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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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Reviews By Our Satisfied Patients

  • "I have been going to chiropractors off and on for many years but only when my back was hurting to a point where I had trouble walking due to the back pain. I’ve had a bad back off and on for as long as I can remember so I was anxious to find permanent relief. I started going to Dr. Kip about 2 years ago and after several months I was put on a maintenance program, initially twice a week and months later, once a week. Since I’ve been on the maintenance program, I’ve had no regular issues. These regular visits also have other benefits due to discussions with the Dr. and office staff and info on the “health T.V.”"
    -Ron R.
  • "I have been coming to see Dr. Kip for almost a year. I started coming in because of my back pain but I wasn’t really sure what chiropractic was or how it could help. Today I feel I have a much better understanding and that chiropractic is a very good and necessary asset of healing. My back pain is not so severe now. It feels better, and when it does begin to hurt I know what to do to make it better. The kindness and understanding of the office staff give the whole experience a calming and reassuring vibe."
    -Joycie G.
  • "Our family has been coming to see Dr. Kip for 2 years. We came in initially because Julie was having severe shoulder pain along with numbness in her arms. She thought it was linked to a problem in her neck. Brian suffered from migraines every few months. We didn’t know much about chiropractic care before. We’d had some in the past but never on a regular basis. I believe our family is healthier as a result of chiropractic care. In fact this year has been the healthiest year for our family with no sickness other than colds and Brian experiencing fewer migraines! We love the staff, of course, and the affordable care plan allows our entire family to receive care."
    -Brian K. and Family