What's your opinion on my shoulder impingement, neck pain, and bone spur?

by Arlene Y
(Rochester, NY)

I'm curious about your opinion on my shoulder impingement.

New Dr. points out something to me on my mri...calls it a bonespur and says he is convinced that THIS is what is causing me all my pain(I was in severe pain for 2 weeks that radiated to the neck and back).

Now he wants to schedule me for surgery and all...but FIRST, cause of neck pain associated with this now, he is sending me to spine/neck dr.

This gets more and more complicated.

I did attend physical therapy for awhile, but it barely addressed the pain area.

Massage and ultra-sound did more than their exercises.

And I always wondered....if certain movements cause pain and inflammation because of the impingement, weren't we just setting me up for more pain and inflammation in doing exercises?

Help...I certainly DONT want surgery, shots or pills.

I want to stop hurting that's all.


Joshua Answers:

Hi Arlene.

Sounds like you're having an adventure of sorts......

So let's see. I'll ask you some questions in a moment, but let me comment on a couple things.

Bone spur included, whether you have actual Tendonitis or not, it's safe to say that you have a Tendonitis Dynamic, which is a progression of muscles getting tighter, connective tissue shrinkwrapping, and pain mechanism (including inflammation), increasing.

Too much pull/pressure/tension, and bone spurs can develop. Removing the bone spur may or may not reduce pain, because the dynamic is still in place.

1. Pain and such could be due to the bone spur. And, bone spurs don't just show up for no reason. So, something caused the bone spur.

Maybe it's a good idea to remove it. But lots of people have bone spurs and no pain. And even if it does get removed, the original problem/cause of your neck and shoulder pain will still be there.

Also, if the bone spur was -the- problem, then wouldn't you -still- have severe pain like you did those two weeks?

Also, my first thought is that you're having a lot of pain in a big area, and I'd want the doctor to explain to me/you -exactly- how that is causing it.

Doctors tend to look for -the- isolated cause of pain. But that's not how the body works. There's always multiple factors at play.

2. There is a RIGHT tool for every job. It sounds like Physical Therapy isn't the right tool for your particular job.

And granted, I'm biased towards skilled massage therapy, and I see pain and injury partly as a function of tight, overworked muscles. Working them more rarely helps, in my experience, until other factors are resolved.

Ironically enough, sometimes exercising a muscle is -exactly- what it needs to make it feel and work better.
Doesn't sound like that's the situation in your case.

Was the PT setting you up for more pain and inflammation?
In this particual case, it looks like the answer is 'yes'.

3. I get what you're saying about just wanting the pain to stop. Pain sucks.

I work under the premise that most anything can be made better, if you figure out the dynamic that is causing the pain and problem, and then reversing that dynamic.

It will take some work and diligence on your part. There is no magic pill.

And maybe we can't get you back to 100%. But I have no doubts that we can get you to 80% plus better and show you how to stay there with minimal effort.

I'm happy to help you out to the extent that you are willing to be motivated to reverse the physical dynamic that got you where you're now at.

4. I'm guessing that you've experienced the usual procedure from the world of doctors, which is rest, pills, maybe corticosteroid shots, prescription for PT, and a push towards surgery.

Good news/bad news, it's all they have in their tool box, and the results you have experienced are unsurprising.

5. Also, as you are looking for an opinion about 'shoulder impingement', I'll have questions about that.

Did you see the Shoulder Impingement page?

So. Questions.

A. Do you have a history of whiplash injury?

B. Why do you think you have a shoulder impingement? Please explain, and describe your symptoms, including, can you lift your arm over your head, is that limited, what other range of motion do you have with your arm?

C. Please describe all your pain and symptoms in detail, including what makes it worse or better, and including how long it's been, did it start out as an ache and progress, or just suddenly appear.

D. Did you do anything in particular that started this?

E. Your age and general activity level, including what are the specific activities you have done regularly with your body over the past decade.

F. What else has the doctor said?

G. What else have you tried, other than PT?

H. Big bone spur, little bone spur?

I. Anything else that may or may not be relevant that would be good information for me.

Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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Comments for What's your opinion on my shoulder impingement, neck pain, and bone spur?

