By Mary O’Donoghue, Chief Clinical and Product Officer, MedRisk
Shoulder pain is one the most common musculoskeletal problems in workers’ compensation, second only to low back pain. In fact, it is even more prevalent in some industries. Like low back pain, shoulder pain has been shown to respond well to conservative care, especially physically therapy.
Strenuous work, including heavy lifting over a long period of time, carrying, pulling, or pushing can cause shoulder pain and problems. The type of repetitive overhead arm motion that warehouse workers, flight attendants and construction workers perform also contributes to shoulder issues.
Symptoms include pain at rest and when lifting and lowering the arm or with specific movements. Some patients feel weakness when lifting or rotating the shoulder or experience a crackling sensation when moving the shoulder in certain positions. Limited range of motion and/or pain associated with internal and external rotation and forward flexion can indicate a partial thickness tear of the rotator cuff. Another symptom is painful abduction, which is the movement away from the median plane of the body. Full-thickness tears are indicated by weakness of external rotation and abduction.
Until recently, surgery was the common approach to rotator cuff tears and similar shoulder injuries. Now, guided by research, clinicians are adopting more conservative methods. This usually involves a combination of physical therapy and temporarily modifying activity, such as avoiding heavy lifting or sustained overhead use of the arms.