Should Pain
Care
Find effective shoulder pain treatment in Clinton Township, MI with physician-led care for shoulder injuries, joint pain, and musculoskeletal conditions.
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35103 Silvano Street, Suite 8, Clinton Township, MI 48035
Phone: (586) 275-7044
FAX: (312) 392-5195
Shoulder Pain Treatment
in Clinton Township, Michigan
Shoulder pain can interfere with reaching, lifting, dressing, sleeping, driving, exercising, working, and many other everyday activities.
The shoulder is not a single joint working in isolation. Normal shoulder movement depends on coordinated motion between the upper arm, shoulder blade, collarbone, muscles, tendons, ligaments, and surrounding joints.
Because of this complexity, shoulder pain can have many different causes.
Common conditions include rotator cuff tendinopathy, rotator cuff tears, bursitis, frozen shoulder, arthritis, biceps tendon problems, and injuries involving the shoulder joint. Pain felt in the shoulder can also originate from the neck or nervous system.
How We Can Help?
At Michigan Rehab Consultant, evaluation focuses on determining the likely source of symptoms, understanding how the problem affects function, and developing an individualized treatment plan.
For many shoulder conditions, treatment can begin without surgery and may include exercise, physical therapy, medication, activity modification, and image-guided procedures when appropriate.
If shoulder pain is interfering with sleep, reaching, lifting, work, exercise, or everyday activities, schedule an evaluation with our board-certified Physical Medicine and Rehabilitation physician in Clinton Township, Michigan.
What Causes Shoulder Pain?
Common causes of shoulder pain include:
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Rotator cuff tendinopathy
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Rotator cuff tears
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Subacromial pain or bursitis
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Adhesive capsulitis or frozen shoulder
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Glenohumeral osteoarthritis
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Acromioclavicular or AC joint arthritis
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Biceps tendon disorders
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Calcific tendinopathy
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Shoulder instability
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Labral injury
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Fracture or traumatic injury
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Muscle weakness or imbalance
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Repetitive overhead activity
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Referred pain from the cervical spine
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Cervical radiculopathy
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Peripheral nerve disorders
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Inflammatory arthritis
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Less common infectious, neurologic, or systemic conditions
Determining the cause requires more than
identifying where the patient feels pain.
The physician may evaluate shoulder movement, strength, tenderness, neurologic function, the cervical spine, posture, and the way the shoulder blade and arm move together.
Rotator Cuff–Related Shoulder Pain
Rotator cuff disorders are among the most common causes of shoulder pain.
The rotator cuff consists of four muscles and their tendons:
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Supraspinatus
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Infraspinatus
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Subscapularis
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Teres minor
Together, these muscles help stabilize the shoulder and control movement of the arm.
Rotator cuff–related pain may occur with tendinopathy, partial tendon injury, calcific deposits, or a full-thickness tear.
Symptoms may include:
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Pain when reaching overhead
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Pain when reaching away from the body
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Difficulty lifting
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Pain when reaching behind the back
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Pain when lying on the affected shoulder
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Nighttime shoulder pain
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Weakness
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Difficulty performing work or recreational activities
Not every painful rotator cuff is torn, and not every rotator cuff tear causes symptoms.
The history and physical examination therefore remain important even when imaging is available.
Rotator Cuff Tendinopathy
Rotator cuff tendinopathy refers to a spectrum of conditions involving the rotator cuff tendons.
It may develop gradually and is often associated with repetitive loading, changes in activity, age-related tendon changes, or altered shoulder mechanics.
The condition has historically been described using terms such as:
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Rotator cuff tendinitis
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Shoulder impingement
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Subacromial impingement
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Subacromial pain syndrome
Modern treatment generally focuses less on the idea that a tendon is simply being “pinched” and more on restoring the shoulder's ability to tolerate movement and load.
For most patients with rotator cuff tendinopathy, initial treatment is non-surgical.
Exercise and Rehabilitation
for Rotator Cuff Pain
Exercise-based rehabilitation is a central treatment for rotator cuff tendinopathy.