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Sep 28, 2010
What's your opinion on my shoulder impingement, neck pain, and bone spur?
by: Anonymous

In your last statement you asked this person if they had a previous Whiplash injury.
I was rear-ended back in June of 2010. I was told had a process fracture C-7 and a severe case of whiplash. I then found out that the process fracture was old but was still sent to PT.

I started getting pain in my jaw and pain on my rt shoulder. i was told by the PT that that was normal in some cases of whiplash. i was sent to my dentist and was told I had TMJ I then went to an Ortho for my shoulder and was told that I had shoulder impingement tendenitis with 2 bone spurs.

Can all of this happen from whiplash? I am in pain and need to know what to do next. They said more PT...Yes or No? what do you suggest.


Joshua Comments:

Hi Anonymous.

Yes, whiplash can and does ABSOLUTELY cause all that, in both a short term and long term situation.

Should you do PT? Sure. Do a couple sessions and see if it helps. If it doesn't help and/or they don't seem to know what they're doing, then try someone else or some other therapy option.

Granted I'm biased, but I suggest that you get my Reversing Whiplash ebook.

You'll learn about what's happening, and how you can fix yourself. You can't get rid of your bone spurs, but you may or may not find that you can create an ecology where they don't cause you pain, and you'll definitely reverse the environment that is CAUSING the growth of the bone spurs. (Never mind, I just reread and you didn't say you had spurs, but I'll leave this here since somebody that reads this might.)

And, you need a plan, not just a tip/idea or two.

The good news is, it's reversible. The good news is, you can get yourself out of pain and keep yourself out of pain AT HOME without large expense.

The bad news is, it'll take some time and some effort. But it's a lifelong skill you can use.

Oct 06, 2010
Got the same problem as Arlene
by: Anonymous

Josh I have the exact same situation as Arlene. Doctor can only see a bone spur and some arthritis as anything abnormal on an MRI. I'm 41 years old and a little over a year ago i started religiously lifting weights 3x a week which I'm convinced is what caused the bone spur to form on both shoulders (right one worse than the left). With that said I feel I should have the doctor shave it down knowing I can pretty much trace the problem to that activity (which I've since stopped and will not do again!). I've tried PT for a month and its not gotten any better. What are your thoughts? Thanks..


Joshua Comments:

Hi Anonymous.

Well, my only complaint about getting those spurs shaved off is that A. it might not fix anything and B. they might not be the source of the pain.

In other words, those spurs grow because everything in the area has been TOO TIGHT for TOO LONG, and the body responds.

So it very well may work out great to get the doc in there to shave them down. I'm not saying it won't.

Any REALLY good massage therapists around you? If nothing else, if you can soften up your muscles and connective tissue, you may be able to get out of pain without surgery. And if you DO get surgery, your body will respond and recover FAR better if you're soft instead of if you're TIGHT (which it's safe to bet that you are).

1. Ask your doctor how long it would have taken those bone spur's to grow.

2. Not getting any benefit from some PT doesn't necessarily mean anything.....

3. Get your Vitamin D up to between 50-80, and definitely learn about Magnesium for Tendonitis.

Apr 18, 2012
Impingement vs tear plus cyst
by: Anonymous

My MRI report shows labral tear, tendonitis, bursitis and cyst. The Dr. however states he is not certain I have a tear that they over read the MRI and thinks I have an impingement. I do think I have an impingement due to nerves jumping in thumb and forefinger. He gave me a cortisone shot which has now caused muscle spasms on the back of the shoulder and up the back of the neck. I also have jaw pain and my hearing become muffled at times.

I have had two cervical spine surgeries previously with fusion of 4 cervical disc (c4-7) there is no issue noted in the MRI regarding the spine but if they over read the shoulder MRI they may have misread the cervical MRI and my spine Dr. has not yet seen the film on disc.

Most my pain is in the front inner side of the shoulder and into the arm and hurt worse at night. Cortisone shot was given one week ago in the AC joint however with little relief.

The Dr. wants to do athroscopy and scrape the bone to remmove the impingement and see if there is a tear. I do not want any more surgery :-(


Joshua Comments:

Your doctor can't even tell if you have a tear or not?? Hmmmm.

