Shoulder Pain: differential diagnostics to determine the root of the pain. Stop chasing your symptoms.

This simple sentence can mean a dozen different things. Is the pain coming from a tired muscle, deep within the socket of the joint, or an irritated nerve? As a PT, my first job is to be a detective. What is the root cause of the pain because each source requires a different treatment plan.

Here's a simplified guide to help you start decoding the source of your pain:

Muscle Pain:

How it Feels: Usually a dull, deep ache. The area is often tender to the touch and you may feel muscle "knots"

How it Behaves: Symptoms get worse when you use that specific muscle, and often feels better with rest, heat, or gentle stretching. You can usually point your finger right to where your pain is.

Joint Pain:

How it Feels: Deep, internal ache that is described as stiff. It can become sharp with specific movements like squatting or reaching overhead. 

How it Behaves: Causes morning stiffness that gets better with movement throughout the day. The pain is felt deep within the joint making it difficult to point to a specific point of pain.

Nerve Pain:

How it Feels: Sharp, shooting, burning, tingling, numbness "pins and needles" or "electrical" type sensations. 

How it Behaves: Pain travels or radiates along a clear path. it can happen unexpectedly, even when you're not moving.

Now what gets tricky is that many of these overlap. An issue in your joint can cause your muscles to spasm, but it could also pinch a nerve. If you're unsure what is the root cause of your pain, we're here for you. No MRI, x-ray or referral needed. Contact Cape Concierge Physical Therapy today to determine which is the source of your pain.

What about my Rotator Cuff?

Often times patients assume that shoulder pain is the source of their shoulder pain, but most times that is not true. Most rotator cuff tears are part of a natural degenerative process of the shoulder and are not necessarily related to shoulder pain.

Even if you have a tear it doesn't meant that is the source of your pain. Even if you have an MRI and it shows that you have a tear in one of the muscles that make up your rotator cuff, it doesn't mean that is the source of your pain. Muscles are complex and they have complex referral patterns. Physical therapists are the experts of the musculoskeletal system and we are well equipped to handle such different diagnostics.