Shoulder Pain Evaluation: Expert Diagnosis and Treatment in Durango, Colorado

Dr. Brian Butzen MD has been helping patients understand and treat shoulder pain in Durango, Colorado since 2013. As a board-certified, fellowship-trained orthopedic surgeon specializing in shoulder problems, Dr. Butzen brings over a decade of experience to shoulder pain evaluation. His commitment to the Four Corners community extends throughout Durango, Farmington, New Mexico, Cortez, Colorado, and his satellite clinic in Pagosa Springs, Colorado. Patients consistently praise Dr. Butzen for his thorough approach to diagnosing shoulder problems and his clear explanations of treatment options.

A few weeks ago, a ski instructor from Purgatory came to see Dr. Butzen after dealing with shoulder pain for months. "I kept thinking it would just go away," she explained during her appointment. "But every time I demonstrated a turn to my students, the pain got worse." Her story reflects what many active people in our mountain community experience - shoulder pain that starts small but gradually interferes with the activities they love most.

Understanding Your Shoulder Pain

Your shoulder is like a ball sitting on a plate. The ball is the top of your arm bone, and the plate is part of your shoulder blade. This design gives you amazing movement but also makes your shoulder vulnerable to injury.

Shoulder pain evaluation starts with understanding where your pain comes from. Sometimes the problem is in the shoulder joint itself. Other times, pain comes from muscles, tendons, or other structures around the shoulder. A shoulder doctor needs to figure out exactly what's causing your discomfort.

Dr. Butzen sees patients with shoulder pain every day in his Durango practice. Each person's story is different, but the evaluation process follows a systematic approach that helps identify the real source of the problem.

Common Shoulder Pain Causes

Living in the Four Corners region means staying active despite our challenging terrain. Dr. Butzen has treated shoulder injuries from many different activities popular in our area.

Rotator Cuff Problems are the most common shoulder pain causes Dr. Butzen sees. Your rotator cuff includes four muscles that help move and stabilize your shoulder. These muscles can get torn from sports, work activities, or just normal wear and tear over time.

A rancher from Cortez recently came to see Dr. Butzen after years of throwing hay bales finally caught up with him. "I always knew this day would come," he said. "My dad had the same problem." This type of gradual wear happens to many people who do repetitive overhead activities.

Shoulder Arthritis affects many patients, especially those who've spent decades enjoying Colorado's outdoor lifestyle. The cartilage that cushions your shoulder joint gradually wears away, causing pain and stiffness.

Frozen Shoulder can develop suddenly, making it hard to lift your arm or reach behind your back. This condition sometimes follows an injury, but it can also happen without any obvious cause.

Shoulder Impingement occurs when tissues get pinched inside your shoulder joint. This often causes pain when you lift your arm overhead, which can make activities like putting dishes away or combing your hair difficult.

Fractures happen from falls or direct impacts. Mountain biking, skiing, and hiking accidents sometimes result in broken bones around the shoulder.

What Happens During Shoulder Pain Evaluation

Dr. Butzen's shoulder pain evaluation process starts before you even sit down. He watches how you move your arm when you walk into the room and take off your jacket. These simple observations provide clues about what might be wrong.

Medical History comes first. Dr. Butzen asks about when your pain started, what makes it better or worse, and how it affects your daily activities. He also wants to know about your work, hobbies, and sports activities.

A construction worker from Farmington recently told Dr. Butzen, "The pain started after I spent a weekend roofing my neighbor's house. I haven't done that kind of work in years." This information helped Dr. Butzen understand that overuse likely caused the problem.

Physical Examination involves testing how well your shoulder moves and where pain occurs. Dr. Butzen checks your range of motion, strength, and stability. He also feels around your shoulder to find tender spots or swelling.

Some tests might seem strange, but each one provides specific information. When Dr. Butzen asks you to lift your arm in certain directions or resist pressure, he's testing different muscles and structures.

Imaging Studies sometimes become necessary to see inside your shoulder. X-rays show bone problems like fractures or arthritis. MRI scans reveal soft tissue problems like rotator cuff tears or labral injuries.

Specific Tests During Evaluation

Shoulder doctors use many specialized tests during evaluation. These tests have names that might sound complicated, but each one checks a specific part of your shoulder.

Impingement Tests check whether tissues get pinched when you move your arm. Dr. Butzen might lift your arm overhead or move it across your body while watching for pain.

Rotator Cuff Tests evaluate the strength and function of each rotator cuff muscle. You might be asked to hold your arm in different positions while Dr. Butzen applies gentle pressure.

Stability Tests check whether your shoulder joint stays in the right position during movement. Some people have loose shoulders that slip out of place easily.

A young rock climber from Durango learned she had shoulder instability after several episodes of her shoulder "popping out" while climbing. The specific tests Dr. Butzen performed helped confirm this diagnosis and guide her treatment plan.

When X-rays and MRIs Are Needed

Not every shoulder pain evaluation requires imaging studies. Dr. Butzen can diagnose many problems based on your history and physical examination alone. However, certain situations do call for pictures of your shoulder.

X-rays are usually the first imaging study ordered. They show the bones clearly and can reveal fractures, arthritis, or bone spurs. X-rays are quick, painless, and available right in Dr. Butzen's office.

MRI Scans provide detailed images of soft tissues like muscles, tendons, and cartilage. These studies take longer and cost more than X-rays, so Dr. Butzen orders them when specific information is needed.

