Shoulder Pain – Symptoms, Causes, Diagnosis, Treatment

Shoulder pain is one of the common problems that occur in aged people. Shoulder is that part of the body which is made of several joints, bones and muscles and is involved with wide range of movement of the arm. Shoulder joint allows you scratch your back and also make a perfect throw. Shoulder pain is not the same for all. For some people it is acute and occurs only during particular movement but for some it can be chronic and continuous needing medical treatment. Any injury or trauma to the underlying joints, ligaments or tendons can affect the shoulder causing pain. Any inflammation of the cartilages and bursae can strongly affect the movement of the shoulder. Accidents and falls can result in fracture of shoulder bones causing shoulder pain.

Anatomy :

Shoulder consists of three bones namely humerus, scapula and collar bone or clavicle. The humerus (upper arm bone) would exactly fit into a cup like socket of the shoulder blade which is known as glenoid. The tissues that bind the bone are known as rotator cuff.

Shoulder Pain

Symptoms :

Shoulder pain can be mild to severe depending on the cause. For some people shoulder pain is present with other signs like pain in the forearm and back.

Shoulder Pain Causes :

Four major causes of shoulder pain can be due to fracture, inflammation of tendons, arthritis and instability. Sometimes infection and nerve disorders in the shoulder can cause shoulder pain. Overuse of shoulder can cause excess of wear and tear resulting in breaking up of soft tissues. In rare cases shoulder pain can occur due to liver or gallbladder disease and heart attack.

Shoulder Pain

  • Inflammation Of Bursea :

Several small sacs are found in the shoulder joints known as bursea. They are capable of preventing friction that may arise due to movement. Actually they are cushioning agents present between the soft tissues and bones. Inflammation (swelling) of bursea can occur due to overuse of shoulder and making wrong movement. This condition is known as bursitis.

  • Inflammation Of Tendons :

Tendons are subjected to wear and tear due to aging process and are common in old aged people. Degenerative disease can cause chronic problems in tendons leading to tendinitis. Sports personalities who are involved in repeated throwing are at high risk of developing tendinitis. Tendons in the rotator cuff region and biceps are often affected during tendinitis.

  • Aging :

It is quite normal for the body to undergo degenerative changes in old age. Wear and tear of the tendons can cause shoulder pain. Tearing of tendons can be acute or chronic. In some cases the tendons are totally pulled away and gets detached from the bone.

  • Impingement :

This occurs due to extra pressure builds-up on the shoulder blade damaging the underlying tissues of the shoulder. As one rotates his arm the shoulder blade would rub with the rotator cuff causing bursitis and shoulder pain. In severe cases it can restrict the normal movement of the shoulder. Sudden injury or fall can cause instability on the shoulder muscles wherein the upper arm bone gets detached from the socket.

Dislocation of the shoulder joints can occur when the tendons get torn. It can be partial or complete causing intense pain. Arthritis (inflammation of the joints or bones) can lead to arthritis causing swelling and stiffness of joints restricting movement. Sports related injuries can also cause arthritis. Broken bones or fracture is a serious problem causing shoulder pain. Fracture can occur on the collarbone or upper arm bone or on the shoulder blade. Motorbike accidents and falls can cause fracture.

Shoulder Pain

Diagnosis :

Your doctor would complete physical examination and listen to your symptoms. He may order for X-ray, ultrasound or MRI scan to get clear picture of the injury and wear and tear inside. During physical exam he may get idea about fracture or swelling or any kind of deformity. For some people arthrogram test or arthroscopy is done.

Shoulder Pain Treatment :

Mild form of injury/inflammation causing shoulder pain can be treated at home and over the counter painkillers. You can follow the RICE method for treating shoulder pain. Take complete rest and don’t give any activity to the injured shoulder. Apply ice pack over the injured shoulder to reduce swelling and pain. Use a bandage on the affected shoulder to compress the area and keep it intact. Keep the injured shoulder above heart level to facilitate blood flow.

Shoulder Pain

For severe injuries like bursitis or tendinitis you need to consult your doctor before taking any medicines. You can take Ibuprofen and aspirin to control pain before visiting the clinic. Once the inflammation has reduced you will be referred to a therapist to do gentle stretching exercises to regain the lost motion. For severe cases your doctor may give a shot of corticosteroid on the injured shoulder. Heat therapy and stretching exercises can help in managing the symptoms of frozen shoulder. Electrical stimulation can be done to get improvement.

Surgery is the last option for tendinitis /bursitis. For fracture your doctor will try placing a sling on the crack bone to keep it intact. In case of severe fracture surgery will be done to place artificial bones. Generally by making small changes in routine activities can give strength to the injured shoulder. Follow the instructions of your doctor/therapist.

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