All You Need to Know about Shoulder Pain

QI Spine Clinic, 2 months ago

Shoulder pain may occur due to different reasons. This joint is the most mobile, and pain may occur due to an injury, overuse, and chronic diseases. It is important to know the cause to get the right treatment. Pain can affect the movement of the joint and cause discomfort. Therefore, you must consult with an orthopedic doctor immediately if you experience pain for a long time. You can read further to understand what is shoulder pain, its symptoms, causes, and treatment.

Parts of the Shoulder Joint

It is important to understand the parts of a shoulder joint so that you can understand the nature of pain. The shoulder joint forms a connection between bones to help your arms move in different directions. The shoulder joint is made of the following parts:

• The upper arm bone called the humerus
• The shoulder bone (scapula)
• The collarbone (clavicle)

Other Parts of the Shoulder Joint are:

• Rotator Cuff: These are the muscles that surround the shoulder joint and upper part of the arm. These muscles give support and stability to the joint.
• Bursa: It is a sac filled with fluid that provides cushion to the joint and protects it from injury.
• Acromion: It is a bone at the top and outer edge of your shoulder blade.
• Coracoid: It is a bone that extends out from the shoulder blade and attaches muscles and ligaments.
• Labrum: It refers to the cartilage that gives stability to the joint.

Different Types of Shoulder Pain

Shoulder pain may be caused due to a variety of reasons. Some common types are:

• Tendinosis: It is a condition that causes shoulder pain. It occurs when the rotator cuff and biceps tendon become worn out. The pain may be mild and severe, depending on the inflammation. The rotator cuff tendon becomes trapped under the acromion and the humeral head.
• Dislocation: Dislocation can also produce shoulder pain. Dislocation of the shoulder joint is the most common cause of pain. It occurs when the ball of the joint gets separated from the socket due to an intensive force.
• Separation: Separation of the joint occurs when the ligaments are torn. It may occur due to a sudden and forceful blow to the shoulder or due to a fall.
• Bursitis: Bursa protects the shoulder, but inflammation of the bursa due to tendonitis or impingement syndrome can cause pain in the shoulder joint.
• Rotator Cuff Tear: It occurs due to overuse of rotator cuff tendons, a fall, a collision, or an outstretched hand. Pain occurs due to a tear in the rotator cuff.
• Adhesive Capsulitis (Frozen Shoulder): It occurs due to an injury and causes restrictive movement of the joint. It also occurs due to a lack of synovial fluid in the gap between the bone and socket that helps to move the joint.
• Fracture: A fracture of the shoulder bones can cause pain and swelling. It may occur due to a forceful injury to the shoulder joint.
• Shoulder Instability: Repetitive strain can cause a sensation of instability in the shoulder joint. It causes pain and discomfort in the shoulder.
• Nerve Entrapment Syndrome: If nerves get compressed, it can cause discomfort and tingling sensations in the fingers. It can also cause pain in the shoulders. Exercise and managing correct posture can provide relief in some cases.

Causes of Shoulder Pain and Risk Factors

Shoulder pain may be caused due to several factors. The important causes of shoulder pain are:

• Rotator Cuff Tendinitis: In this condition, tendons become swollen. This causes a lot of pain & discomfort.
• Injury: Injury is the most common cause, and it is mostly seen in athletes. It may also occur due to an injury to the neck or biceps. This is called referred pain.
• Impingement Syndrome: It is a condition in which the rotator cuff gets pinched between the acromion and humeral head.

Other Causes are:

• Cartilage Injury: An injury to the cartilage can cause shoulder pain
• Arthritis and Other Degenerative Diseases: Arthritis and other degenerative diseases cause inflammation and pain in the shoulder joint.
• Bone spurs: Bone spurs are the outgrowths of the bones and may cause shoulder pain.
• A Pinched Nerve in the Shoulder or Neck: If a nerve gets pinched in the shoulder or neck, you can experience pain in the joint
• Frozen Shoulder: It occurs due to overuse of the joint, which causes the joint to become immovable.
• Fracture of the Collarbone: If there is a break in the shoulder bone, it can cause joint pain.
• Overuse or Repetitive use of the Shoulder Joint: Repetitive or overuse of the joint in athletes can also cause moderate to severe pain in the joint.
• Heart Attack: Many people experience pain in the left shoulder that may extend to the arm due to a heart attack.
• Dislocation of the Shoulder Joint: If the bones forming the shoulder joint get dislocated from a normal position, pain may occur in the joint.
• Injury to the spine: An injury to the spine can also cause pain in the shoulder. This is often called referred pain.
• Poor Posture: Poor posture can also cause pain in many cases.
• Cervical Spondylosis: Neck pain or cervical spondylosis can cause pain in the shoulder. This occurs due to stiffness of the neck and shoulder muscles.