A rehabilitation program may address:
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Rotator cuff strength
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Shoulder blade or scapular strength
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Range of motion
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Shoulder coordination
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Posture when relevant
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Gradual loading of the tendons
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Work-related movements
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Overhead activities
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Return to exercise or sport
The appropriate exercises depend on the patient's symptoms, strength, mobility, activity level, and goals.
Complete rest is generally not the long-term solution.
Instead, painful activities may be temporarily modified while strength and tolerance are gradually rebuilt.
Physical Therapy for
Shoulder Pain
Physical therapy may help improve:
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Shoulder mobility
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Rotator cuff strength
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Scapular strength and control
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Functional reaching
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Lifting tolerance
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Posture and movement mechanics
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Ability to perform work activities
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Ability to return to exercise or recreation
Physical therapy may also help patients understand which activities can safely continue and how to progressively return to more demanding movements.
A home exercise program is often important so that improvement continues outside formal therapy sessions.
Risk Factors for Knee Osteoarthritis
Shoulder pain can stem from injuries, inflammation, arthritis, nerve issues, or overuse. Identifying the cause is an important step toward finding the right treatment and relief.
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Rotator Cuff Tears
Rotator cuff tears may develop after an injury or gradually over time.
A tear may be:
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Partial thickness
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Full thickness
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Traumatic
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Degenerative
Rotator cuff abnormalities become increasingly common with age, and some tears are present in people who have little or no shoulder pain.
An imaging report showing a tear therefore does not automatically determine treatment.
The physician must consider:
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How the symptoms began
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Patient age
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Strength
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Functional limitations
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Tear size
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Whether the tear was traumatic
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Amount of tendon retraction
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Muscle quality
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Activity demands
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Response to previous treatment
Frozen Shoulder
Adhesive capsulitis, commonly called frozen shoulder, causes progressive pain and stiffness.
Unlike many rotator cuff conditions, frozen shoulder produces significant restriction in both active and passive shoulder movement.
Patients may have difficulty:
- Reaching overhead
- Reaching behind the back
- Putting on a coat
- Fastening clothing
- Washing or styling their hair
- Reaching into a cabinet
- Sleeping comfortably
Frozen shoulder may develop without an obvious injury.
It is more common in people with certain medical conditions, including diabetes.
Symptoms often evolve over months rather than days.
Treatment for Frozen Shoulder
Treatment may include:
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Education
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Appropriate stretching and mobility exercises
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Physical therapy
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Pain management
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Activity modification
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Corticosteroid injection when appropriate
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Image-guided procedures in selected patients
The intensity of exercise should be matched to the stage and irritability of the condition.
Aggressive stretching is not necessarily better and may aggravate a highly painful shoulder.
Recovery can take time, but many patients gradually regain meaningful motion and function.
Shoulder Osteoarthritis
Osteoarthritis can affect the glenohumeral joint, where the upper arm meets the shoulder socket.
Symptoms may include:
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Deep shoulder pain
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Stiffness
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Grinding or crepitus
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Reduced range of motion
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Difficulty reaching
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Difficulty dressing
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Nighttime pain
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Increasing difficulty with everyday activities
As with arthritis in other joints, the severity of symptoms does not always perfectly match the severity of changes seen on an X-ray.
Treatment should consider both imaging and the patient's functional limitations.
Treatment for Shoulder Arthritis
Non-surgical treatment may include:
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Activity modification
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Exercise
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Physical therapy
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Medication
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Topical medication when appropriate
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Intra-articular corticosteroid injection
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Maintaining shoulder mobility
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Strengthening surrounding muscles
Advanced arthritis causing substantial pain and disability despite conservative treatment may require referral to an orthopedic shoulder surgeon to discuss surgical options such as shoulder replacement.
Subacromial Bursitis
A bursa is a small fluid-containing structure that helps tissues glide over one another.
The subacromial-subdeltoid bursa lies near the rotator cuff and may become irritated in association with rotator cuff disorders or repetitive shoulder loading.
Symptoms may include:
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Pain when raising the arm
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Pain when lying on the affected side
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Pain with reaching
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Tenderness around the outer shoulder
Bursitis frequently exists together with other shoulder pathology rather than as an isolated condition.
Treatment should therefore address the underlying shoulder mechanics and functional problem rather than simply treating the bursa.