Your doctor wanting to 'remove the impingement' with surgery pisses me off to no end!

Surgery won't remove the impingement. The impingement will remain, but the surgeon will remove YOUR tissue that is getting compressed.

See: Shoulder Impingement

It's like you stepping on a hose, and a hose doctor wanting to cut the hose away so there will be better flow of water. SHOULDN'T YOUR DOCTOR BE WORRIED ABOUT THE FOOT???

Impingement happens for a set of reasons. A very obvious and predictable set of reasons/factors. It's not rocket science. Any why your doctor wants to remove perfectly good tissue from your body is beyond me.

Oh, I take it back, the answer is obvious....he's a surgeon. That's what surgeons do.

What does 'nerves jumping' mean? If you just mean twitches etc, then combine that with jaw pain (clenching) and muffled hearing and I suggest that you would be WELL served by getting a bunch of Magnesium into your system.

Why? Because some of the symptoms of magnesium deficiency are: muscle tightness, muscle spasm, muscle twitch, chronically tight muscle, hearing/inner ear issues, etc, etc, etc.

See: Magnesium for Tendonitis

Apr 18, 2012
Thank you
by: Anonymous

I will try more magnesium. I already take a low dose but not enough.

It is all a guess and gamble and $$$$ which I learned the hard way having spine surgery. I was advised before it the Dr. did not operate I would be paralyzed if I got hit with a car. Well what will it be if I get hit with all this hardware in my neck? Then the surgery failed and I had to have a 2nd one. Not their fault I have DDD but I think the first Dr. I had was about money the second Dr. is not and relieves heavily on PT.


Joshua Comments:

Yeah...not all health professionals (in every category) are created equal....

Jul 27, 2016
Shoulder injury
by: Fernando

My issue is with my left shoulder and injured it back in 2012 and had PT done for about 6 months with a bit of relief.

I still continued to lift weights as prescribed by my PT. She told me to strengthen my shoulder as you lose what you don’t use. Never really felt too much pain and figured it was from my heavy weights and muscle soreness.

As months went by I started to feel like it was more than muscle soreness and noticed my range of motion was off. I again went to PT and talked to my doctor who told me to continue with treatment and continued to lift. Well the pain started and it was bad at times so I went to the doctor and demanded an MRI to see what was going on. Of course my worst fear had come true. This is what they saw

-moderate tendinopathy of superspinatus and infraspinatious
-moderate tendinopathy of the intra-articular portion of the long head of the biceps tendon with longitudinal split
-degenterative labaral tear, predominately involving the posterior and superoir labrum
-posterior subluxation of the humeral head withrespect to the glenoid and moderate chondrosis
-paralabarl cyst posteriorly and inferiorly
-further moderate to severe degenerative changes at the acromioclavicular joint. The acromion has a flat undersurface.

In conclusion:

-Moderate tendinopathy of superspinatus and infraspinatus
-Moderate tendinopathy the inter-articular portion of the long head of the biceps tendon with longitudinal split.
-Extensive degenerative labral tear predominate posterial and superiorly.
-Moderate chondrosis at the glenohumeral head joint. I question whether there may be an elemant of multidirectional instability at the shoulder.
-Moderate to severe degenerative changes to the acromioclavicular joint

One ortho said to leave it alone and to stop the heavy weights and another said he would like to go in and clean it up (bone spur and cysts which got bigger) or try PRP or cortisone shot if I don't want to do surgery.

I have taken 8 weeks off to try and heal and have been pretty depressed because of it.

I have been feeling a bit of discomfort for the past week and am afraid to get the cortisone shot as it may weaken the tendons and make my pain worse. I have an appointment with the sport doc on Aug 11 to discuss the shot or other alternatives.

Any help from you would greatly be appreciated.

Thanks in advance.


Joshua Comments:

Hi Fernando.

1. There is, or is not, an actual bone spur?

2. 'Cleaning it up' may or may not be a good idea. Let's say it gets cleaned up....great. But that means you've been injured by surgery so there's recovery time and an increase in 'muscle guarding' and inflammation.

Which is what got you where you're at in the first place.

3. Degeneration etc doesn't happen by accident.
But your doctors don't ask why or address the reasons.

Basically, short of Osteoporosis, degeneration happens because of tightness.

