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The Elusive Origin of the Referred Shoulder Pain

Understanding Referred Shoulder Pain

Referred shoulder pain is a condition in which pain is experienced in the shoulder area although it originates a different area of the body, commonly in the neck or spine.  Perhaps the most commonly known example of referred pain is the pain experienced in the left arm during a heart attack.

Referred pain is common in the human body due to the many nerves, which run from the spinal cord to the entire body and limbs. These nerves pass through or around many different structures, joints and tissues.  Referred pain in the shoulder can also be due to structural damage of the shoulder joint, ligaments, or tendons. If this is not the case the most often seen cause of referred shoulder pain is a problem in the cervical spine, chest, or abdomen. Additional causes include infections and complete neurological disorders.

Referred shoulder pain or “shooting pain” can be associated with movement pathologies within the shoulder.  A thorough evaluation by a medical professional is the best only way to ascertain the pain’s true origin. When considering the source of referred shoulder pain in sports, the cause can be a muscle impingement in the upper back. This is most often associated with activities involving aggressive upper torso movements such as twisting and bending. Several examples of these are baseball, football, tennis, and martial arts.

Signs & Symptoms of Referred Shoulder Pain

  • Sharp intense pain in the shoulder.
  • Dull shoulder pain with long duration
  • Weakness in the shoulder and upper arm.
  • Numbness within the shoulder and upper arm.
  • Changes in color.
  • A feeling of coolness or clamminess in the shoulder and/or any part of the arm.

Professional Treatment for Referred Shoulder Pain

  • Rest the affected shoulder.
  • Discontinue all activities that create pain in the shoulder or neck.
  • Utilize the latest physical therapy modalities and rehab devices to reduce swelling and decrease pain.
  • Utilize physical therapy to stretch the neck and upper back.
  • If pain continues or limits activity consult with a medical professional.

Asking the Right Questions Like a Pro

Here’s what a smart pro athlete would ask his/her sports medicine specialists to ensure a fast and safe return to sports:

  1. Is this pain due to damage to my shoulder or is it something else?
  2. How common is this injury within my sport?
  3. Will I need an MRI?
  4. What is the length of recovery time I can expect with this injury?
  5. Would I benefit from consulting with a physical therapist or can I manage this on my own?

Elite Sports Medicine Tips from Mike Ryan

  • Ice it! – Treat any signs of inflammation or pain with regular intervals of ice! Twice an hour for 10-15 minutes should do the trick.  Sure, ice will make it stiff but it will help decrease the source of the pain.
  • Unsure? Be Sure – If you are unsure of the cause of your shoulder pain, stop the activity and see a doctor to find the answer.
  • Fix the real problem first – Pain down the arm can only be treated by first treating the true cause of the pain.
  • Follow a plan – Following a correct diagnosis of the referred shoulder pain cause be sure to follow a strict plan of treatment and time off to prevent re-injury.
  • Know your history – With referred pain of any type it is important to know your medical history in an effort to help your medical professional determine the cause of the pain.
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