Expert: Dr. J. Shawn Leatherman - 10/21/2006

Question
Several weeks ago, I noticed a pain in my left shoulder and arm (both the upper arm and forearm) when I moved my arm toward my back.  There is no pain when my arm is at rest or in a forward position, but it also hurts when I try to straighten it above my head.  I think I may have done some damamge by carrying too much weight day in and day out (a heavy briefcase), but I'm not sure that's the cause.  In any event, I haven't seen a doctor or a chiropractor, as I was hoping the injury would heal on its own.  I think it MIGHT be a tad better than it was a few weeks ago, but the improvement, if any, is not appreciable.  Any ideas what might be causing the problem?  Can you suggest some home remedies to try before I have to see an expert?  Thank you so much for your help!

Answer
Dear Gracie,

Several weeks ago???  Are you kidding me?  You need to bite the bullet and get a professional to perform a thorough orthopedic examination on the neck and shoulder area.  With the history you have give me there is obviously the chance for an overuse injury, but there may be something more insidious such as shoulder impingement, ligamentous tearing, cartilage fragments in the joint space, or nerve root inflammation/encroachment.  You have given this enough time to show an appreciable change for the better if it was nothing more than a simple strain/sprain.

Now if this was just a shoulder issue, I would say that a medical orthopedist would be a good choice for evaluation of the joint.  But you have also mentioned that the pain extends in to the upper and lower arm, which makes me think the problem may be originating in the neck.  The nerves that exit the spinal cord in the neck supply all the sensory and muscular function to the arms.  In particular the C5 and C6 nerve roots innervate the shoulder and arm.  This is also the most common area to have injuries and degeneration in the neck.

I would recommend that you schedule an appointment with a local chiropractic physician.  It would be a bonus if the doctor has post-doctoral training in either sports injuries or orthopedics. Check out credentials and ask your family/co-workers/friends for a referral to someone they trust.  Initial examination should include active ranges of motion of the affected arm and neck, orthopedic tests, neurological tests, evaluation of muscle function, and possible x-rays of the neck depending on what the exam yields.

For the mean time...until you get in to see a doctor...take warm showers before stretching the affected shoulder and the neck, and then follow-up with an ice pack for 20 minutes afterward.  You can also utilize ice packs throughout the day to help alleviate pain-this will aid in the reduction of inflammation.  In addition you need to refrain from lifting over head, and do not replicate pain provoking motion repeatedly as this could cause further damage to any injured tissues.

The bottom line Gracie is that you do need to have this looked at more closely by a qualified physician.  Chiropractors are experts in orthopedic evaluation and management concerning the biomechanics of joints and their surrounding tissues.  Take the steps now to minimize any further progression of the problem.

Respectfully,
Dr. J. Shawn Leatherman