Let's just say that all the muscles that make up/are attached to your shoulder are too tight, 24/7, and compressing the joint.

So you go throughout your day, lift, etc, over time, with constantly grinding joints (basically).

So while cleaning up may or may not be a good idea, the causes i.e. the Pain Causing Dynamic will still be in play.

I suggest that you get and start working with the Reversing Shoulder Tendonitis program.

Depending, that may be enough to get you entirely pain free and functional again.

Or 80% there (which ain't bad, all things considered).

But the overall ecology will be much more healthy and functional, and then if you do get clean up surgery, your structures will be better able to deal with the trauma, recovery will be better (and you'll be using the program for recovery), etc.

Jul 28, 2016
Surgery or not to have surgery on my shoulder?
by: Anonymous

Hi Joshua,thank you for your quick response and appreciate all the feedback you have given me. To answer your question, yes there is a bone spur that they saw when they did an ultrasound for potential prp shot.

The "clean up" would be to stitch the tear up, deal with the cysts and file down the spur from what I gathered. I get what you are saying but wouldn't surgery deal with my "issues" that you mentioned above and help me heal properly?

Just trying to understand what you are saying, sorry for uneducated in the matter and hope you can further help me understand. I will definitely look into the remedies you posted above but would like some more feed back if you dont mind.


Joshua Comments:

Hi again Fernando.

No problem, I'm happy to answer questions.

It very well may be a good idea to stitch up the tear and grind off the bone spur. Sometimes, depending on the size of things, it just is.

Tears, depending on the scenario, don't heal back/repair themselves on their own without help (surgery).

And an already developed Bone Spur will only ever stay the same size or grow bigger.

The question is, are the tear and/or the spur actually causing pain/problem?

We'll get back to that in a second.

The doctor's theory is that repairing the tear and removing the bone spur will help you heal. And it very well might like I said, tears usually need surgical repair.

But, that doesn't magically solve the problem THAT CAUSED THE TEAR AND THE BONE SPUR.

The tear and spur didn't just show up for no reason. It wasn't an accident.

Doctors will basically tell you that tears happen for no reason. Maybe you'll get a "Oh, your tendon was weak", or "Oh, your connective tissue was weak".

Well even if that's true, WHY was it weak?

WHAT caused the tear? What caused the bone spur?

And I say, the very simple version of the answer is that 'tightness' caused it. Compression of the shoulder by tight muscle/connective tissue structures.

So getting back to the 'maybe' the tear and/or spur are causing symptoms...

Many people have tears, bone spurs, bulging and ruptured discs, but have no pain.

Why? Because a huge factor in the pain dynamic there is the compression.

Remove the compression (make things less tight) and maybe things will heal and/or become pain free without surgery.

I'm definitely not saying that you shouldnt get surgery, but I am saying that in any scenario, if you remove the tightness and get the ecology healthier...

- You will recover from surgery better/faster
- Surgery will be less traumatic
- You may or may not experience reduction in symptoms from reversing the tightness, and that will help you to better evaluate whether you want to get surgery or not.

Aug 04, 2016
by: Anonymous

Thanks Joshua for your response, appreciate all the help. The tear has given me slight discomfort as does the cysts but not that bad.

The bone spur I only feel it clicking but no real pain. I was just listening to the doctors and ortho's about how I shouldn't do anything and get a shot ( cortisone or PRP) or surgery but at no time was any type of treatment advised to me, which really has annoyed me cause I could have dealt with this earlier with better results other that "don't do anything".

I have actually visited a chiropractor this past Tuesday to address mobility and such as I have had no such treatment before to address what you have mentioned in your reply.

Well let me tell you that you are 100% right in first treating the causes ( weightlifting is the cause and lack or stretching/adequate rest) and had everything assessed.

After my first treatment about 60% off my issues went away and will continue done this road to get me as healed as possible. The chiro is confident this will help and as you mentioned if it doesn't then it will help me deal with surgery if I need it.

I have some exercise/stretches to do and we'll see how it goes. Thank you for all you replies and words of encouragement as it has helped me see the other side of this injury as opposed to strictly surgery.


Joshua Comments:


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