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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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  • "I love it there so polite and right to the point never pushy or rude vet respectful. I wouldn’t go anyplace else. Love them all!!"
    Kandice Desalvo V.
  • "Dr. Ho and Dr. Q are caring and compassionate doctors. Their goal is to make you feel great. They take the time to listen to your concerns and address them. I would definitely recommend these doctors!"
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  • "I got refer from a Dear good friend Jennifer which ive been having problems with my neck n knees. I would definitely recommend Pinnacle Wellness they have a great friendly staff n Doctors are great! I've learned a lot about our bodies n etc. I will continue seeing them again !!! My adjustments are great!"
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  • "We have been going to Pinnacle Wellness for over 3 months now, back pain has stopped 100%. We are still blown away by how amazing Dr. Q and Dr. Ho are. We are blessed they came into our lives and have truly added so much to our knowledge about our bodies and even personal growth and development. Pinnacle Wellness is nothing short of a breath of fresh air. Isabelle at the front desk always makes our day. If you are looking for a chiropractor that truly cares for your well being, my family would definitely recommend you to look no further and make Pinnacle Wellness your destination. I had just learned to live with and accept my daily back pain. Thanks to Pinnacle Wellness our lives have been forever changed and look forward to seeing the happy faces of the staff and will be enjoying a pain free life thanks to our journey with Pinnacle Wellness."
    Cara C.
  • "If you have back and/or neck trouble and have never been to a chiropractor before, then this is the place for you. I was referred here by my wife who has been seeing the doctors for several years. Since starting my adjustments I sleep better and feel better all around, and no it doesn't hurt. Currently I am recovering from tennis elbow and bursitis which the doctors are helping me recover by using a massager on my arm when I visit, even my physical therapist was glad they were helping out."
    Royce S.
  • "I have been a patient of Pinnacle Wellness for many years. They have a great, friendly staff and Doctors who truly care about there patients. I would recommend this place to anyone with back or neck pain."
    James S.
  • "The staff is extremely friendly and personable when you enter the facility. They make you feel like you are a part of the family. Our kiddos get adjusted too and for our infant it helped him to crawl properly when he was having difficulties or crawling abnormally. It is a vital part of our healthiness and we would recommend them to everyone!"
    Jennifer C.