Server left shoulder pain not getting relief

Dear Ask The Doctor: I have server left shoulder pain and the pain goes to my elbow, fore arm then into my hands causing me to lose control of my fingers, I have tried icey hot heat pads ice packs it even cause me to lose sleep at night for the pain is great some times it goes into my chest so what can I do?

Dear Robert: Shoulder pain may be caused due to conditions affecting the shoulder joint. These can be rotator cuff tear, nerve impingement syndromes, arthritis, gout etc.  A definite diagnosis can be made by physical examination and a radiograph of the affected shoulder joint, also bloodwork may reveal other disease like arthritis and gout which may also effect the shoulder joint. The treatment of shoulder joint depends on the etiology, so you may need to see your physician to run you through these test.