Common Shoulder Conditions Treated at CHLMD
The shoulder is the most mobile joint in the body — and that mobility comes with vulnerability. The rotator cuff, bursa, glenohumeral joint, acromioclavicular joint, and surrounding musculature are all potential pain generators that require accurate differentiation for effective treatment.
- Rotator cuff tendinopathy and partial tears — inflammation or microstructural damage to the supraspinatus, infraspinatus, subscapularis, or teres minor tendons
- Subacromial bursitis — inflammation of the bursa between the rotator cuff and acromion, producing pain with overhead activity
- Shoulder impingement syndrome — mechanical compression of rotator cuff structures under the acromion
- Adhesive capsulitis (frozen shoulder) — progressive shoulder stiffness and pain from capsular fibrosis
- Glenohumeral osteoarthritis — degeneration of the shoulder joint cartilage
- Acromioclavicular (AC) joint injury — separation, arthritis, or distal clavicle osteolysis
- Biceps tendinopathy and SLAP tears — long head of biceps pathology at the shoulder
- Myofascial shoulder pain — trigger points in the rotator cuff, periscapular, and cervical musculature
Diagnosis and Evaluation
Accurate diagnosis of shoulder pain requires a structured clinical examination that assesses range of motion, strength, specific impingement signs, and rotator cuff integrity. Dr. Lichtblau reviews imaging (X-ray, MRI, or ultrasound) in the context of the clinical presentation — because imaging findings must correlate with symptoms to guide meaningful treatment decisions. When nerve involvement is suspected, EMG and nerve conduction studies differentiate shoulder pathology from cervical radiculopathy.
Nonsurgical Treatment Approach
The majority of shoulder conditions respond well to nonsurgical management. Subacromial corticosteroid injections provide rapid relief from bursitis and impingement, creating a therapeutic window for rehabilitation to proceed. Glenohumeral injections are used for arthritis and adhesive capsulitis. Trigger point injections address periscapular and rotator cuff myofascial pain.
Therapeutic exercise is the cornerstone of shoulder rehabilitation — specifically, rotator cuff strengthening, scapular stabilization, and posterior capsule stretching. These exercises correct the biomechanical dysfunctions that generate and perpetuate most shoulder pain. Physical rehabilitation programs are progressed systematically from pain control through strength restoration and functional movement.
When Surgery Is Considered
Most shoulder conditions do not require surgery. Dr. Lichtblau's nonsurgical approach is appropriate for the vast majority of rotator cuff injuries, bursitis, impingement, and arthritis. For the rare cases where surgery is ultimately required — full-thickness rotator cuff tears, severe instability, or end-stage arthritis — Dr. Lichtblau coordinates surgical referral and provides post-surgical rehabilitation management.
