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Mom was right, sit up straight to help shoulder pain

Jody McIntyre

You lift up your arms to get something just out of reach and you feel it -- pain in your shoulder. It used to be a slight twinge, but now it’s a consistent ache. Should you be considering a visit to the doctor?

This week’s guest on “Take Care” explains that even if your shoulder pain is a result of some other problem, there are treatment options available. Joining us to discuss these issues is Dr. Stephanie Siegrist. A board-certified orthopedic surgeon, Siegrist is a fellow of the American Academy of Orthopaedic Surgeons and has practiced orthopedics in Rochester for over 20 years.

As with any injury, the decision of when to seek treatment depends on the patient’s level of comfort, but there are some signs to watch out for when it comes to shoulder pain.

“If it’s something that starts very suddenly that starts to interfere with your ability to move the arm or lift anything … once the pain starts to interfere with things you’d rather be doing, it’s worth seeing your doctor to get an evaluation,” Siegrist says.

But how do shoulder injuries occur?

Misconceptions and misuse

Most shoulder pain, aches and injuries are related not to the bone but to the soft tissue around the bone, according to Siegrist. She says the most common problems include muscle strains, arthritis in the joint and rotator cuff injuries.

Siegrist finds there are two major reasons for shoulder pain to occur. One potential cause is injury (like falling with outstretched arms or improperly lifting something). The second, and far more common, cause is what she calls misuse or disuse.

“What I mean by that is we really take our shoulders for granted,” Siegrist says. “We really don’t maintain the core strength or the upper back strength to provide a firm anchor for the upper extremity.”

Bad posture and lack of core strength can actually cause the muscles to get weak and out of balance, she says. And that makes your once-yearly spring cleaning spree considerably more dangerous.

History, then physical exam

“In medical school we’re taught that you make the diagnosis from the patient’s history, so they’re describing their symptoms,” says Siegrist. “You confirm the diagnosis with the physical exam and then you plan your treatment with diagnostic testing like an X-ray or an MRI.”

Typical symptoms and types of shoulder pain, according to Siegrist:

  • aching pain in the arm
  • clicking
  • a sense of instability
  • inability to lift certain things

Follow up physical exams will test certain muscle groups and see what their function is. And an X-ray will give your doctor some clues as to the best treatment option for you, Siegrist says.
Relieve pain, restore function

According to Siegrist, relieving pain and restoring function are the key goals of treatment, but that’s not going to happen with a cortisone shot or a surgery alone. A lot of the responsibility falls on the shoulders (pun intended) of the patient.

“The basis of everything is patients need to be taught to correct their body mechanics and make things stronger,” she says. “So whether that’s through modifying the way they do their usual activities and usual exercises, or working with a physical therapist to get them up to where they need to be and then the patient needs to continue doing those exercises on their own.”

Take a look at an anatomical image of the back, Siegrist suggests. It paints a very obvious picture of why so much of the way we position the rest of our body is related to the health of our shoulders.

“We have muscles that go from the base of the skull to the tailbone -- so the whole length of the spine -- that then come over and anchor the shoulder blade to the body,” Siegrist says.

Try working on core strength and general posture to help keep your shoulders in good shape.