Shoulder Pain - Heart Attack or Rotator Cuff Injury?

The great TV classic ER helps teach armchair physicians to become amateur diagnosticians. He's in shock! She's got kidney stones! Rule-out pheochromocytoma!

But sometimes a little knowledge can be a dangerous thing.

You've learned somewhere - on the network news, in the Science section of The New York Times, or in a CPR class at your job - that shoulder pain can mean you're having a heart attack. Now, seemingly out of the blue, your shoulder begins to ache and throb. Very concerned, you rush to the local emergency room.

The resident's first question, of course, is "where does it hurt"? You point to your right shoulder and blurt out, "Am I having a heart attack?" The resident smiles, gently reassuring. "A heart attack might give you pain in your left shoulder," she says. "Have you been to the gym lately? This might be a rotator cuff strain."

The resident knows that heart attack symptoms usually involve chest pain (in two-thirds of cases), and may include faintness, shortness of breath, sweating, and a feeling of impending doom.1 Chest pain may spread to the back, jaw, and arms. Left arm pain may radiate to the inside of the forearm and the ring and little fingers. So, shoulder pain by itself probably doesn't suggest a heart attack.

She orders an MRI which shows mild damage to the right rotator cuff. What's going on? What exactly is the rotator cuff?

The rotator cuff is a muscular sheath that surrounds the head of the arm bone (the humerus) and the entire shoulder joint (really, two joints - the acromioclavicular and glenohumeral joints). The four muscles that comprise the rotator cuff help raise the arm to the front and the side and help turn the shoulder inward and outward.

If you're a sports fan, you know that rotator cuff injuries affect baseball pitchers, tennis players, swimmers, and football players. Such injuries are due to repetitive motion, and may also result from falling on the shoulder or arm or lifting heavy weights.

Rotator cuff injuries may also be slowly developing and chronic, related to arthritic and degenerative changes in the rotator cuff tendon and the two shoulder joints. Low-grade pain may develop, and the pain may become aching, throbbing, and chronic. Raising the arm may cause pain, and there may be loss of mobility.2

In the above-40 population, lack of exercise and chronically poor posture may contribute to rotator cuff problems. Sitting at a desk all day, with the neck jutting forward and slumped shoulders, places long-term mechanical stress on the rotator cuff.

Chiropractic treatment may be very useful in helping to rehabilitate chronic rotator cuff injuries. The chiropractic physician is expert in evaluating postural problems and associated spinal conditions. By providing effective treatment, postural corrections, and rehabilitative exercise, chiropractors offer a comprehensive therapeutic program to reduce pain, improve shoulder mobility, and regain function.

1Source: Cedars-Sinai www.cedars-sinai.edu
2Baring T, et al: Management of rotator cuff disease. Best Pract Res Clin Rheumatol 21(2):279-294, 2007.

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  • "Life would not be the same without Dr. Jayne! In addition to being the loveliest and most caring person, she's an extraordinary chiropractor. She truly has healing hands, an incredible knowledge of the body (MY body!), an uncanny gift for knowing exactly what the issue is right away, and then correcting it effectively. I always know I can rely on her to correct my neck and back issues when they arise, sometimes just after one visit. And Dr. Lou and Jayne's staff are wonderful - kind and patient, and always extremely helpful. I wouldn't go anywhere else."
    Beth B
  • "Dr Jayne and Dr Lou are both amazing! They offer not just great care, but a warm, welcoming atmosphere— truly family friendly! They go above and beyond and truly care about the whole patient, well beyond chiropractic care. Dr Jayne has offered amazing support and solace through my journey as a new mom and I will always be grateful!"
    Katherine G.
  • "Absolutely amazing ! First, the staff was very friendly. I am 8 months pregnant and I've had a lot of back/shoulder pain, and the doctor Jayne was very friendly and professional. You can tell she know what she's doing. She did an amazing job, when I got up from the chair I felt like I was 10 years old again ! My pain was completely gone. I am so happy I have found that place !"
    Manon J S.
  • "I've seen a whole bunch of chiropractors and Lou and Jayne are the best, by far. They're also two of the sweetest people I know."
    Scott C.
  • "I have no words to express my gratitude for Dr. Jayne. I was looking for a Webster Technique chiropractor during my pregnancy and I am so happy I found her. Thanks to her treatments we were able to turn the baby in optimal position and avoid any kind of medical interventions during delivery. But most of all, I valued her precious advice and physical and emotional support during before and after my baby was born. The most beautiful moment of all was giving my son his very first adjustment when he was only couple of days old. I definitely recommend her and her team!"
    Marija R.
  • "Dr Lou and Dr Jayne are fantastic. They've put my spine back in line and are always the nicest people to work with."
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  • "Friendly and welcoming. I enjoy my visits here as they are short and sweet, and really contribute overall health. Twice a week was all I needed and it has changed my world."
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  • "Dr. Lou has taken care of me for close to 20 years. ALWAYS spot on and just an amazing staff. Thank you for all you do."
    Marc W
  • "For two days I have been dealing with that ache in my bicep and having to stretch my hand and it constantly cracking...within minutes of leaving your office from my adjustment my ache is gone and no need to stretch the hand and when I did no cracking. Magic Hands I tell ya!!"
    Janice Bowman
  • "I highly recommend Family Chiropractors for all you health needs ..... From a tune up to a serious issue they will bring you back to the road of recovery ..... They are knowledgable and listen to your needs and concerns ..... I have gone to Dr Lou for over 10 years and I will tell you as a runnner and a yogi you can not find someone better or more caring ... Give them a try ... I believe you will be glad you did and so will your body."
    Thomas Randazzo
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  • "Drs. Lou and Jayne are the best. Wonderful with even the very youngest children and babies, all the way to folks in later life. Friendly, personable, and strong at what they do -- each with his or her own style. Great to have appointments with both of them! They also have things like a water massage table, which is a wonderfully relaxing mini-escape, and laser treatments for things like carpal tunnel. They are also a gay-friendly business, which encourages me to refer more folks to them."
    Elizabeth Schroeder
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