Posts Tagged ‘Painful Shoulder’

Patricia is Free From Physical Pain After Dealing With Childhood Abuse!

Help for shoulder pain

Patricia – an accountant with her own practice – had been suffering with a painful shoulder for nearly three years. With her prescribed pain-killers becoming less effective, she had visited her consultant again – but had been dismayed when he’d told her that her only option was a potentially dangerous operation. Not keen on the odds, Patricia had decided to go down the “alternative” route, which is how she came to be sitting in my office.

As soon as Patricia had walked through the door, I felt an immense sadness – coupled with the feeling that something traumatic had happened in her past. As I poured her a coffee, I asked Patricia if she felt weighed down by responsibility in her life. “Absolutely,” she said, “as well as the practice, I also run the family home single-handed and make sure that my elderly parents are looked after too. Why do you ask?”

I explained that the mind and body are very strongly connected – and that very often issues that have psychological roots express themselves as pain or problems within the body. “Curiously,” I told her, “the body tends to speak in puns. For example people who have difficulty expressing themselves often develop ailments around their throat – which is the area we associate with communication and free speech.” Leaning forward in her seat, Patricia looked at me with an intense gaze and softly asked what problem shoulders signified. “It could be one of several things,” I replied, “but it’s amazing how often shoulder problems seem to be connected with ’shouldering’ too much responsibility.”

Patricia agreed that the concept made sense – but as I looked deep in her eyes, I had the overwhelming sense that we needed to explore deeper into the pain. I asked Patricia to close her eyes and talked her into a deep state of relaxation. Then, drawing on the techniques used by the ancient shamans, I asked Patricia – in her mind’s eye – to travel into her shoulder and describe what she could see. “I see a black pyramid – with a lid.” I asked her if it would be safe to remove the lid from the pyramid and as she nodded her response, I directed her to do so.

Immediately Patricia began to sob. After five minutes or so her tears started to subside – and still in a light state of trance she began to talk about how her father had both sexually and physically abused her as a little girl. The tears started again as she recalled her terror. I asked Patricia if she was prepared to do whatever was necessary to free her shoulder from pain. Again she nodded, and together we went through a psycho-dynamic exercise in which she eventually chose to forgive her father, while of course not condoning his actions. Patricia had been quick to realise that only she was being affected by the past, not her father – and that forgiving her father would be her pathway through to freedom.

As we finished the exercise, I asked Patricia to revisit the black pyramid. “Oh,” she said, “its smaller now – but its still there.” Once again she began to cry, this time more softly. Her voice was heavy when she started to speak. “I have never told anyone about the abuse as I didn’t want the family to break up and I thought no one would believe me anyway. But now I’m frightened for my daughters – they don’t know what their grandfather is capable of doing and it would hurt them dreadfully if I shattered their image of him. I have tried so hard to make sure that I am always in the room whenever we go to visit him, just so they are protected.”

Suddenly I began to understand the real message from her shoulder. Patricia was shouldering the responsibility for protecting her daughters – and her father. But she had left herself out of the equation and now her mind was asking her – through her shoulder pain – to deal with the situation. Adamant that she couldn’t tell her daughters the horrible truth, I knew that she had to be shocked into seeing the potential disaster that lay ahead if she kept quiet. “How will you feel if you discover that one of your daughters has been abused by your father – knowing that you could have prevented the situation by being honest?”

A shocked silence lay heavy in the room. “You’re right – but it’s going to be very hard.” I brought Patricia out of her light state of hypnosis and together we worked out a plan for telling her daughters in a way that would protect them but not frighten them.

Patricia left my office looking as though a weight had been lifted from her shoulders. She called me a week later to say that her shoulder pain had eased considerably – and that she was sleeping better than she had for years. A further update a month later revealed that she had gently warned her daughters without going into too much detail – and that her shoulder pain had gone entirely!

Use ice to decrease pain

Shouldering the Pain

Help for shoulder pain

If you have ever woken up at night with a painful shoulder, you’re not alone. It’s a very common complaint in the over 50s, and could be hiding a more serious problem, but one that could be dealt with quickly and simply.Things that go bump in the night

It’s a strange occurrence that shoulder pain is generally much worse at night. People often think that it’s simply to do with the fact that at night, the brain doesn’t have anything else to concentrate on. However, although not yet fully understood, there is a scientific reason that goes some way in explaining the phenomena. It’s all related to our body’s natural rhythms, as our cortisol drops to its lowest level in the early hours of the morning, so the pain increases.

