Shoulder Issues: When to See an Orthopedic or Neurology Specialist? - Orthopedics

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When it comes to shoulder issues, particularly when you notice asymmetry (one shoulder being higher than the other), sounds (like popping or cracking) during movement, and feelings of weakness in the affected arm, it is crucial to determine the underlying cause of these symptoms. Given your description, it would be advisable to consult both an orthopedic specialist and a neurologist, as these symptoms can stem from both musculoskeletal and neurological issues.

Orthopedic Evaluation:
An orthopedic specialist focuses on the musculoskeletal system, which includes bones, joints, ligaments, tendons, and muscles. In your case, the asymmetry of your shoulders and the audible sounds during movement could indicate a structural issue, such as:
1. Shoulder Impingement or Rotator Cuff Injury: These conditions can cause pain and weakness in the shoulder and may lead to abnormal shoulder mechanics, resulting in one shoulder appearing lower than the other.

2. Shoulder Instability: This occurs when the shoulder joint is loose and can lead to dislocations or subluxations, which might explain the popping sounds you hear.

3. Scapular Dyskinesis: This refers to abnormal movement of the shoulder blade, which can lead to shoulder pain and weakness. It can be caused by muscle imbalances or injuries.

4. Arthritis or Degenerative Changes: Conditions like osteoarthritis can lead to joint changes that may cause asymmetry and audible sounds during movement.

An orthopedic evaluation typically involves a physical examination, imaging studies such as X-rays or MRI, and possibly functional assessments to determine the exact nature of the problem.

Neurological Evaluation:
On the other hand, a neurologist specializes in the nervous system, which includes the brain, spinal cord, and peripheral nerves. The weakness you feel in your arm, especially if it is accompanied by other symptoms like numbness, tingling, or changes in sensation, may indicate a neurological issue such as:
1. Nerve Compression or Entrapment: Conditions like thoracic outlet syndrome or cervical radiculopathy can lead to nerve compression, resulting in weakness and possibly the asymmetry you are observing.

2. Peripheral Neuropathy: This condition affects the peripheral nerves and can lead to weakness, numbness, and pain in the arms and legs.

3. Cervical Spine Issues: Problems in the cervical spine, such as herniated discs or spinal stenosis, can affect nerve roots that innervate the shoulder and arm, leading to weakness and sensory changes.

A neurologist would conduct a thorough neurological examination, which may include tests of reflexes, muscle strength, and sensory function. They might also recommend imaging studies like MRI of the cervical spine to assess for any nerve compression.

Conclusion:
In summary, given the complexity of your symptoms, it is advisable to see both an orthopedic specialist and a neurologist. They can work collaboratively to diagnose the underlying cause of your shoulder issues and develop a comprehensive treatment plan. Early intervention is key to preventing further complications and improving your overall shoulder function. Additionally, consider lifestyle modifications such as ergonomic adjustments at your workstation, regular stretching, and strengthening exercises to support shoulder health.