Why Atlas Shrugged: The Sore Subject of Shoulder Pain

atlas shruggedWhen people say they feel the weight of the world on their shoulders, their language isn’t always figurative. Literal pain in the area of your shoulders can be an annoyance at least, and debilitating at most. While the cause may seem obvious – injury or overuse – there are actually many different sources and explanations for experiencing shoulder pain.

Discomfort can originate in the joint itself, or from any of the many surrounding muscles, ligaments or tendons. But also certain diseases and conditions affecting structures in your chest or abdomen, such as heart disease or gallbladder disease, can be the cause of shoulder pain. “Referred pain” is the term for an infliction in an area of the body where the cause of the symptoms stems from a different physical region.

Emily Joan Slaven and Jessie Mathers reported on a Duke University Medical Center study in the Journal of Manual & Manipulative Therapy about various sources and conditions causing shoulder pain. You could be experiencing mechanical pain from musculoskeletal structures, including the bones and ligaments. Shoulder pain may also stem from regional structures such as the thoracic spine (upper and middle back) or brachial plexus, which is the nervous system. It’s also possible to experience referred pain from the viscera, or internal organs, which may cause pain in your arm. While pain from the muscles or ligaments surrounding the shoulder usually worsens with additional movement and activity, referred shoulder pain usually doesn’t worsen when you move.

trojan horse

The Trojan Horse of Shoulder Pain

Many of the healthiest activities can bring with them a byproduct of injury causing pain in the neck and shoulder region. While most individuals are advised to take part in sports programs or other workouts, eventual injury can be the result.

Brachial plexus injuryMost injuries to the brachial plexus, the network of nerves in the neck with branches to other nerves that control movement and sensation, are caused by trauma, says the Johns Hopkins Medicine 

website in an article under the heading “Neurology and Neurosurgery.” There are other causes, including:

  • High-speed vehicular accidents
  • Inflammatory processes
  • Neuropathies
  • Stab or gunshot wounds

A brachial plexus injury can leave your arm paralyzed with loss of function and sensation. Nerve grafts, nerve transfers or muscle transfers become necessary to help patients regain function.

Osteoarthritis—The most common form of arthritis, there is no cure for osteoarthritis, says the Mayo Clinic website in an article about the condition. Injury occurs when there is too much wear on the protective cartilage at the ends of your bones. The condition worsens over time and requires those suffering from osteoarthritis maintain a healthy weight and stay active.

Rotator cuff injury—The group of muscles surrounding the shoulder joint, the rotator cuff is made up of tough, rubbery cords connecting the bones to the muscles. The condition causes pain and tenderness just outside a joint and occurs when a person has a repeated motion, in particular, overhead movement, says an article on rotator cuff injury at MayoClinic.org. Occupations experiencing this injury most often are painters, carpenters and athletes, particularly baseball pitchers.

Tendinitis—Inflammation of the thick, fibrous cords attaching muscle to bone is the cause of tendinitis, according to the Mayo Clinic website in a section on tendinitis. The condition causes pain and tenderness just outside a joint. It is commonly found at the shoulder, wrists, knees, elbows and heels, but can occur in any of the body’s tendons. Issues of tendinitis may cause:  


  • Tennis elbow
  • Runner’s knee
  • Pitcher’s shoulder

Polymyalgia rheumatica—An inflammatory disorder that causes muscle pain and stiffness, polymyalgia rheumatica is most evident in the morning, says the Mayo Clinic staff in an article on the hospital’s website in a section on diseases and conditions. Symptoms may include pain in the shoulders, mild fever, fatigue and loss of appetite and weight loss.

Herculean Treatment by Chiropractors

When patients present with pain in the shoulder, neck and arms, one line of treatment involves spinal manipulation. While there are hundreds of adjustment techniques administered by chiropractors across the globe, spinal manipulation is the form of chiropractic adjustment that serves as the basis for newer techniques and is sometimes referred to as high-velocity, low-amplitude (HVLA) thrust. Goals for the treatment include reducing pain, improving motion and restoring function to the head and neck region.

Aim for Elysium

Shoulder pain sufferers have options when it comes to minimizing, or even eliminating, discomfort. Failure to act may inhibit your chance of success, so seeking the advice of a chiropractor is the first priority. Other procedures may follow.

While a practitioner will seek out imbalances, patients need to work on endurance when being treated for shoulder pain, says an article on shoulder injuries by the American Chiropractic Association. While you might lose mobility, you need to build other muscles to compensate. To avoid reinjuring the shoulder joint, a careful rehabilitation pattern must be followed. Restoring mobility can lead to greater stability.

Moving more, not less, is advised for patients recovering from medical trauma to areas related to the shoulder joint. And with early intervention, an ephemeral pain doesn’t have the chance to grow to a level of mythic proportions.

Image used under Creative Commons Licensing courtesy of Emilia Eriksson


Image used under Creative Commons Licensing courtesy of Richard Fisher

Image used under Creative Commons Licensing courtesy of CGP Grey