Shoulder pain is a very common complaint responsible for millions of doctor visits, acupuncture visits and massage therapy visits each year.
Shoulder Girdle Pain – What Causes It
After back pain and headaches, it’s one of the most prevalent musculoskeletal pain complaints for patients. Pain in the shoulder can come from hundreds of causes. Often the cause of the pain is a mystery to the patient since it has often been affected for years and sometimes as long as a decade. Nerves are responsible for messaging and signaling pain, and the shoulder area and the surrounding anatomy is covered by a dense network of nerves and muscle fibers.
Many of the nerves in the shoulder area are on their way to other sites in the body. Often pain or injury in body part is felt in another area such as when a nerve in the back of the head can cause neck pain or a headache in the front of the forehead. This is called referred pain.
Shoulder Girdle Pain – How To Treat It
Successful treatment of shoulder pain really depends on accurate diagnosis from your doctor or healthcare provider and correctly identifying the cause of the pain. An accurate diagnosis is the most integral part in correcting and eliminating shoulder pain.
Discomfort in this anterior chest area can possibly have referred pain from the cardiovascular areas such as the heart or the respiratory area such as the lungs, or digestive system such as the GI tract. Cervical spine (neck) issues can refer pain and discomfort to the upper chest region also.
Shoulder pain does not often refer to the upper chest wall itself. There are a significant number of nerves around the pectoralis major tendon that are coming out of the neck area that go behind the clavicle, also called the collar bone on their way down the forearm along the chest wall.
So it’s easy to imagine that pain in this region can result from referred pain from this rich network of nerves traveling behind the coracoid and pectoralis minor.
Shoulder Girdle Pain – The Connection To The Rotator Cuff
We can see a significant number of nerves passing by the area of the biceps on their way down the arm. Cervically mediated pain can be referred here, pain from other chest wall abnormalities, and certainly shoulder pathology itself can also be referred as anterior shoulder pain.
The other part that can result in interior shoulder pain is a problem with the subscapularis which is the hidden part of the rotator cuff because it’s so often missed.
Occult shoulder instability can also present primarily as anterior shoulder pain. As we move on to the posterior aspect of the rotator cuff here we see the infraspinatus and the teres minor, and typically, pathology here will result in posterior shoulder pain.
Shoulder Girdle – Causes Of Pain
Posterior shoulder pain has many different causes, tightness, muscular strain, referred pain again from the cervical spine, also referred pain in this region can come from a pinched nerve in the shoulder such as the supra-scapular nerve.
There are a large number of deeper, supportive muscles connecting the shoulder girdle to the remainder of the skeleton and a strain or sprain in any of these can result in pain in the upper back in addition to the posterior shoulder and back pain.
So it’s important to see that the shoulder girdle fits within the overall skeletal system and you can imagine if there’s abnormal curvature of the thoracic spine that might make the shoulder blade tilt forward further creating impingement and shoulder pain.