Rotator cuff syndrome is one of the most common causes of chronic shoulder pain. It occurs when the tendon of the rotator cuff muscles (shoulder girdle muscles) is torn (rotator cuff tear) or inflamed (tendinitis). One of the most involved muscles is the supraspinatus. When this happens, the affected shoulder will become painful especially during movement, and the range of motion will be limited.
Adhesive capsulitis, commonly known as frozen shoulder, is another top cause of shoulder pain. Patients usually wake up with pain in the morning due to gelling overnight, and the shoulder will be painful both during passive and active range of motion. Certain conditions such as stroke, Parkinson’s disease, and others can be risk factors for frozen shoulder.
Arthritis of the shoulder joint is most commonly the wear and tear type (osteoarthritis) and can affect either the shoulder joint proper (glenohumeral joint) or the AC joint (acromioclavicular joint) which is the connection between the shoulder and the collar bone (clavicle). The pain associated with this tends to be deep, bony in nature.
When a patient comes to my clinic, I use a combination of very specific questions on history, physical exam maneuvers, diagnostic testing (nerve conduction studies, MRI), to get to the right pain generator. A common issue we see with shoulder pain patients is that they tend to be misdiagnosed and receive medications or even invasive procedures for the wrong pain generator unfortunately. That is why I like to take a step back and examine the facts before individualizing the treatment approach.
The general approach to shoulder pain treatment is a spectrum, starting with more conservative measures (physical therapy for example), progressing to non-opioid medications (usually NSAIDs such as voltaren gel or a short course of oral meloxicam), and if that fails, injection therapy (subacromial bursa injection, glenohumeral joint injection, AC joint injection). The last resort (or if there are specific indications/red flags) is a referral to orthopedic surgery.
Providing specialized neurological and pain management care with a patient-centered approach. Dr. Sader combines clinical expertise with compassionate care to help patients achieve optimal health outcomes.