Biceps-Related Shoulder Pain
The long head of the biceps tendon travels through the front of the shoulder and may contribute to anterior shoulder pain.
Symptoms may include:
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Pain in the front of the shoulder
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Pain with lifting
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Pain with pulling
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Pain during certain overhead activities
Biceps tendon abnormalities may coexist with rotator cuff or labral conditions.
Treatment may include activity modification, rehabilitation, medication, and image-guided procedures when appropriate.
AC Joint Pain & Arthritis
The acromioclavicular, or AC, joint is located at the top of the shoulder where the collarbone meets the acromion.
Pain from this joint may be aggravated by:
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Reaching across the body
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Lifting
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Push-ups or pressing movements
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Sleeping on the affected shoulder
AC joint arthritis becomes increasingly common with age and does not always cause symptoms.
A diagnosis should therefore be based on the clinical picture rather than an X-ray finding alone.
Calcific Tendinopathy
Calcific tendinopathy occurs when calcium deposits develop within a rotator cuff tendon.
Some deposits cause no symptoms, while others can produce significant shoulder pain and inflammation.
Symptoms may develop gradually or, in some cases, become suddenly severe.
Treatment depends on the severity and duration of symptoms and may include:
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Activity modification
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Medication
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Physical therapy
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Corticosteroid injection when appropriate
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Ultrasound-guided procedures in selected patients
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Specialty referral when conservative treatment fails
Can Shoulder Pain Come From the Neck?
Yes.
Not all pain felt around the shoulder originates from the shoulder joint.
Cervical radiculopathy occurs when a nerve originating in the neck becomes irritated or compressed.
Symptoms may include:
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Neck pain
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Shoulder blade pain
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Pain traveling down the arm
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Numbness
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Tingling
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Burning pain
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Arm or hand weakness
A shoulder examination alone may therefore be insufficient in some patients.
At Michigan Rehab Consultant, evaluation may include the cervical spine and neurologic system when the symptoms suggest a nerve-related condition.
Warning Signs:
When to Seek Care Promptly
Most shoulder pain does not require emergency treatment.
Prompt evaluation may be appropriate when shoulder pain occurs with:
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Major trauma
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Visible deformity
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Inability to move the arm after an injury
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Sudden substantial weakness
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Suspected fracture or dislocation
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A hot, red, swollen joint
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Fever with severe shoulder pain
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Progressive arm or hand weakness
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Significant numbness
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New neurologic symptoms
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Unexplained weight loss or systemic illness
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Persistent severe pain that continues to worsen
Chest pressure, shortness of breath, sweating, nausea, or pain radiating from the chest into the shoulder or arm may represent a medical emergency rather than a musculoskeletal shoulder problem and should be evaluated immediately.
Type of Shoulder Pain
Evaluations
Understanding the cause of shoulder pain may require different evaluations, including a physical examination, strength and range-of-motion testing, and imaging when appropriate. These help guide an individualized treatment plan.
X-Ray
Shoulder X-rays may help evaluate:
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Arthritis
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Fracture
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Joint alignment
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Calcific tendinopathy
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Certain bone abnormalities
Musculoskeletal Ultrasound
Diagnostic ultrasound can evaluate many superficial shoulder structures dynamically.
Depending on the clinical question, ultrasound may help evaluate:
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Rotator cuff tendons
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Certain rotator cuff tears
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Long-head biceps tendon
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Subacromial-subdeltoid bursa
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Joint fluid
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Calcific deposits
Ultrasound also allows certain procedures to be performed with real-time visualization.
MRI
MRI may be appropriate when:
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A significant rotator cuff tear is suspected
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There is substantial weakness after trauma
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Symptoms persist despite appropriate treatment
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A labral or other deeper structural injury is suspected
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Surgical planning is being considered
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The diagnosis remains unclear after evaluation
Imaging should be ordered when it is likely to clarify the diagnosis or change treatment—not simply because shoulder pain is severe.
Medications for Shoulder Pain
Medication may be used as one component of treatment.
