Shoulder Pain

At Nucellin Orthopedic Clinic in Seoul, Dr. Heejun Kim personally assesses shoulder pain through your symptoms, physical examination, strength, movement and imaging when necessary.

A scan shows structure. It does not always explain pain.

The goal is to identify the source of symptoms and choose the least invasive treatment that can reasonably restore function.

Common Shoulder Problems

Shoulder pain may come from:

• Rotator-cuff tendinopathy or tears
• Frozen shoulder
• Calcific tendinopathy
• Subacromial bursitis
• Biceps tendon problems
• Shoulder osteoarthritis
• Acromioclavicular-joint pain
• Labral injuries or instability
• Sports or overuse injuries
• Previous injury or surgery

Symptoms such as night pain, difficulty raising the arm, progressive stiffness, weakness or a sense of instability can provide important clues.

Pain around the shoulder may also come from the neck or peripheral nerves, particularly when accompanied by tingling or numbness extending into the arm or hand.

Two people with similar MRI or ultrasound findings may have very different symptoms. Imaging should therefore be interpreted together with the examination.

Diagnosis

Diagnosis begins with your history and a hands-on examination.

Dr. Kim may assess:

• Location and pattern of pain
• Active and passive range of motion
• Rotator-cuff strength
• Shoulder-blade movement
• Biceps tendon and joint tenderness
• Joint stability
• Neck and neurologic findings
• Activities that reproduce symptoms

Distinguishing stiffness from weakness is important. Difficulty lifting the arm may reflect pain, tendon dysfunction or nerve involvement, while restriction of both active and passive movement may suggest frozen shoulder or arthritis.

The purpose is not simply to identify an abnormality, but to determine whether it actually explains the patient’s symptoms.

Imaging

X-rays may be used to assess arthritis, calcific deposits, alignment, fracture or previous injury.

Musculoskeletal ultrasound may evaluate the rotator cuff, biceps tendon, subacromial bursa, joint fluid and selected tendon tears. It also allows assessment during movement and can guide targeted procedures when appropriate.

MRI is not required for every painful shoulder. It may be recommended when there is significant weakness, a suspected traumatic tendon tear, labral injury or instability, or when the result would change the treatment plan.

If MRI is required, imaging can be arranged at a nearby radiology centre and reviewed by Dr. Kim.

Treatment

Treatment depends on the diagnosis, severity of the condition and your functional goals.

Options may include:

• Load modification and rehabilitation
• Regenerative Physical Therapy
• Shockwave Therapy for selected tendon and soft-tissue conditions
• Medication when appropriate
• Ultrasound-guided injections
• PDRN-based injections for selected conditions
• Activated PRF Therapy
• Selected cell-based regenerative treatments
• Surgical referral when necessary

Treatment is introduced step by step. A procedure should not be selected simply because an ultrasound or MRI shows degeneration or a tendon tear.

Rehabilitation may focus on restoring mobility, rotator-cuff strength and shoulder-blade control. Shockwave Therapy may be considered for selected conditions such as calcific rotator-cuff tendinopathy.

Learn more about Regenerative Physical Therapy →

Learn more about Shockwave Therapy →

Activated PRF

For selected patients with chronic rotator-cuff tendinopathy, partial-thickness tendon injuries, biceps tendon problems or other appropriate shoulder conditions, Dr. Kim may recommend Activated PRF Therapy.

Activated PRF is prepared from the patient’s own blood using Nucellin’s mechanically activated platelet- and fibrin-based protocol.

The treatment is intended to support the biologic environment of the affected tissue, but results vary according to the diagnosis, tendon quality and severity of the condition. It cannot guarantee closure of a tendon tear or replace necessary surgical repair.

Learn more about Activated PRF Therapy →

Cell-Based Treatment

Selected patients with symptomatic shoulder-joint degeneration or chronic tendon degeneration may be considered for autologous bone marrow- or adipose-derived cell-based treatment.

These treatments are not appropriate for every patient with shoulder pain. Suitability depends on the extent of degeneration, tendon quality, tear size, joint stability, remaining function and the patient’s goals.

Evidence for cell-based treatment in shoulder conditions remains limited. These procedures cannot reliably repair a large retracted tendon tear or replace surgery when repair or joint replacement is necessary.

Learn more about Cell-Based Therapy →

When Surgery May Be Appropriate

Non-surgical treatment is not always the right answer.

A surgical opinion may be appropriate when there is:

• An acute traumatic rotator-cuff tear with significant weakness
• A large or retracted tendon tear
• Recurrent shoulder dislocation or major instability
• A significant labral injury affecting function
• Fracture or major traumatic injury
• Advanced arthritis with substantial loss of function
• Persistent pain and functional loss despite appropriate non-surgical treatment

The goal is not to avoid surgery at all costs, but to determine when non-surgical treatment is reasonable and when surgery may provide a better result.

When to Seek Medical Attention

Arrange an assessment if your shoulder pain:

• Persists or repeatedly returns
• Interrupts sleep
• Causes weakness or progressive stiffness
• Limits lifting, dressing or reaching behind your back
• Began after an injury
• Is associated with tingling or numbness
• Has not improved despite previous treatment

Seek urgent medical care for obvious deformity, inability to move the arm or sudden major weakness after injury, a hot and swollen joint with fever, or a cold, pale or numb arm. Shoulder pain accompanied by chest pain, shortness of breath or sweating requires emergency assessment.

International Patients

International patients can consult directly with Dr. Kim in English.

You may send or bring previous X-rays, ultrasound images, MRI images and medical reports. Same-day consultation, ultrasound assessment and selected treatments may be possible when medically appropriate.

If MRI is required, we can arrange imaging at a nearby radiology centre.

Bone marrow- and adipose-derived procedures require separate planning.

The goal is to restore comfortable movement, strength and confidence in your shoulder.

Contact Nucellin Orthopedic Clinic →