SHOULDER PAIN

 

SHOULDER PAIN

Overview

The shoulder has a wide and versatile 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 shoulder is a ball-and-socket joint that has three main bones: the humerus (long arm bone), the clavicle (collarbone), and the scapula (also known as the shoulder blade).

These bones are cushioned by a layer of cartilage. There are two main joints. The acromioclavicular joint is between the highest part of the scapula and the clavicle.

The glenohumeral joint is made up of the top, ball-shaped part of the humerus bone and the outer edge of the scapula. This joint is also known as the shoulder joint.

The shoulder joint is the most mobile joint in the body. It moves the shoulder forward and backward. It also allows the arm to move in a circular motion and to move up and away from the body.

Shoulders get their range of motion from the rotator cuff.

The rotator cuff is made up of four tendons. Tendons are the tissues that connect muscles to bone. It may be painful or difficult to lift your arm over your head if the tendons or bones around the rotator cuff are damaged or swollen.

You can injure your shoulder by performing manual labor, playing sports, or even by repetitive movement. Certain diseases can bring about pain that travels to the shoulder. These include diseases of the cervical spine (neck), as well as liver, heart, or gallbladder disease.

You’re more likely to have problems with your shoulder as you grow older, especially after age 60. This is because the soft tissues surrounding the shoulder tend to degenerate with age.

In many cases, you can treat shoulder pain at home. However, physical therapy, medications, or surgery may also be necessary.

Here’s what you need know about shoulder pain, including causes, diagnosis, treatment, and prevention.

What causes shoulder pain?

Several factors and conditions can contribute to shoulder pain. The most prevalent cause is rotator cuff tendinitis.

This is a condition characterized by swollen tendons. Another common cause of shoulder pain is impingement syndrome where the rotator cuff gets caught between the acromium (part of the scapula that covers the ball) and humeral head (the ball portion of the humerus).

Sometimes shoulder pain is the result of injury to another location in your body, usually the neck or biceps. This is known as referred pain. Referred pain generally doesn’t get worse when you move your shoulder.

Other causes of shoulder pain include:

• arthritis
• torn cartilage
• torn rotator cuff
• swollen bursa sacs or tendons
• bone spurs (bony projections that develop along the edges of bones)
• pinched nerve in the neck or shoulder
• broken shoulder or arm bone
• frozen shoulder
• dislocated shoulder
• injury due to overuse or repetitive use
• spinal cord injury
• heart attack

How is the cause of shoulder pain diagnosed?

Your doctor will want to find out the cause of your shoulder pain. They’ll request your medical history and do a physical examination.

They’ll feel for tenderness and swelling and will also assess your range of motion and joint stability. Imaging tests, such as an X-ray or MRI, can produce detailed pictures of your shoulder to help with the diagnosis.

Your doctor may also ask questions to determine the cause. Questions may include:

• Is the pain in one shoulder or both?
• Did this pain begin suddenly? If so, what were you doing?
• Does the pain move to other areas of your body?
• Can you pinpoint the area of pain?
• Does it hurt when you’re not moving?
• Does it hurt more when you move in certain ways?
• Is it a sharp pain or a dull ache?
• Has the area of pain been red, hot, or swollen?
• Does the pain keep you awake at night?
• What makes it worse and what makes it better?
• Have you had to limit your activities because of your shoulder pain?

When should I seek medical help?

You should contact your doctor if you experience fever, inability to move your shoulder, lasting bruising, heat and tenderness around the joint, or pain that persists beyond a few weeks of home treatment.

If your shoulder pain is sudden and not related to an injury, call 911 immediately. It may be a sign of a heart attack. Other signs of a heart attack include:

• trouble breathing
• chest tightness
• dizziness
• excessive sweating
• pain in the neck or jaw

What are the treatment options for shoulder pain?

Treatment will depend on the cause and severity of the shoulder pain. Some treatment options include physical or occupational therapy, a sling or shoulder immobilizer, or surgery.

Your doctor may also prescribe medication such as nonsteroidal anti-inflammatory medications (NSAIDs) or corticosteroids. Corticosteroids are powerful anti-inflammatory drugs that can be taken by mouth or your doctor can inject into your shoulder.

If you’ve had shoulder surgery, follow after-care instructions carefully.

Some minor shoulder pain can be treated at home. Icing the shoulder for 15 to 20 minutes three or four times a day for several days can help reduce pain. Use an ice bag or wrap ice in a towel because putting ice directly on your skin can cause frostbite and burn the skin.

Resting the shoulder for several days before returning to normal activity and avoiding any movements that might cause pain can be helpful. Limit overhead work or activities.

Other home treatments include using over-the-counter nonsteroidal anti-inflammatory medications to help reduce pain and inflammation and compressing the area with an elastic bandage to reduce swelling.

How can I prevent shoulder pain?

Simple shoulder exercises can help stretch and strengthen muscles and rotator cuff tendons. A physical therapist or occupational therapist can show you how to do them properly.

If you’ve had previous shoulder issues, use ice for 15 minutes after exercising to prevent future injuries.

After having bursitis or tendinitis, performing simple range-of-motion exercises every day can keep you from getting frozen shoulder.