Depending on the diagnosis and patient's medical history, options may include:
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Topical anti-inflammatory medication
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Oral NSAIDs
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Acetaminophen
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Other condition-specific medications
NSAIDs are not appropriate for everyone and may require caution in patients with kidney disease, gastrointestinal bleeding, certain cardiovascular conditions, anticoagulant use, or medication interactions.
Medication should complement rather than replace rehabilitation whenever an active rehabilitation approach is appropriate.
Shoulder
Injections
Injection treatment may be considered for selected patients when pain interferes with function or participation in rehabilitation.
The appropriate injection depends on the diagnosis.
Possible targets include:
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Glenohumeral joint
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Subacromial-subdeltoid bursa
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AC joint
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Biceps tendon sheath
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Other specific structures when clinically appropriate
A shoulder injection should not simply be given because “the shoulder hurts.”
The target should correspond with the suspected source of symptoms.
Ultrasound-Guided Shoulder Injections
Ultrasound allows the physician to visualize soft tissues, the intended target, and the needle during many shoulder procedures.
Depending on the diagnosis, ultrasound guidance may be used for:
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Glenohumeral joint injections
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Subacromial bursa injections
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AC joint injections
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Biceps tendon sheath injections
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Aspiration of certain fluid collections
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Selected other musculoskeletal procedures
The purpose of image guidance is accurate anatomical targeting.
Injection treatment is generally most useful when incorporated into a broader plan addressing movement and function.
Corticosteroid Injections
Corticosteroid injections may provide short-term pain relief for selected shoulder conditions.
Potential uses may include:
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Painful rotator cuff–related conditions
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Subacromial bursitis
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Frozen shoulder
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Shoulder arthritis
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AC joint pain
The benefits and risks depend on the diagnosis and individual patient.
Repeated injections should not be viewed as a substitute for appropriate rehabilitation, and the number and frequency of injections should be considered carefully.
PRP and Other Biologic Treatments
Platelet-rich plasma, or PRP, and other biologic procedures are marketed for rotator cuff and other shoulder disorders.
Evidence varies substantially depending on the condition, procedure, and outcome being studied.
Current major guidelines do not support presenting these treatments as proven cures for rotator cuff disease.
Patients considering biologic treatment should understand the limitations and uncertainty in the available evidence.
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How Michigan Rehab Consultant Evaluates Shoulder Pain
At Michigan Rehab Consultant, the evaluation focuses on identifying the likely source of symptoms and determining how shoulder pain affects function.
The visit may include:
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Review of when and how symptoms began
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Review of previous injuries or surgery
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Review of previous imaging
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Review of prior physical therapy and injections
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Evaluation of active and passive range of motion
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Rotator cuff strength testing
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Evaluation of the shoulder blade and movement mechanics
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Assessment of the AC joint
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Evaluation of the biceps tendon
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Assessment for instability when appropriate
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Cervical spine examination when appropriate
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Neurologic examination
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Strength, sensation, and reflex testing when nerve involvement is suspected
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Evaluation of work and functional limitations
The physician then determines whether additional imaging, rehabilitation, medication, an image-guided procedure, electrodiagnostic testing, or specialty referral is appropriate.
Shoulder Pain Treatment at Michigan Rehab Consultant
Depending on the diagnosis and patient's individual needs, treatment may include:
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Education and activity guidance
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Personalized home exercise
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Physical therapy
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Rotator cuff strengthening
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Scapular stabilization and strengthening
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Range-of-motion exercises
-
Medication management
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Topical medication
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Activity modification
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Diagnostic musculoskeletal ultrasound when appropriate
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Ultrasound-guided shoulder injections
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Evaluation for cervical radiculopathy or other nerve disorders
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Electrodiagnostic testing when appropriate
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Coordination with physical therapy
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Coordination with primary care
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Coordination with neurology when appropriate
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Coordination with orthopedic surgery when appropriate
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Home-based physician visits for eligible patients who have difficulty traveling to the office
The goal is not simply to reduce a pain score.
