Shoulder Pain
Shoulder pain can originate from the shoulder itself, the cervical spine, surrounding soft tissues, or referred sources. Examination is what determines which structures are most relevant.
Working Out Where the Pain Is Coming From
Most shoulder pain is a shoulder problem. Rotator cuff tendinopathy and tears, subacromial pain, adhesive capsulitis, labral injury, biceps tendon involvement and glenohumeral or AC joint arthritis are all common, and all are managed on their own terms. Establishing which of these is present is the first job of the examination.
Some shoulder-region pain, though, is not coming from the shoulder joint at all. The muscles that move and stabilize the shoulder are supplied by nerve roots from the cervical spine, so cervical radiculopathy can present as shoulder pain — often with pain below the elbow, altered sensation, or weakness in a nerve-root pattern. Thoracic and scapular mechanics can also load the shoulder. These are the presentations where a structural assessment adds something.
The distinction matters clinically. Shoulder pain that reproduces on shoulder-specific orthopedic testing and moves with the arm is a shoulder problem, and treating the neck will not help it. Where examination points to the cervical spine instead, that is where we look. Some presentations also involve both.
When the Neck or Upper Back May Be Involved
Structural findings we assess when the examination suggests a cervical or thoracic contribution:
- • Shifts in the neck may affect nerves associated with shoulder movement, sensation, and muscular function
- • Thoracic and scapular mechanics: Mid-back position and shoulder-blade control affect how the shoulder is loaded
- • Loss of Cervical Curve: A measurable change in neck alignment that may be relevant where cervical findings are present
- • Anterior Head Syndrome: Forward head carriage, which alters resting load through the neck and shoulder girdle
Our Structural Correction Approach
- •Spinal Analysis: We assess structural changes in the neck and upper back that may be contributing to shoulder pain.
- •Targeted Corrections: Specific adjustments to realign your cervical and thoracic spine.
- •Muscle Stabilization: Exercises to strengthen the muscles supporting the neck, scapula and shoulder.