A teacher from Pagosa Springs had shoulder pain that didn't improve with initial treatment. Her MRI showed a rotator cuff tear that wasn't obvious from the physical examination alone. This information changed her treatment plan completely.

Ultrasound can sometimes show tendon problems or guide injections. This technology continues improving and offers advantages like real-time imaging during movement.

Red Flags That Need Immediate Attention

Most shoulder pain develops gradually and doesn't require emergency care. However, certain symptoms suggest serious problems that need immediate evaluation by a shoulder surgeon.

Sudden, Severe Pain after an injury might indicate a fracture or major tendon rupture. Don't wait to get this checked, especially if you can't move your arm normally.

Numbness or Tingling in your arm or hand could suggest nerve problems. While these symptoms sometimes come from shoulder problems, they can also indicate more serious conditions.

Signs of Infection like fever, redness, or warmth around your shoulder need immediate medical attention. Shoulder infections are rare but can become serious quickly.

A mountain biker from Cortez came to the emergency room after a crash left him unable to lift his arm. His X-rays showed a broken collarbone that needed immediate treatment to prevent complications.

How Age Affects Shoulder Problems

Shoulder pain causes change as we get older. Dr. Butzen sees different patterns of problems in different age groups.

Younger Patients often have injuries from sports or accidents. Dislocations, fractures, and acute tendon injuries are more common in this group.

Middle-Aged Patients frequently develop overuse problems. Years of work activities or sports participation can lead to rotator cuff problems or impingement.

Older Patients more commonly have arthritis or degenerative rotator cuff tears. These problems often develop slowly over many years.

A 65-year-old woman from Durango came to see Dr. Butzen because she couldn't reach high shelves anymore. Her evaluation revealed shoulder arthritis that had been developing for years. Understanding this helped Dr. Butzen explain why the problem developed and what treatment options made sense.

Work-Related Shoulder Problems

Many jobs in the Four Corners region involve physical labor that can affect your shoulders. Dr. Butzen sees work-related shoulder problems regularly in his practice.

Overhead Work like electrical or construction work can lead to impingement and rotator cuff problems. Painters, roofers, and maintenance workers often develop these issues.

Heavy Lifting can strain shoulder muscles and joints. Ranch work, warehouse jobs, and moving companies put workers at risk for various shoulder problems.

Repetitive Motions in manufacturing or office work sometimes cause shoulder pain. Even activities that don't seem strenuous can cause problems over time.

Dr. Butzen works with local employers to help prevent work-related shoulder injuries and get injured workers back to their jobs safely.

Sports and Recreation Injuries

Living in Colorado means having access to amazing outdoor activities. Unfortunately, some of these activities can lead to shoulder injuries.

Skiing and Snowboarding can cause shoulder problems from falls or overuse. Snowboarders especially risk shoulder injuries when they fall on an outstretched arm.

Mountain Biking leads to shoulder injuries from crashes or from maintaining riding position for long periods.

Rock Climbing puts unique stresses on shoulders and can cause both acute injuries and overuse problems.

Golf might seem gentle, but poor technique or overuse can lead to shoulder pain.

A golfer from Pagosa Springs developed shoulder pain after increasing his practice time before a tournament. Dr. Butzen's evaluation showed early signs of impingement that responded well to treatment and technique modification.

Treatment Options After Evaluation

Shoulder pain evaluation leads to treatment recommendations based on what Dr. Butzen finds. Treatment options range from simple rest and physical therapy to complex surgery.

Conservative Treatment works for many shoulder problems. Rest, ice, anti-inflammatory medications, and physical therapy can resolve many conditions without surgery.

Injections sometimes help reduce pain and inflammation. Dr. Butzen uses ultrasound guidance to place injections precisely where they're needed.

Surgery becomes necessary when conservative treatments don't work or when the problem is severe. Dr. Butzen's fellowship training in shoulder surgery means he can handle complex procedures when needed.

The goal is always to get you back to your normal activities with the least invasive treatment possible.

Why Choose Dr. Butzen for Shoulder Pain Evaluation

Dr. Butzen's fellowship training specifically focused on shoulder and upper extremity problems. This specialized education means he's seen thousands of shoulder problems and knows how to diagnose even unusual conditions.

His practice in Durango since 2013 has given him experience with the types of injuries and problems common in our area. He understands how our active lifestyle and work demands affect shoulders.

Patients appreciate Dr. Butzen's thorough approach to evaluation and his clear explanations of what he finds. He takes time to answer questions and make sure you understand your condition and treatment options.

Getting Started with Your Evaluation

If you're dealing with shoulder pain that isn't improving, don't wait for it to get worse. Early evaluation and treatment often lead to better outcomes and faster recovery.

Dr. Butzen sees patients with shoulder problems at his main office in Durango and at his satellite clinic in Pagosa Springs. His staff can help schedule an appointment that works with your schedule.

During your visit, Dr. Butzen will perform a comprehensive shoulder pain evaluation to determine exactly what's causing your discomfort. He'll explain his findings in terms you can understand and discuss treatment options that make sense for your situation.

Whether you're dealing with a sports injury, work-related problem, or age-related wear and tear, Dr. Butzen's expertise in shoulder problems can help you get back to the activities you enjoy. His decade of experience serving the Four Corners community has taught him that every patient's situation is unique, and he takes the time needed to provide the thorough evaluation you deserve.