Shoulder pain
The shoulder is a very mobile joint that has a wide range of motion. When something goes wrong with your shoulder, it hampers your ability to move freely and can cause a great deal of pain and discomfort. The pain may be temporary, or it may continue and require medical diagnosis and treatment.
What causes shoulder pain
Several factors and conditions can contribute to shoulder pain. A few common causes are as below :
- Tendon inflammation (bursitis or tendinitis)
- Tendon tear
- Arthritis
- Frozen shoulder
- Fracture
Tendon inflammation (bursitis or tendinitis)
A tendon is a cord-like structure that connects muscle to bone.
When the tendon gets inflamed, it gives rise to tendinitis and causes pain.
Generally, tendinitis can be:
- Acute. Excessive overhead activities during work or sport can lead to acute tendinitis.
- Chronic. Degenerative diseases like arthritis or repetitive wear and tear due to age can lead to chronic tendinitis.
The most commonly affected tendons in the shoulder are the four rotator cuff tendons and one of the biceps tendons. The rotator cuff helps provide shoulder motion and stability.
Shoulder impingement is one of the common causes of bursitis and tendinitis. This occurs when the top of the shoulder blade (acromion) puts pressure on the underlying tendon and bursa when the arm is lifted away from the body. As the arm is raised, the acromion rubs, or “impinges” on, the rotator cuff tendons and bursa.
Tendon Tears
Tendon tear and injury may result from:
- Acute injury due to trauma or sports
- Degenerative changes in the tendons due to advancing age, wear and tear, or a sudden injury
These tears may be partial or may completely separate the tendon from its attachment to bone. Rotator cuff and biceps tendon injuries are among the most common of these injuries.
Arthritis
The most common type of arthritis in the shoulder is osteoarthritis, also known as “wear and tear” arthritis. Symptoms such as swelling, pain, and stiffness typically begin during middle age.
Osteoarthritis may be related to sports or work injuries or chronic wear and tear, rotator cuff tears, infection, or an joint inflammation.
Frozen shoulder
Frozen shoulder causes pain and stiffness in the shoulder. Over time, the shoulder movement becomes severely restricted.
Frozen shoulder most commonly affects people between the ages of 40 and 60 and occurs in women more often than men. In addition, people with diabetes are at an increased risk for developing frozen shoulder.
Fracture
Fractures are broken bones. Shoulder fractures commonly involve the clavicle (collarbone), humerus (upper arm bone), and scapula (shoulder blade). Shoulder fractures are often the results of a fall, motor vehicle accident, or sports injury.
Fractures often cause severe pain, swelling, and bruising.
How is the cause of shoulder pain diagnosed?
The doctor will conduct a thorough evaluation to determine the cause of your shoulder pain and provide you with treatment options.
They’ll request your medical history and do a physical examination. Your doctor may order specific tests to help identify the cause of your pain and any other problems.
These tests include:
- X-rays. These will show any injuries to the bones that make up your shoulder joint.
- Magnetic resonance imaging (MRI) and ultrasound. These imaging studies may help your doctor identify injuries to the ligaments and tendons surrounding your shoulder joint.
- Computed tomography (CT) scan. This tool combines x-rays with computer technology to produce a very detailed view of the bones in the shoulder area.
- Arthroscopy. In this surgical procedure, your doctor looks inside the joint with a fiber-optic camera. Arthroscopy may show soft tissue injuries that are not apparent from the physical examination, x-rays, and other tests.
Treatment options
Treatment will depend on the cause and severity of the shoulder pain.
- Activities modification
- These involve rest, altering your activities, avoiding overexertion, or overdoing activities
- Physiotherapy/shoulder rehabilitation
- Pain management with medical devices
- Proper strengthening exercises
- Medication
- Your doctor may prescribe medication to reduce inflammation and pain. Your doctor may also recommend injections of numbing medicines or steroids to relieve pain.
- Surgery
- Surgery may be required to resolve some shoulder problems.
- Surgery can involve arthroscopy to remove scar tissue or repair torn tissues or traditional open procedures for more extensive reconstructions or shoulder replacement.
