Shoulder Pain Specialist

Solutions Integrated Medicine

Integrated Medical Clinic & Chiropractors located in Elizabethton, TN

At Solutions Integrated Medicine, we have much success with treating shoulder problems. Whether you have chronic shoulder pain or a recent injury, we have much experience and use the most advanced tools for precision diagnosis and the latest treatments. All of our treatments for shoulder problems are natural and many of our patients have been able to avoid shoulder surgery. If you have recently injured your shoulder, Solutions is the place to come so you can feel better and get to the root of your problem as quickly as possible. If you have suffered with shoulder pain for a long time, contact us immediately for a full evaluation.

Shoulder Pain

Shoulder Problems

There’s no question as to how crippling shoulder pain can be. It’s easy to take for granted how many movements are controlled by your shoulders. This becomes painfully aware when you injure your shoulder and suddenly realize how painful many normal life tasks have become. Jolts of sharp pain when reaching a dial on your car’s dashboard, washing your hair or putting on a shirt cause most shoulder pain sufferers to seek professional help soon. If all the pain and added difficulty during the day doesn't result in a doctor's appointment, nighttime for shoulder pain sufferers is often much worse! Many patients complain of severe shoulder pain and problems when pulling on covers or changing positions and have regular interference with sleep.

Besides all the pain and physical difficulties, the next concern is treatment. The shoulder joint is quite complex and sometimes diagnosis can be elusive; misdiagnosis is common, sometimes regardless of advanced imaging and expert advice. The wrong diagnosis can create the wrong treatment, producing either no changes in the patient’s condition or even potential harm (depending on how invasive the measure). One reason many shoulder problems are misdiagnosed is because the practitioner fails to rule out the spine. Pinched nerves in the mid-upper thoracic and cervical spine can cause symptoms many patients describe as ‘shoulder pain’. Irritated nerve roots also cause neuritis and referred pain into the shoulder joint and/or surrounding areas, commonly mimicking organic shoulder problems.

There are many patients who present with both organic problems in their shoulders (tears, problems with the actual joint) and pinched nerves in their back/neck. Cases where the pinched nerve problem is the primary cause of the patient’s pain are commonly misdiagnosed by traditional medicine. To make it even more difficult, many patients have previous injuries in their shoulders that have already healed (or the body has compensated for) so are no longer causing symptoms, despite positive MRI findings. Unfortunately, this scenario can create patients who get medical treatment (including surgery) on joints that either don’t need it or may have responded with less invasive measures. As a patient, including a good chiropractor in your team of treating physicians for a shoulder problem is smart so they can diagnose and treat any pinched nerves or rule out potential spinal involvement.

Types of Shoulder Problems

Another reason why shoulder problems are tricky to diagnose is because there are numerous different causes. Shoulder pain can come directly from trouble within the joint or can be referred pain from somewhere else in the body. Referred pain to the shoulder can originate from the spine (neuritis/pinched nerve), a gall bladder issue or even a heart problem. Referred pain associated with issues from organs may or may not have other symptoms as well, for example sharp, colicky pain in the upper right quadrant of the abdomen suggests possible gall bladder involvement. Most shoulder issues stemming from the joint itself however can be reproduced from movement.

Acute (sudden) shoulder problems are often characterized by sharp, stabbing pain in the joint associated with certain movements. This is usually the result of some type of injury however not always; there are many patients who suffer with shoulder pain that just woke up with it, unaware of any type of precipitating event. Injuries and/or overuse are common causes of bursitis, rotator cuff sprains/strains and ligament or muscle tears. Pinched nerves in the spine can also cause pain in the shoulder joint that’s very similar to muscular/ligament/tendon sprains, strains and tears. As the shoulder joint is comprised of several joints, the glenohumeral and acromioclavicular joint make up the actual (ball and socket) shoulder joint. Just like any other joint, these can misalign and be the source of acute (or chronic) pain in the shoulder.

Chronic (long term) shoulder pain can be constant, intermittent sharp or dull, achy pain that may or may not be associated with movement. Many chronic shoulder pain patients also have trouble with decreased range of motion and/or severe stiffness. This is often because of joint deterioration and/or degeneration of the soft tissues that help stabilize and contribute to movement. Osteoarthritis of the shoulder is the most common cause of degeneration and reason for shoulder replacement surgery. Bony spurs associated with this condition can be another source of pain and reduced motion in the shoulder. In older adults, postural deterioration can change the angle of the shoulder joint, causing pain directly or setting the joint up for an acute injury.

Diagnosis + Typical Treatment

Regardless of whether it’s acute or chronic, locating the cause of the pain is paramount to receiving proper treatment. Like many other conditions, shoulder problems are generally diagnosed with a series of tests. These may include functional testing like range of motion, orthopedic and muscle strength. For the most complete diagnosis of shoulder pain, different types of imaging can also be important. While x-rays are best for viewing joint deterioration and alignment, MRI is the best imaging for diagnosis of muscular, ligamentous/rotator cuff tears.

Traditional medical treatment for shoulder problems often begins conservatively with anti-inflammatories and/or physical therapy. Sometimes results from therapy can be hit or miss – particularly if the diagnosis is incorrect; rehabilitating a shoulder joint is pointless if the pain is coming from a pinched nerve in the spine. Therapy results can also vary depending on how severe the injury is. Mild to moderate ligament sprains and/or muscular strains should respond well to therapy, however can sometimes take months of diligent work. If there is a tear in soft tissues of the shoulder, physical therapy may work but only if the tear is very small. For larger tears, therapy may not produce any result and can even make the condition worse. Other typical medical treatments for shoulder problems may include pain medication and/or steroids taken orally or injected directly into the joint.

If conservative treatment doesn’t produce the desired result, the next step is usually surgery. While the most common is arthroscopic, the type of surgery will vary depending on what the surgeon thinks needs to be done. Sometimes this may include cleaning out debris/scar tissue, repairing a tear or removal of an osteophytic spur. Unfortunately, many shoulder surgeries also seem to be hit or miss, with many patients either having no result or a worsening of symptoms afterwards. Even if successful (symptomatically), all shoulder surgeries cause scar tissue, leaving the joint in a weakened state and more prone to either future injuries and/or setting up the beginning of arthritic degeneration.

Solution’s Treatment Shoulder Problems

Regardless of whether conservative therapy or invasive surgery was recommended, no traditional medical treatment for shoulder problems will cause the joint to regenerate. Solutions Integrated Medicine is one of the best places to come whether you have chronic shoulder pain or a recent injury. We have both chiropractors and medical personnel on staff to be able to properly diagnose the condition and distinguish between pain from a pinched nerve and an actual shoulder problem. Our treatment programs often consist of a combination of natural treatments designed to relieve pain, help the joint heal and optimize function.

In many cases, we recommend regenerative medicine treatments using either PRP, amniotic fluid or human tissue cellular allograft injections. For acute injuries, regenerative medicine injections help greatly by reducing inflammation and also promoting healing of damaged tissues. For chronic problems such as degenerative arthritis or a frozen shoulder, regenerative medicine is well known for combatting deterioration by filling tissue voids and improving joint space. In nearly every shoulder pain case, rehabilitation therapy is a must for balancing and strengthening the soft tissue structures while the joint is recovering. Often, chiropractic is recommended to reduce structural and nervous system interference that can otherwise limit or lengthen recovery time. Our medical team’s integrative approach and cutting edge treatments have helped many chronic shoulder pain patients with pain relief and even regain function.