Shoulder Pain Brooklyn, NY
- Rotator Cuff & Joint Care
- SoftWave-First Approach
- No Drugs or Surgery
Shoulder pain is my favourite example of why I do not like treating based on where someone points. I am Dr. Brian Donovan, and at Nuro Chiropractic in Brooklyn a fair number of people who point at their shoulder have a neck problem.
Where you feel pain and where the problem originates are not always the same place. Shoulder pain is a location. It is not a diagnosis.
How Shoulder Problems Show Up
- Deep ache through the shoulder
- Sharp pain reaching overhead
- Difficulty putting on a jacket
- Pain reaching behind the back
- Weakness while lifting
- Cannot sleep on that side
Some people feel clicking or catching. Others describe a shoulder that feels stiff or frozen. Athletes may only notice it while throwing, pressing, or swimming. And some patients point squarely at the shoulder when the source is the cervical spine.
How I Evaluate Shoulder Pain at Our Brooklyn Office
- 1 Establish how it began, whether there was an injury, which movements reproduce it, and how it affects sleeping, working, dressing, and reaching overhead.
- 2 Assess active and passive range of motion, strength, tenderness, and run orthopedic testing on the structures I suspect.
- 3 Compare active with passive motion. If you cannot raise the arm but I can move it much farther for you, a rotator cuff problem becomes more likely. If both are significantly restricted, I am thinking about a different group including adhesive capsulitis, or frozen shoulder.
- 4 Examine the cervical spine and run a neurological examination when there is arm pain, numbness or tingling, or when the shoulder findings simply do not explain what you are describing.
Digital X-ray helps with fracture, arthritis, and bony change. It does not show me the rotator cuff or labrum. When I suspect a significant tear or a labral injury where the answer would change management, MRI or diagnostic ultrasound is the better test.
Treatment Options I Consider
- Relatively mild mechanical shoulder pain: mobility and stretching, massage and soft-tissue techniques, IASTM, appropriate manual therapy, and progressive rehabilitation.
- Chronic tendon problems such as diagnosed rotator cuff or calcific tendinopathy: SoftWave therapy, which has evidence behind it particularly in calcific rotator cuff tendinopathy.
- A contributing cervical problem: appropriately selected chiropractic care, mobility, soft-tissue treatment, or rehabilitation. That is a long way from saying every painful shoulder needs a neck adjustment.
A large part of shoulder treatment is restoring strength and control, which means progressively loading the rotator cuff and surrounding muscles and improving how the shoulder blade works during movement. If you want to lift, throw, swim, or work overhead again, a shoulder that temporarily feels better has not finished the job. It needs to tolerate those demands.
When a Shoulder Needs Medical Evaluation
New unexplained shoulder or arm discomfort with chest pressure or pain, shortness of breath, sweating, nausea, or faintness requires urgent medical evaluation. Cardiac and other medical conditions can produce pain felt around the shoulder or arm.
A visibly deformed shoulder after trauma, severe swelling, or an arm you simply cannot use needs medical assessment rather than conservative treatment. Sudden substantial weakness after an injury makes me suspicious of a significant rotator cuff tear, fracture, or dislocation.
Progressive neurological weakness, persistent numbness, or muscle wasting may call for MRI, electrodiagnostic testing, or a neurologist or orthopedist. A red, hot, markedly swollen shoulder with fever also needs prompt evaluation.
Shoulder Pain FAQs
Is my shoulder pain coming from my neck?
Sometimes, and it is common enough that I check routinely. Clues include pain travelling below the elbow, numbness or tingling, and a shoulder examination that does not reproduce your symptoms. When the shoulder testing does not explain what you are describing, the neck is the next place I look.
What is frozen shoulder and how long does it last?
Adhesive capsulitis restricts both active and passive motion, which is what distinguishes it in the examination. It typically runs through phases over a considerable period, and honest expectations matter more here than with most shoulder problems. Care focuses on maintaining what motion you have and managing symptoms through it.
Can a rotator cuff tear heal without surgery?
Many partial tears do well with progressive strengthening, and plenty of people function perfectly with imaging that looks imperfect. A large tear with substantial weakness after a traumatic injury is a different situation and deserves orthopedic evaluation. Strength on examination tells me more than the size of the tear on a report.
Why does my shoulder hurt more at night?
Night pain is one of the more common shoulder complaints, and lying on the side compresses structures that are already irritated. Position changes can help in the short term. What actually resolves it is addressing why the tissue became sensitive, which is where the loading work comes in.
Should I stop lifting weights until it settles?
Usually we modify rather than stop. Overhead pressing may come out temporarily while other work continues, since a shoulder that does nothing for two months returns weaker. For athletes and lifters the plan should end with you back under the bar, not merely comfortable at rest.
Identify the Structure, Then Treat It
My first question is not which treatment to use. It is whether this is actually coming from the shoulder, and if so which structure is involved. Then we decide between mobility work, soft-tissue treatment, progressive strengthening, SoftWave, care for a contributing neck problem, imaging, or referral.
Nuro Chiropractic, 9408 4th Ave, Brooklyn, NY 11209. Serving Bay Ridge, Staten Island, Bensonhurst, Park Slope, Prospect Park, Borough Park, Manhattan, Dyker Heights, Williamsburg, and the greater Brooklyn area.