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Shoulder Pain - Heart Attack or Rotator Cuff Injury?

The great TV classic ER helps teach armchair physicians to become amateur diagnosticians. He's in shock! She's got kidney stones! Rule-out pheochromocytoma!

But sometimes a little knowledge can be a dangerous thing.

You've learned somewhere - on the network news, in the Science section of The New York Times, or in a CPR class at your job - that shoulder pain can mean you're having a heart attack. Now, seemingly out of the blue, your shoulder begins to ache and throb. Very concerned, you rush to the local emergency room.

The resident's first question, of course, is "where does it hurt"? You point to your right shoulder and blurt out, "Am I having a heart attack?" The resident smiles, gently reassuring. "A heart attack might give you pain in your left shoulder," she says. "Have you been to the gym lately? This might be a rotator cuff strain."

The resident knows that heart attack symptoms usually involve chest pain (in two-thirds of cases), and may include faintness, shortness of breath, sweating, and a feeling of impending doom.1 Chest pain may spread to the back, jaw, and arms. Left arm pain may radiate to the inside of the forearm and the ring and little fingers. So, shoulder pain by itself probably doesn't suggest a heart attack.

She orders an MRI which shows mild damage to the right rotator cuff. What's going on? What exactly is the rotator cuff?

The rotator cuff is a muscular sheath that surrounds the head of the arm bone (the humerus) and the entire shoulder joint (really, two joints - the acromioclavicular and glenohumeral joints). The four muscles that comprise the rotator cuff help raise the arm to the front and the side and help turn the shoulder inward and outward.

If you're a sports fan, you know that rotator cuff injuries affect baseball pitchers, tennis players, swimmers, and football players. Such injuries are due to repetitive motion, and may also result from falling on the shoulder or arm or lifting heavy weights.

Rotator cuff injuries may also be slowly developing and chronic, related to arthritic and degenerative changes in the rotator cuff tendon and the two shoulder joints. Low-grade pain may develop, and the pain may become aching, throbbing, and chronic. Raising the arm may cause pain, and there may be loss of mobility.2

In the above-40 population, lack of exercise and chronically poor posture may contribute to rotator cuff problems. Sitting at a desk all day, with the neck jutting forward and slumped shoulders, places long-term mechanical stress on the rotator cuff.

Chiropractic treatment may be very useful in helping to rehabilitate chronic rotator cuff injuries. The chiropractic physician is expert in evaluating postural problems and associated spinal conditions. By providing effective treatment, postural corrections, and rehabilitative exercise, chiropractors offer a comprehensive therapeutic program to reduce pain, improve shoulder mobility, and regain function.

1Source: Cedars-Sinai www.cedars-sinai.edu
2Baring T, et al: Management of rotator cuff disease. Best Pract Res Clin Rheumatol 21(2):279-294, 2007.

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Reviews By Our Satisfied Patients

  • "I can't believe how professional, efficient, and effective the entire staff is at CHAWC. I am out and on my way to work in a short time, while achieving maximum results."
    Jodie Richmond, VA
  • "Dr. Jo has been such a blessing and resource for my health and my back. I have been doing chiropractic for about 15 years, and Dr. Jo's treatments and home therapies have seriously changed my life and my back and neck in the past year. I am in awe of how much better I feel overall and so appreciate their dedication to my health and well-being!"
    Joy
  • ""I have suffered from lower back and sciatica pain for over two years now. Prior to my visit to this practice, I have been x-rayed, tested, MRI, countless specialists visits and not to mention the costs associated with all of that. I have been in chiropractors' offices before and they usually adjust my back and the pain decrease for a day or two but never goes away. Dr. Cally was thorough, knowledgeable in her specialty, and kind. Although, I was skeptical at first but, Dr. Cally's knowledge put me at ease. Needless to say, now I am pain free. Not only she is good with her patients but once you walk-in that office you will feel the good vibe from her staff (happy employee means happy customer), which tells me she is treating her staff good as well. Thank you, Dr. Cally for all you do. You and your practice are hard to find these days. Keep up the good work.""
    Dr. Beygatt, PhD
  • "I can't say enough good things about Dr. Jo and the rest of the staff. I've never enjoyed a medical treatment so much. Every time I come in, I feel like I'm seeing good friends. Chiropractic Care has changed my life for the better, and I believe the philosophy at CHAWC has been key to my success. I have recommended CHAWC to many and will continue to do so!"
    Sunni
  • ""Dr. Cally Parks has so greatly impacted my overall well being! Her thorough and compassionate care has lead me to feeling my best. I highly recommend her to anyone with any back or hip pain.""
    Megan