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Another shoulder story 4-Dec-2010 At 1:48:28 PM Elaine Stevenson

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@ropedonkey ..

Among other things, the pain you're getting could possibly be due to something as simple as a trigger point. Overworking a muscle is a great way to cause them and if not treated they can sometimes hang about for ages, often mimicking much more serious pathologies. There are a number of muscles in the rotator cuff and associated areas that refer variously down the arm, into the hand/wrist/fingers and around the scapula/shoulder. Referal symptoms are generally remote to muscle affected and include not only pain, but on occassions tingling and sometimes weakness have also been reported. Sometimes the pain is really distinct while at other times it can be annoyingly vague to try and pin down and describe clearly.

My advice would be to go see a *good* soft tissue person - ie myotherapist, remedial therapist, osteo, physio etc; it doesn't really matter which sort, all should be trained in detection and treatment of TPs. If the problem arises from a TP, diagnosis is simple enough, palpation to find the source of the problem and then localised treatment, either with highly targeted direct pressure or dry needling (like acupuncture).

If a TP (or TPs) are the cuprit then you'll have an answer quickly (treatment will make difference - or not) and depending on the situation (ie there may be another problem causing the TP), most TPs resolve easily with a small number of treatments. If the problem doesn't respond to treatment then further investigation may be warranted, and, depending on the situation, this may involve referral to a neurologist (for nerve conduction studies) and/or ultraound/MRI (to look for issues with joint and surrounding structures).

If you do see a doc, you may want to think about seeing a sports doc rather than a GP. Sports docs tend to me much more clued in to soft-tissue / joint issues and have additional training in assessing and treating musculoskeletal injuries. They also have good networks with other specialists and if xrays or other work is required will send you to someone who specialises in the sort of problem you've got.

That said, some GPs are absolutely brilliant with soft-tissue injuries so if you've got one who's strong in that area, then start with them.

re Acupuncture - yes acupuncture can be very effective for soft-tissue injuries, depending on injury, of course. In addition to acupuncuture (performed by a Licenced Acupuncturist (Chinese Medicine Practitioner)) some osteos, physios, myotherapists and soft-tissue practitioners have specialist training a technique called myofascial dry needling which uses acupuncture needles to treat particular types of musculoskeletal pain and dysfunction.

Hope this helps.
Good luck with your shoulder.

Elaine.
Cheers!