But if you are suffering, what can be done, and what is the probable cause?Dread getting dressed – Symptom 1

Sufferers who have a combination of steady pain when the shoulder is at rest and more intense pain when the arm is raised to shoulder height, for example, when reaching for objects from a shelf or even when driving, may be suffering from a tendon injury. This is where the tendons have changed shape, which may have happened for a number of reasons.

Most sufferers of this type of shoulder problem can be helped with a series of three Hydroctorisone injections.

However, there is some effort required by the patient, as an exercise regime will help to strengthen up the other muscles in the shoulder to prevent them rubbing against the tendon.Hands Up – Symptom 2

Generally, if the type of pain you are feeling is localised on the tip of the shoulder, with pain most obvious when lifting the arm straight upwards, you may be suffering from a degenerative condition which is affecting a small joint located between the collarbone and shoulder blade. Again, the majority of patients can be helped with a course of Hydrocortisone injections.Patience is an unnecessary virtue – Symptom 3

Truly agonising pain and progressive stiffness in the shoulder are symptoms of a ‘frozen shoulder’. Extremely painful, the condition progresses in three stages. The first 6-8 months is characterised predominately by pain, the second 6-8 months by pain and stiffness and the third, by mainly stiffness. Be warned, this condition does not show up by X-ray or by scanning as both of these simply appear normal. The good news is that by 18-24 months the condition will have naturally run its course and resolved itself. If you think that you have a frozen shoulder and do not want to wait, you may be able to benefit from a manipulation of the shoulder under anaesthetic. This should break the natural cycle of events and help restore movement and reduce the pain.Grinding to a halt – Symptom 4

Grating in the shoulder, together with progressive pain and stiffness, and a restriction of all movements, could be a sign of osteoarthritus. This is a condition that needs to be managed and is best controlled with analgesics and anti-inflammatories. Fortunately, only a very few patients with this condition require shoulder replacements, and those that do can be cheered by the fact that this generally has excellent results.

So if your stirrings in the night are due to a painful shoulder, don’t hesitate. Go and see an orthopaedic surgeon. There’s really no need to live with the pain.

From an original article published in IDF50 HEALTH, 29TH AUGUST 2001

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Chiropractic And Shoulder Joint Pain

Help for shoulder pain

This is a very common problem that is seen daily in chiropractic practices. I have patients who come in to my offices  and complain about their painful and stiff shoulder. By this they usually mean that their upper trapezius muscles are tight and painful and that they have restricted movement and pain in the region of the upper thoracic spine where it meets the cervical spine at the neck.Chiropractors enjoy a large success rate with these patients who respond well to manipulation and muscle stretching. The second category of patients are those who have a genuine problem with the shoulder. By this I mean the area where the head of the humerus or upper arm bone inserts into the glenoid fossa of the scapula or shoulder blade.The muscles that hold the humerus in place are called rotator cuff muscles and there are four of those. Painful shoulder conditions that limit movement are common, and are caused by problems with the shoulder joint and its surrounding structures. The shoulder is more prone to injuries than other joints because of its wide range of movementWhat are some of the common causes of shoulder pain? There are several conditions that cause pain and limit movement of the shoulder joint, including:* Rotator cuff disorders. The rotator cuff is a group of muscles and tendons that help to move the shoulder and hold the joint in place. Rotator cuff disorders result from inflammation or damage to the rotator cuff muscles or tendons, or inflammation of the subacromial bursa (which is a fluid-filled pad that sits under the highest part of the shoulder). The inflammation can be caused by general wear and tear that occurs with age, activities that require constant or repetitive shoulder motion (especially above shoulder level), heavy lifting, trauma, or poor posture. Serious  injuries and untreated inflammation of the tendons can cause the rotator cuff to tear. The pain associated with rotator cuff problems is normally felt at the front or on the outside of the shoulder, particularly when you raise your arm or lift something above your head. You may also notice the pain more when lying in bed. Severe injuries can cause weakness of the shoulder muscles, restricted shoulder movement and continuous pain. Your rotator cuff is a group of muscles and tendons that hold the shoulder joint in place and help move the shoulder. The 4 muscles (and their tendons) that make up the rotator cuff include: * the supraspinatus; * the infraspinatus; * the subscapularis; and * the teres minor.

