Do I have a rotator cuff tear?

We can usually tell on exam and ultrasound, with MRI confirming when needed. Many tears do well with conservative treatment; not every tear requires surgery.

What is frozen shoulder and how is it treated?

Adhesive capsulitis (frozen shoulder) is a self-limited but lengthy condition. We treat with a combination of intra-articular injection, hydrodilation under ultrasound, and a structured rehab plan to shorten the painful course.

Is PRP worth it for my shoulder?

PRP has the strongest evidence in rotator cuff tendinopathy and partial tears that have failed conservative care. We will give you an honest assessment of likely benefit before recommending it.

Why does my shoulder hurt at night?

Night pain is classic for rotator cuff and bursal pathology. Sleeping on the affected shoulder loads the inflamed tissue. Pain that disturbs sleep is also a marker that the condition warrants treatment, not just rest.

Could my shoulder pain be from my neck?

Yes — cervical radiculopathy can refer pain into the shoulder and arm in a pattern that mimics shoulder pathology. We screen for this in the exam and will image the cervical spine if indicated.

Will a steroid injection make my tendon worse?

Repeated steroid injections in the same tendon can be harmful long-term. We limit corticosteroid use to a small number of injections per region per year and prefer biologics like PRP for tendon healing when appropriate.

How long until I can return to overhead activities?

Depending on diagnosis, most patients return to overhead activities within 6–12 weeks of beginning a structured plan. We do not push you to return early.

Pain Center

Shoulder Pain & Injuries

Rotator cuff, labrum, and tendon issues — diagnosed precisely, treated thoughtfully.

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A young man in a grey t-shirt grimaces while gripping his right shoulder with his left hand against a plain white wall.

Overview

Understanding shoulder pain & injuries.

The shoulder is the most mobile joint in the body, and that mobility comes at the cost of stability — which is why shoulder problems are common, and often layered. The rotator cuff, the labrum, the biceps tendon, the AC joint, the bursa, and the cervical spine can all contribute to what a patient experiences as "shoulder pain." The trick is sorting them out.

Most shoulder pain has a tendinous or bursal contribution that responds to a precise, ultrasound-guided injection plus targeted physical therapy. Some shoulders need biologic support — PRP for partial rotator cuff tears or persistent tendinopathy. Others need surgical referral, and we will tell you when that is the right call.

We coordinate closely with orthopedic shoulder colleagues. We do not see ourselves as competing with them — our job is to treat the cases that do not require surgery and to be honest about the ones that do.

Common Symptoms

Pain with overhead reaching or lifting
Night pain that interferes with sleep
Loss of strength or range of motion
Catching, clicking, or instability sensations

Common Causes

Rotator cuff tendinopathy or partial tearing
Subacromial bursitis or impingement
Adhesive capsulitis (frozen shoulder)
AC joint arthritis

Treatments at HTx Pain

How we approach shoulder injuries.

Ultrasound-Guided Shoulder Injections

Steroid or hydrodissection for bursa, joint, or tendon pathology.

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PRP Therapy

Biologic option for rotator cuff tendinopathy.

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Suprascapular Nerve Block

Targeted relief for refractory shoulder pain or frozen shoulder.

Diagnosis & workup

Pattern of pain — overhead, reaching behind, sleeping on the side.
Focused exam — Hawkins, Neer, drop-arm, O'Brien, AC joint stress.
Ultrasound for dynamic visualization of the rotator cuff and bursa.
MRI for suspected significant tearing, labral pathology, or surgical planning.
Cervical spine imaging when arm symptoms are atypical or radicular in pattern.

When to see a specialist

Shoulder pain limiting work, sleep, or daily function for more than 4 weeks.
Loss of strength or range of motion.
Mechanical symptoms — clicking, catching, instability.
Pain after a specific injury or fall.
Multiple failed prior treatments at other practices.

Recovery & outlook

What to expect over time.

Most shoulder conditions respond to a combination of one or two image-guided injections and a thoughtful PT plan over 6–12 weeks. PRP cases work on a slower biological timeline — improvement builds over several weeks, with continued improvement over the following months, and individual timing varies. Patients with significant structural tears who need surgical repair are referred to a trusted orthopedic colleague; we provide pain management coverage during their post-op course.

Common Questions

Direct answers — no jargon.

If your question isn’t here, ask us at your consultation.

We can usually tell on exam and ultrasound, with MRI confirming when needed. Many tears do well with conservative treatment; not every tear requires surgery.

Why HTx Pain Institute

How we treat shoulder pain & injuries, differently.

Ultrasound-guided shoulder injections are the standard of care, and we use them for every shoulder injection. Beyond that, our willingness to use multiple tools — corticosteroid, hydrodissection, PRP, suprascapular nerve block — based on what your specific shoulder needs is what differentiates the work.

Other conditions we treat.

See all conditions

Reviewed by Edward Baumgartner Jr., MD · Last reviewed September 10, 2026. Information on this page is not medical advice. Always consult your physician.

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Two Houston-area locations. Same-week consults available. Most insurance accepted.