Shoulder Pain

The shoulder is the most mobile joint in the body, which is exactly why it gets irritated, worn, and injured so readily. At CorePoint in Laguna Hills, shoulder pain is approached with chiropractic care, massage therapy, and cupping, once one specific possibility has been ruled out. That possibility is not a shoulder problem at all, so it goes at the top of the page.

Sudden left shoulder pain can be a heart attack

Call 911 if shoulder pain arrives as sudden pressure or crushing pain, and especially if it runs from the chest toward the left jaw, arm, or neck, or comes with shortness of breath, dizziness, or sweating. MedlinePlus says exactly this on its shoulder pain page. Its heart attack page adds that the discomfort can show up in one or both arms, the back, shoulders, neck, jaw, or upper stomach, and that women more often report unexplained tiredness as a symptom.

Call even if you are not certain. This is an emergency room, never a chiropractic appointment.

Shoulder pain that needs a doctor before a table

Go to an emergency room if you have just taken a serious injury and the shoulder is severely painful, swollen, bruised, bleeding, or visibly out of its normal shape.

Contact your physician promptly, ahead of any manual treatment, if:

• you cannot lift your arm after a fall or a sudden heavy pull. MedlinePlus notes that right after a sudden rotator cuff tear it may be hard to move the shoulder or raise the arm above it, and a full thickness tear that has pulled back from the bone does not heal on its own
• the shoulder hurts along with fever, swelling, or redness
• it is significantly painful even when somebody else moves the arm for you
• the joint has dislocated before, or feels like it is slipping out

Dr. Tina Navarifar checks for this group during every new patient exam and refers out when the findings call for imaging or a medical opinion. MedlinePlus also suggests contacting a provider when shoulder pain lasts more than two to four weeks despite home care, which is a reasonable prompt to have somebody look at it properly.

What is usually behind it

Most shoulder pain is mechanical, and MedlinePlus lists the usual sources: rotator cuff tendinitis, which is also called impingement, along with bursitis, arthritis in the joint, bone spurs, muscle imbalance, frozen shoulder, and tears in the rotator cuff tendons themselves.

The habits behind the common version are ordinary ones. Holding the arm in a single position for hours is one of them, which is why computer work and hairstyling appear on the list, and overhead work such as painting or carpentry sits beside them. Overhead sport belongs there too: tennis, pitching, swimming, and pressing weights. So do sleeping on the same arm night after night and years of poor posture. Pain typically shows up first in the front of the shoulder, travels along the outside of the arm, and announces itself when you reach overhead, behind your back, or out to the side.

When the shoulder is really the neck

Rotator cuff pain has a boundary worth memorizing. MedlinePlus notes that the pain always stops above the elbow; pain that continues past the elbow into the forearm or hand, especially with tingling or numbness, suggests an irritated nerve in the neck rather than a cuff problem. If that description fits, read the neck pain page too, because the exam is a different one.

There is a second pattern worth knowing about. Shoulder pain can be referred from somewhere else entirely, including the neck or the lungs, and its signature is that it hurts at rest and does not get worse when the shoulder moves. That belongs with your physician.

Frozen shoulder moves at its own pace

When a shoulder loses motion rather than simply hurting, the question of frozen shoulder comes up. MedlinePlus describes an inflamed joint capsule that stiffens until reaching overhead or behind your back becomes impossible. Women between 40 and 70 are most affected, though men get it too, and the listed risk factors include diabetes, thyroid problems, hormonal change around menopause, injury, and surgery.

Be skeptical of anyone offering to free it in a couple of visits. MedlinePlus puts progress at weeks and full recovery at as long as nine months to a year, and notes that even untreated the condition often settles within about two years. Gentle work and daily movement have a genuine place in that timeline. A dramatic promise does not.

The exam happens before the treatment

A first visit here is a full hour, and a real part of it is spent working out which structure is actually complaining. Dr. Navarifar takes the history, watches the shoulder move in each direction, tests the rotator cuff and the surrounding muscles, and checks the neck, because a stiff upper back and a guarded neck are so often part of a shoulder story. Only then does she treat, and only after telling you what she found.

Follow-up appointments are 45 minutes, and the emphasis shifts as the shoulder does. She sees every patient herself, so the person who examined your shoulder in March is the person who remembers it in July.

Where each service fits

Chiropractic care addresses joints that have stopped moving well, and for shoulders that regularly means the shoulder complex plus the neck and upper back that feed into it. Manual work here is adapted to what the exam found, and nothing forceful happens to a shoulder that cannot tolerate it.

Massage therapy takes on the muscular half: the rotator cuff muscles themselves, the ones anchoring the shoulder blade, and the ridge of upper trapezius that grips when the shoulder is protecting itself. A session lasts an hour, in the Swedish style or as deep tissue work, and Dr. Navarifar has held a massage license since 2008, well ahead of either doctorate.

Cupping works the same tissue from the opposite direction, lifting rather than pressing, which some people much prefer around a tender shoulder blade. Attached to an appointment you already have, it comes in two kinds: glass cups that rely on a quick flame for their suction, or plastic cups that need no flame. It can also be booked as a 15 minute session by itself.

Between visits

MedlinePlus sets out the standard home care, and it is worth doing: ice the area for about 15 minutes at a time with breaks between, rest the shoulder for a few days, and then return to normal use gradually rather than all at once. If you are recovering from tendinitis, keep moving the joint through its range, precisely so a stiff shoulder does not become a frozen one.

Two small changes help more than they sound like they should: stop sleeping on the painful side, and raise whatever you work on so your arm is not held out or up for hours. Bring the specifics to your visit, since which motion provokes your pain is genuinely diagnostic.

Booking, insurance, and cancellations

Shoulder care starts with the chiropractic hour, and each 45 minute follow-up after it is booked one at a time. Massage and cupping can be scheduled alongside those visits or on separate days. Insurance is billed directly, though what a plan covers varies, and the pricing page sets out each visit's length and the forms of payment accepted. Cancellations need a full day of warning.

Related care at CorePoint

Three services do the shoulder work here:

• Chiropractic care, the hour that produces a working diagnosis and treats the joints behind it
• Massage therapy, for the cuff itself and the muscles anchoring your shoulder blade
• Cupping therapy, a 15 minute addition when the upper back refuses to let go

If your shoulder has been complaining for weeks and none of the warnings above describe it, reserve the first hour or phone (949) 377-4707.