t even think about, such as brushing your hair or lifting your groceries. So, if you have an injury, pain or develop difficulty in moving your shoulder, don’t hesitate to see your doctor. 

And remember – prevention is the best medicine! Stronger shoulders are less likely to incur injury and you can strengthen your rotator cuff. Here’s a Real Simple way to improve your shoulder health. Always use caution when starting a new exercise routine and take it slow.

We encourage you to talk with your primary doctor about your shoulder pain and if getting a medical image could be helpful in your situation. If together you determine this course of care, consider Wake Radiology and find out more about our team approach to imaging.

Image credit: Shoulder joint by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) via Wikipedia Copyright Public Domain

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