Usually it is the rotator cuff tendons (the thick bands of tissue that connect the muscles to the bones) that tear, but sometimes the tear occurs in the muscle. The most common site of a tear is in the supraspinatus tendon. Severe injuries can cause several of the tendons and muscles to tear. There are special movement tests that your doctor can use to help determine which of the muscles or tendons has been torn. Frozen Shoulder is another painful condition. Frozen shoulder, also known as adhesive capsulitis, is characterised by progressive pain and stiffness in the shoulder. The pain is felt deep in the shoulder joint and may be worse at night. It can be treated by cortisone injections or by a hydrodilatation, a surgical procedure developed by Dr. Frank Burke of Melbourne. This procedure involves an injection of saline and local anesthetic into the shoulder capsule. It is usually not overly painful and is done at his practice in Prahran, Melbourne. This procedure has been very successful in a great majority of patients. The old idea that one had to endure pain for 2 years has been largely disbanded.Dislocation of the shoulder can occur after a fall. Shoulder dislocation occurs when the ball-shaped head of your upper arm bone (humerus) comes out of the shoulder socket. It may be caused by a fall, a sporting injury, or trauma, and is an extremely painful condition. A dislocated shoulder is visibly deformed or out of place, and there may be swelling or bruising around the joint. Shoulder movement is severely restricted in people with a dislocated shoulder.  Doctors can usually put the shoulder bones back into place using gentle manoeuvres. Following a dislocation, the shoulder joint sometimes becomes unstable and is susceptible to repeated dislocations. This condition is known as shoulder instability, and causes pain and unsteadiness when you raise your arm or move it away from your body. Your shoulder may feel as if it is slipping out of place when you lift your arm over your head. Arthritis can cause shoulder pain. Arthritis causes progressive joint pain, tenderness, swelling and stiffness. Both rheumatoid arthritis and osteoarthritis can affect the shoulder joint. Shoulder pain can come from other causes such as referred pain. Sometimes shoulder pain is actually due to problems in your neck or a mixture of several different problems. Rarely, shoulder pain may be caused by infection, problems with the nerves, or a tumour.

Tests need to be done to determine the cause. You may also need to have an X-ray, or other scans, such as an ultrasound scan or MRI. Sometimes, an arthroscopy is needed. In this  test, your doctor can look inside the shoulder joint using a small, telescopic instrument that has a camera on the end.  Your chiropractor will refer you to your doctor if necessary and a referral to a shoulder specialist can be arranged.

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Is The Pain In My Shoulder From A Rotator Cuff Injury

Help for shoulder pain

There are several structures that can cause a painful shoulder. Injury to these structures can lead to the common diagnosis of shoulder tendinitis or a rotator cuff injury. This is not always the case and the source of the pain may not be the shoulder muscles and tendons at all. This article discusses the possible pain generators of the shoulder.

The most recognized way for pain to develop in the shoulder is through trauma. This could consist of something obvious like falling onto your outstretched arm causing your shoulder to jam or trying to push or pull on a stuck object. A less obvious traumatic event could be forcefully using the muscles of the shoulder over time and then pain occurs. This could happen during activities such as chopping firewood, hammering, or exercising in a repetitive fashion. The first traumatic event is identified as a macrotrauma meaning it’s a large and obvious event. The second situation is termed a microtrauma meaning it’s less obvious and occurred with repetitive insults to the muscle tissue. One does not necessarily occur more than the other, but both can cause significant injury and pain.

The macrotraumatic event can lead to injury of the muscle by causing a major tear in the muscle fibers. A muscle tear describes just that, a tear in the muscle. The muscle fibers actually rip apart and become separated from each other or where the muscle tendon inserts on a bone in the shoulder. The rotator cuff muscles can tear to different degrees. The size of the tear can vary and will be termed partial, full or full-thickness tear. It is important to remember that just because a muscle tear is present that doesn’t always mean you will have to have surgery. Signs that a shoulder muscle is torn include but are not limited to pain, weakness, and loss of motion.

