Shoulder pain first thing in the morning, difficulty putting on shirts and jackets, and pain lifting the arm above the shoulder are all symptoms of a common yet debilitating condition called shoulder impingement syndrome. They are also common symptoms of a condition called rotator cuff syndrome. Unfortunately, those symptoms are one of the few things these two conditions have in common. While there is no difference in how they feel to sufferer, shoulder impingement and rotator cuff syndromes need to be treated very differently for healing to take place.
Shoulder impingement syndrome is an inflammation of three tissues that pass through the sub-acromial space: two tendons and a bursa. All three can inflame together, singly, or any combination of two. Pain is usually felt as a generalized soreness in the shoulder and upper arm; it can be hard to localize the center of pain. Lifting the arm, from the side of the hip and laterally out in an arc above the shoulder and head, can be anywhere form mildly sore to excruciating. The arm can sometimes feel “dead.” Poking around the shoulder could cause “sore-to-the-touch” pain, and definitely lying on it (so first thing in the morning) causes intense pain. People with shoulder impingement often report being woken up frequently from the pain.
Shoulder impingement syndrome is a tricky situation because the inflammation could decrease on its own, and sometimes with the help of over-the-counter medication, which can lead to the sufferer falsely believe the problem has corrected itself, only to find it coming back again. Some people allow injury to come and go repeatedly, treating it minimally until symptoms improve, and then discontinuing treatment, creating a cycle. The long-term problem this may lead to is a fibrotic tissue tendon (painful) which can rupture under the force of otherwise normal movements. One patient ruptured his biceps tendon while using a screw driver. Once that happens, conservative care is no longer an option. The upside is that you have some time before that happens, but believe it or not, there are people who allow their shoulder injury to recur year-after-year. There is no reason one cannot completely heal from a shoulder impingement syndrome, but the right things must be done, and it begins with getting the right diagnosis for your shoulder pain.
Rotator cuff syndrome, like its counterpart, has pain around the shoulder and upper arm. It might also hurt to put on shirts or jackets and also hurts on movement. First thing in the morning pain is common as lying on the shoulder also irritates it. This condition is due to deconditioned muscle and often inflamed irritated tendons. This type of pain feels like it needs to be stretched out, but is very difficult to find the muscle which needs stretching. Rotator cuff syndrome leads to an aching pain that seems to be always there.
An untreated rotator cuff syndrome can be as problematic as a recurring shoulder impingement; however, while the latter leads to fibrosis, this one can lead to frozen shoulder (adhesive capsulitis). Frozen shoulder comes with its own problems, primarily the inability to raise the arm at all. It is an excruciating condition that can be difficult to treat. The upside is that even a frozen shoulder can be treated conservatively (without surgery), which I have treated many in my Beverly Hills, Los Angeles, and West Hollywood sports chiropractic office. The easiest stage to treat is the beginnings of rotator cuff syndrome, and it gets progressively harder as it becomes chronic and ultimately turns into frozen shoulder. So the best approach is to address it early.
The biggest difficulty I see patients have is continuing the treatment and rehabilitation to completion. Because both shoulder pain conditions will feel progressively better over time, it is easy to get a false security that healing is complete when there is still some to go. There are tests which determine the degree of healing, so continuing care until those tests are negative is the surest way to complete healing. For clients who have had the problem for some time before seeing me, or those who have had a number of relapses, I find many have had wrong diagnoses. If you find yourself treating a shoulder pain injury currently and it does not seem to be getting better, call me and I will be happy to evaluate you. I have assessed and treated hundreds of shoulder pain patients. I have helped many avoid surgery and correct their shoulder problems completely, so that they could return to sports, an active lifestyle, and to sleeping through the night without pain. Shoulder pain is no fun, and many times it’s debilitating. Don’t allow your first-thing-in-the-morning shoulder pain to continue – call my Beverly Hills, Los Angeles, and West Hollywood sports chiropractic office and get it healing today.