Treatment is designed to improve:
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Reaching
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Lifting
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Dressing
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Grooming
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Sleep
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Work activities
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Exercise
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Driving
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Independence
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Participation in everyday life
What to Expect at Your First Visit
During the first visit, the physician will review:
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When the pain began
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Whether an injury occurred
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Location of the pain
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Activities that worsen symptoms
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Weakness or loss of motion
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Nighttime symptoms
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Neck or neurologic symptoms
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Previous imaging
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Previous physical therapy
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Previous injections
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Medications
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Previous surgery
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How the condition affects everyday activities
A focused musculoskeletal and neurologic examination will then be performed.
Additional imaging or testing will be ordered when medically appropriate.
The visit will conclude with an individualized treatment plan that may include exercise, physical therapy, medication, diagnostic ultrasound, an image-guided injection, additional testing, or specialty referral.
Frequently Asked Questions
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Does shoulder pain mean I have a torn rotator cuff?
No.
Rotator cuff tendinopathy, bursitis, frozen shoulder, arthritis, biceps problems, cervical nerve irritation, and other conditions can all cause shoulder pain.
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Does a rotator cuff tear always need surgery?
No.
Many patients improve with physical therapy and other non-surgical treatment.
Surgery may be appropriate for selected traumatic tears, significant weakness, larger tears, persistent functional limitations, or symptoms that do not improve with appropriate conservative treatment.
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Can physical therapy help a rotator cuff tear?
Yes.
Physical therapy can significantly improve pain and function in many patients with symptomatic rotator cuff tears.
However, some tears can enlarge over time, so treatment and follow-up should be individualized.
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What is the difference between frozen shoulder and a rotator cuff problem?
Frozen shoulder typically causes substantial loss of both active and passive shoulder motion.
Rotator cuff disorders may cause painful movement or weakness while passive motion remains relatively preserved.
A physical examination helps distinguish these patterns.
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Do I need an MRI for shoulder pain?
Not necessarily.
Many shoulder conditions can initially be evaluated clinically. X-rays or ultrasound may answer the relevant question in some patients.
MRI is generally most useful when a significant structural injury is suspected or when the result is likely to change treatment.
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Can ultrasound diagnose a rotator cuff tear?
Musculoskeletal ultrasound can evaluate the rotator cuff and may identify certain partial or full-thickness tears when performed appropriately.
The appropriate imaging study depends on the clinical question.
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Can a shoulder injection help?
Yes, in selected patients.
Corticosteroid injections may provide short-term pain relief for certain shoulder conditions.
The appropriate injection location depends on the diagnosis.
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Are shoulder injections always placed in the same location?
No.
Different shoulder conditions involve different anatomical structures.
Depending on the diagnosis, an injection may target the glenohumeral joint, subacromial bursa, AC joint, biceps tendon sheath, or another structure.
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Can shoulder pain come from my neck?
Yes.
Cervical radiculopathy and other neurologic conditions can cause pain around the shoulder or shoulder blade and may also produce numbness, tingling, or weakness in the arm.
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Why does my shoulder hurt more at night?
Night pain is common in several shoulder conditions, including rotator cuff disorders and frozen shoulder.
Night pain alone does not identify one specific diagnosis, which is why the history and examination are important.
When should I see a surgeon for a rotator cuff tear?
Orthopedic evaluation may be appropriate for an acute traumatic tear, significant weakness, substantial functional loss, certain larger tears, or persistent symptoms despite appropriate non-surgical treatment.
The Bottomline
Shoulder pain can arise from the rotator cuff, shoulder joint, bursa, biceps tendon, AC joint, cervical spine, nerves, or other structures.
An MRI abnormality alone does not determine the cause of pain or the appropriate treatment.
For many shoulder conditions, treatment begins with:
-
Education
-
Activity modification
-
Exercise
-
Physical therapy
-
Gradual restoration of strength and motion
-
Medication when appropriate
Image-guided injections may help selected patients participate more effectively in rehabilitation and daily activities.
Surgery has an important role for certain traumatic injuries, significant rotator cuff tears, advanced arthritis, and other specific conditions, but many patients can initially be treated without surgery.
If shoulder pain is interfering with reaching, lifting, dressing, sleep, work, exercise, or everyday activities, contact Michigan Rehab Consultant to schedule a shoulder pain evaluation with a board-certified Physical Medicine and Rehabilitation physician in Clinton Township, Michigan.