A microtraumatic event or repetitive overuse can lead to injury of the muscle by causing minor tears in the muscle fibers. These are small in degree but enough to cause an inflammatory process to occur which leads to pain. Tendinitis is an inflammation of the muscle or tendon. It is not the same as a partial or full tear. The muscle fibers do not actually separate from each other. This type of event can cause significant pain and dysfunction. Signs that a shoulder muscle is inflamed include but are not limited to pain, weakness, and loss of motion.

Another common cause of shoulder pain is bursitis. A bursa is a fluid filled sack that sits between muscle and bone. The bursa is designed to protect the muscle from scraping against the bone, thus it protects it from becoming irritated against the bone. The bursa has a lot of nerve endings in it. When the bursal sac becomes inflamed we call this condition bursitis. Bursitis of the shoulder can be very painful. A bursitis can occur in the shoulder as the result of a macro or microtraumatic event as described above just like a muscle tear or tendinitis can develop. Signs that a shoulder bursa is inflamed include but are not limited to pain, weakness, and loss of motion.

These are three of the most common pathologies that cause pain in the shoulder. You will notice that the symptoms that you may experience as a result of these conditions are very similar. So how do you tell which problem you may have? Well, to determine that you should consult a competent Physical Therapist in your area that specializes in the evaluation and treatment of musculoskeletal and/or orthopedic pathologies. They will be able to successfully diagnose the source of your pain and treat the problem appropriately.

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How to Treat Rotator Cuff Pain

Help for shoulder pain

Shoulder pain can develop from a microtrauma (a rather benign, repetitive activity) performed over a long period of time that gradually wears down the tendons in the shoulder until they become inflamed. It can also be caused by a macrotrauma (a more significant event or activity that can easily be identified as the source of the shoulder pain). This could be a fall onto the shoulder or onto the outstretched arm. Regardless of the cause of the pain the treatment is often similar from case to case with some individual variations.

Treatment of the shoulder can encompass several different areas. Conservative measures include medication such as anti-inflammatories or pain medications, rest, cortisone injections, and or physical therapy. All of these methods can be effective in helping relieve a painful shoulder especially when they are performed in combination with each other.

Often times when you present to your medical doctor with complaints of shoulder pain they will prescribe some medication as described above. It is easy to recommend that a person rest the painful shoulder but it may be difficult to do depending on their occupation or responsibilities at home. Injections for the painful shoulder are sometimes given right away depending on your medical doctor’s philosophy. Some MD’s would rather you attend physical therapy before considering injecting the painful shoulder. Injections are not the end all beat all and they do not offer relief to all patients that receive them. Often times a well rounded physical therapy program can alleviate shoulder pain and you won’t have to consider having an injection.

Physical therapy treatment can consist of the following interventions:

1. Therapeutic exercises: this will consist of range of motion, conditioning, and strengthening exercises. The goal here is to maximize and restore any loss of range of motion, improve the overall endurance of the shoulder blade and shoulder muscles and to improve the strength of these same muscles. Adequate strength of the shoulder blade muscles is just as important as having strong rotator cuff muscles. These two groups must work together in order to restore normal biomechanics and to prevent further injury.

2. Manual therapy: this will consist of hands on treatment that the physical therapist would perform on you. This might consist of joint mobilization (i.e. techniques designed to improve joint motion and relieve pain), or soft tissue massage (i.e. techniques designed to improve muscle and connective tissue flexibility and to relieve pain).

3. Modalities: this consists of machines that the physical therapist may apply to your painful shoulder to assist in pain relief and healing along with the other treatments mentioned above. Some of these machines are ultrasound, electrical stimulation, TENS, or iontophoresis.

All of these interventions can be used in the treatment of a painful shoulder. It is common in clinical practice to use a combination of these interventions. It has been my experience in treating hundreds of shoulder patients over the years that therapeutic exercise is an absolute in the treatment of the painful shoulder. Well rounded exercises that target the shoulder blade and shoulder muscles are the mainstay of any good physical therapy regimen for the treatment of shoulder pain. A painful shoulder can persist for years. With the right education you won’t have to suffer any longer!

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