Shoulder Pain

Shoulder pain is one of the most common musculoskeletal complaints, and its causes range from simple muscle strain to complex nerve and joint conditions. The shoulder is the most mobile joint in your body, which makes it especially vulnerable to injury. Common causes include rotator cuff tears or tendinitis, shoulder impingement syndrome, bursitis, frozen shoulder (adhesive capsulitis), and arthritis. Importantly, shoulder pain can also stem from nerve issues — cervical radiculopathy (a pinched nerve in the neck) frequently mimics shoulder problems, and conditions like brachial plexopathy or suprascapular neuropathy directly affect the shoulder. Distinguishing between joint, muscle, and nerve causes is essential for effective treatment.

Dr. Zhou takes a comprehensive approach to shoulder pain diagnosis. He performs a detailed physical examination including range-of-motion testing, specific rotator cuff tests (Neer, Hawkins, empty can test), and a neurological assessment of the upper extremity. When a nerve component is suspected, EMG and nerve conduction studies can determine whether the pain is coming from a cervical nerve root, the brachial plexus, or a peripheral nerve around the shoulder. Imaging such as X-rays, MRI, or ultrasound may be used to evaluate the joint structures, rotator cuff, and surrounding tissues. This thorough evaluation ensures nothing is missed and treatment targets the true source of pain.

Treatment is tailored to the specific cause of your shoulder pain. For rotator cuff tendinitis and impingement, Dr. Zhou typically starts with a structured physical therapy program focusing on strengthening and flexibility, combined with anti-inflammatory medications. Joint and bursa injections can provide relief when inflammation is a major component. For nerve-related shoulder pain, treatment is directed at the underlying nerve condition — whether that means addressing cervical radiculopathy or treating a specific nerve injury. BOTOX injections may be used for muscle spasticity or chronic pain. Regenerative medicine options are available for tendon and joint degeneration. Dr. Zhou coordinates care across all these approaches to get you back to full function.