Shoulder Pain Treatment in Laguna Hills

Shoulder Pain doesn't have a single cause.

Shoulder pain is usually a joint, a rotator-cuff, or a referred-from-the-neck issue. We figure out which.

The shoulder is the most mobile joint in the body and pays for that mobility in stability. It is really a complex of four joints working together, held and steered by the four rotator-cuff muscles and the larger muscles across the back and chest. When one part of that system stops contributing — a restricted joint, a weak or irritated cuff tendon, a shoulder blade that has stopped gliding properly across the ribs — the others compensate, and the compensation is frequently where the pain shows up.

The three main categories present differently. Rotator-cuff problems typically hurt with overhead reaching and with lying on that side at night, and often produce a painful arc partway through raising the arm. Joint-based problems — the shoulder joint itself or the AC joint at the top — tend to hurt at end range in specific directions and can be tender to direct pressure. Pain referred from the cervical spine is the one most often missed: it frequently presents as aching over the outside of the upper arm, is not reproduced by moving the shoulder itself, and may come with neck stiffness or symptoms travelling further down the arm. A frozen shoulder is a fourth, distinct picture, marked by progressive loss of motion in every direction including when someone else moves the arm for you.

The examination exists to separate these. Dr. Rundle tests shoulder range of motion actively and passively — the difference between what you can move and what he can move is diagnostic. Specific orthopedic tests isolate individual cuff tendons and the joint structures. He also examines the cervical spine, because a shoulder complaint with a neck origin will not resolve by treating the shoulder, and this is the case most likely to have been treated unsuccessfully somewhere else first.

Treatment follows the finding. Joint restriction in the shoulder complex, the shoulder blade, or the upper back responds to adjustment — Diversified or the low-force Activator instrument depending on presentation and irritability. Soft-tissue work addresses cuff tendons and the surrounding muscles. Where the cervical spine is the source, the neck is what gets treated. Laser therapy is sometimes added for persistent tendon inflammation that is not settling with adjustment and soft-tissue work alone.

Some shoulder problems are surgical, and a full-thickness cuff tear in an active patient may well be one of them. Dr. Rundle will tell you if that is what the examination suggests rather than treating around it.

Shoulder Pain FAQ.

Why would a chiropractor treat a shoulder rather than a spine?

Because a substantial share of shoulder complaints are not coming from the shoulder. Pain referred from the cervical spine commonly presents as an ache over the outer upper arm, and it will not resolve while the neck goes unexamined. Beyond that, the shoulder blade and upper back govern how the shoulder moves, and restriction there is squarely mechanical joint work.

How can I tell a rotator-cuff problem from something else?

Cuff problems characteristically hurt with overhead reaching and with lying on that side at night, and often produce pain through a specific arc as you raise the arm rather than throughout the range. That said, the presentations overlap enough that the distinction is made by the orthopedic tests that isolate each tendon, not by the symptom description.

I cannot lift my arm at all any more. What does that mean?

Progressive loss of motion in every direction — including when someone else moves your arm for you — is the pattern of adhesive capsulitis, or frozen shoulder. It is a distinct condition with its own course, and it is worth identifying early because the management differs from a cuff or joint problem. Dr. Rundle checks active and passive range specifically to catch this.

Do I need an MRI before coming in?

No. The examination comes first, and it determines whether imaging would change anything. Shoulder MRIs frequently show tendon changes in people with no symptoms, so a scan without a clinical picture to interpret it against can point you at the wrong structure. If Dr. Rundle thinks imaging is warranted after examining you, he will say so.

Will this fix the pain that wakes me up at night?

Night pain on the affected side is one of the more common things shoulder patients want back, and it is often among the earlier things to change once the source is addressed. Whether it changes in your case depends on what is generating it, which is what the first visit establishes. Dr. Rundle will give you his read then.