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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

    My name is Lilian and I have struggled with back pain as a result of poor posture. I have been experiencing scoliosis and nerve aches since my teenage years. After a number of visits with two separate neurologists, their recommendation was to simply use pain medication and accept living in pain. Ultimately, I turned to chiropractic care as a final option. Looking back, I wish I could've known sooner about going to see a chiropractor. This specialized care restored my health and changed my outloo

    Lilian G.

    Excellent service, they explain everything and help you to really improve, not for a simple back adjustment

    Javier A.

    I was diagnosed with fibromyalgia, anxiety disorder and PCOS (polycystic ovary syndrome). I was in constant pain and sometimes wasn't able to do simple household chores. I had horrible fatigue and woke up exhausted every day even if I slept 10 hours. I Had migraines daily and anxiety attacks that eventually would come with no apparent cause. I was depressed and miserable. I went to every specialist: Endocrinologist, cardiologist, neurologist, rheumatologist... Some thought I was crazy and asked

    A. Mendez

    Jennifer had done wonders for my shoulder. My first visit I had shoulder lock and I could barely move my arm at all. Three visits later I have full motion and I haven’t felt better. It’s pretty mind blowing what this place is capable of! Visit ASAP

    Austin P.

    Amazing Doctor. She is very passionate in what she does. Highly recommend her. Her staff is also amazing. I feel great thanks to her skills and compassion. My condition with my back is 95% better thanks to her. Very impressed!!!

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