The shoulder is a unique area of the body – a spot where bones, cartilage, and tendons come together to give you the most mobile joint in the body. Being so complicated and so often used, the shoulder is prone to getting injured in the course of daily living. Shoulder pain can be debilitating, making ordinary routine tasks difficult to perform. You can consult a shoulder pain doctor to ensure proper treatment and full recovery.
Understanding the Structure of the Shoulder
The shoulder is a synovial joint, meaning it is a very flexible joint where the upper arm bone connects with the shoulder blade and the collarbone. Two joints in the shoulder connect these three bones with soft tissues, muscles, tendons, ligaments, and cartilage.
The shoulder gets its mobility and stability from these tissues that work together, helping the arm move in various directions and keeping the bones properly aligned. The surrounding muscles, particularly the rotator cuff, sitting between the shoulder blade and the upper arm bone, helps to keep the joint stable.
Shoulder pain is mostly the result of inflammation or injury to one of its structures.
Fracture (broken bones)
A fracture can happen to any shoulder bone, including the clavicle, humerus, and scapula. People participating in contact sports and high-energy activities like cycling competitions are at risk for this type of injury.
Shoulder fractures can cause pain, discomfort, stiffness, and swelling, which can take months to improve.
Bursitis
Bursitis is inflammation of the bursa, small, fluid-filled sacs located in joints throughout the body. They cushion bones and connective tissue so tendons, muscles and bones can move together smoothly.
Painful inflammation of the bursa can happen because of repetitive shoulder movements. Bursitis can affect any joint, but it’s most common in the shoulder. The bursa between the rotator cuff and the part of the shoulder blade known as the acromion is most commonly involved.
The condition can hamper many routine activities like getting dressed.
Tendinitis
Tendonitis is inflammation of a tendon. Tendons connect muscle and bone. In the shoulder, tendinitis affects the four rotator cuff tendons. In the shoulder, tendinitis can result from overuse, repetitive movements, or an injury.
Tendon Tears
You can tear a rotator cuff tendon when you pick up a heavy item or try to catch something heavy. People can also rupture a rotator cuff when they are older, and their tendons have started to degenerate and weaken.
Tendon tears are painful and debilitating, making it impossible to lift your arm.
Impingement
Another source of shoulder pain is when the bones in the shoulder impinge on the tendons or bursa of the rotator cuff. The rotator cuff can easily be pinched by the humerus and the upper part of the shoulder blade when you lift your arm away from your body. This action can narrow the space between the shoulder blade and the rotator cuff, causing friction.
The situation deteriorates over time as some movements put repeated stress on the shoulder joint and rotator cuff. Impingement is common among people who repeat movements like serving when practising and playing tennis.
Frozen Shoulder
Frozen shoulder can affect anyone, but it usually doesn’t happen to people before around 40 years of age. Frozen shoulder is extreme stiffness of the shoulder, making it immobile. People with frozen shoulder need someone to dress and undress them. Scientists are not sure what the cause is, but it is not uncommon to happen when the shoulder has been immobile for a while. It can also be caused by scar tissue from surgery or injury.
With frozen shoulder, the person can’t move the shoulder in any direction, and attempting to do so is painful.
Arthritis
Osteoarthritis is the most common form of arthritis affecting the joints, including the shoulder joint. Osteoarthritis is pain due to the wear and tear of the joints.
The pain usually starts during middle age, and worsens over time. Osteoarthritis develops slowly and the pain it causes worsens over time. In osteoarthritis, the cartilage that covers the bones of the shoulder joint slowly wears away, making movement difficult and painful.
Instability
Shoulder instability, also referred to as shoulder dislocation, is the situation where the head of the upper arm bone slides out of the glenoid cavity, so it no longer fits into the shoulder socket. This is usually the result of a fairly forceful incident like a blow to the shoulder, a bad fall or a contact sport injury.
This kind of injury makes the shoulder susceptible to future dislocations. When this happens repeatedly, doctors talk about chronic shoulder instability.
Treatment for Shoulder Pain
Home Treatment
To help ease the pain in your shoulder and help it recover, you can take the following steps:
- For two or three days, put ice wrapped in a cloth on your shoulder. You can also use a frozen gel pack. Do this for 15- 20 minutes, four to five times a day. The cold will reduce swelling and acute pain. During this time, rest your shoulder.
- You can also use compression to help reduce the swelling and pain. Use an elastic medical bandage to wrap the shoulder. Be careful not to wrap it too tightly.
- Inquire from a physical therapist about some exercises to stretch and strengthen your rotator cuff tendons and shoulder muscles and practice them.
- No matter what the cause of your shoulder pain, do range-of-motion exercises to regain full shoulder movement.
- Stop or change the activity that caused the shoulder pain.
Physical Therapy
Visit a shoulder pain clinic for manual therapy by a physical therapist. Manual therapy can reduce pain and restore joint and tissue function. It is a non-invasive, hands-on technique for physical injuries and chronic conditions. The therapist uses gentle pressure where you experience the problem to prepare the injured joint for return to normal functioning.
The therapist can also teach you stretching and strengthening exercises to improve mobility and muscle strength and stabilize your shoulder.
Medication
You can take oral anti-inflammatory medications, such as aspirin, and naproxen to help with the pain and inflammation.
Surgery
When a shoulder problem like repeated dislocation does not respond to conservative treatment like rest, physical therapy, medication, and exercise, your orthopaedic doctor may suggest surgery.