Risk Factors

Shoulder pain is most commonly caused due to an injury or overuse. It is common in athletes or who are involved in high-risk physical activities. Risk factors are:

• Taking part in sports such as climbing, baseball, softball, basketball, or gymnastics.
• Having a history of spine injury.
• Engaged in constant and repetitive motion of the shoulder joint.
• Advancing age.

Symptoms of Shoulder Pain

Pain is the most important symptom. Other symptoms of shoulder pain include the following:

• Redness and Inflammation of the Joint: Inflammation of the joint may occur due to degenerative diseases such as arthritis or bursitis.
• Restricted Movement of the Shoulder Joint: The movement of the joint will get restricted due to pain. You may not be able to move your shoulder for lifting or rotation.
• Numbness and Tingling in the Fingers: Some people also experience tingling and numbness in the fingers that may occur due to a pinched nerve.
• Difficulty in Raising or Lifting Things with the Affected Side: It becomes difficult to lift and raise the arm.
• Swelling and Weakness of the Joint: Sometimes, swelling and weakness of the joint are experienced due to chronic pain.
• Discomfort: Shoulder pain causes discomfort that can prevent you from sleeping properly and can affect your daily living activities.

Diagnosis of Shoulder Pain

Your orthopaedic doctor will do a complete physical examination and take a medical history. He will assess the range of motion, severity of the pain, and stability of the joint. Other tests ordered by an orthopaedic doctor to diagnose the cause of pain include:

• X-ray: IT helps to use invisible electromagnetic rays to get images of the bones, tissues, and organs internally on a film.
• MRI (Magnetic Resonance Imaging): It helps to get detailed images of organs or structures inside the body. It helps to determine the damage to the surrounding muscles and ligaments.
• Ultrasound: It also helps to get high-frequency images of the internal organs.
• Arthroscopy: It is a minimally invasive diagnostic technique that helps to get images of the inside of the joint seen on a screen. It helps to find the degenerative changes in the joint and to detect bone tumours and diseases.

Treatment of Shoulder Pain

Treatment of shoulder pain depends on different factors such as the level of pain, discomfort, injury to the joint or internal organs, etc. Treatment may be non-invasive or invasive. The orthopaedic doctor will make a treatment plan depending on your symptoms & the underlying cause.

• Non-Invasive Treatment

  Non-invasive treatment of shoulder pain includes the following:
  • Rest: If you have mild pain, the doctor will advise you to take rest. Taking proper rest can relieve your pain.
  • Ice Pack: Apply ice pack to reduce pain.
  • Elastic Bandage: You can use elastic bandage to compress the area and reduce swelling
  • Medications: The doctor may also prescribe non-steroidal anti-inflammatory medications to reduce pain and swelling
  • Massage: You can also massage your shoulder to get relief from pain and swelling
  • Physical Therapy: You can consult with a physiotherapist who can suggest the best exercises that can help to enhance the strength of shoulder muscles and reduce pain. You can learn exercises to improve the strength and stability of your shoulder joint from a physiotherapist.
  • Steroidal Injections: Orthopaedic doctors may recommend steroidal injections to reduce pain and inflammation.
  • Platelet-rich Plasma Therapy (PRP): In this therapy, an injection containing concentrated platelets is injected to stimulate the healing process. It also helps improve tissue healing and reduce inflammation.

• Surgical Treatment

  If the pain does not go away with pain medications and rest or other conservative methods, then your doctor may prepare for surgery. Surgical treatment includes:
  • • Shoulder Joint Replacement: If there is severe damage to the joint due to inflammation or degenerative diseases, then your doctor will recommend shoulder joint replacement. This may help to restore normal functioning and get rid of chronic pain.
    • Arthroscopic Surgery: Arthroscopic surgery is done in some cases to repair the damaged tissues in the shoulder.
  Shoulder pain can be prevented by avoiding overuse and straining of the shoulder joint. Regular exercise can help strengthen the muscles and can reduce the chances of getting shoulder pain. Visiting an orthopaedic doctor on time can help avoid serious complications.

Conclusion

Shoulder pain may occur commonly due to a variety of reasons, such as inflammation of the cartilage or bursa, injury, overuse, or underlying degenerative diseases. Mild to moderate pain can be managed at home by taking rest, using ice, or compression. Severe pain may need surgical intervention. The orthopaedic doctor will take a complete history and order tests to recognise the cause and make a suitable treatment plan. Therefore, you must consult with an orthopaedic doctor immediately if you experience mild to moderate pain for a long time.