FAQ’s on Shoulder Pain
What is Shoulder Pain?
Shoulder pain is any form of pain that arises in or around the shoulder area. The pain may originate from the shoulder itself or from the myriad of muscles surrounding the shoulder. It may also originate from the ligaments or the tendons. Shoulder pain increases with the activities or the movement of the shoulder.
Shoulder pain is considered chronic if symptoms have lasted for more than six months. Shoulder pain accounts for nearly 20% of all musculoskeletal complaints. For every thousand patients in the urgent care setting, 15 of those are there due to injury or pain in the shoulder.
Shoulder pain is divided into six categories, as defined by the American Academy of Family Physicians:
“(1) rotator cuff disorders, including tendinosis, full or partial thickness tears, or calcific tendinitis; (2) adhesive capsulitis; (3) glenohumeral osteoarthritis; (4) glenohumeral instability; (5) acromioclavicular joint pathology; and (6) other chronic pain, including less common shoulder problems and non-shoulder problems.” source
There are several other conditions or problems can have an effect on the shoulder which may be less common, such as biceps and labral pathology, for example, the SLAP tear (superior labrum anterior to posterior tear which is an injury to the root of the long head the biceps tendon). Extremely uncommon conditions may be a super scapular nerve injury, narrow path of shoulder injuries, or brachial plexus neuritisis such as Parson Turner syndrome.
Fibromygalia and thoracic outlet syndrome can affect symptoms extending past the elbow often at the hands; the subtype can lead to additional neurological or vascular symptoms.
What Are The Causes of Shoulder Pain?
The major cause of shoulder pain is when the rotator cuff tendons become trapped under the bone area in the shoulder leading to the inflammation and damage of the tendons, a condition known as Rotator Cuff Tendinitis.
- Dislocation of the shoulder joint
- Frozen Shoulder caused by stiffening of muscles, ligaments and tendons inside the shoulder
- Shoulder joint instability
- Bone spurs in the shoulder area
- Strain arising from overexertion
- Inflammation of a fluid filled sac (bursa) that protects the joint and helps it move smoothly. This condition is known as Bursitis
- Arthritis in the shoulder joint
- Fracturing of the collar or upper arm-bone
How is Shoulder Pain Diagnosed?
The first diagnosis starts with doctor having a discussion with the patient on the symptoms. This is followed by a physical examination of the shoulder which involves comparison of the two shoulders, checking on the swelling, bruising redness and looking for any signs of dislocation. The shoulder may be moved to determine whether particular movements cause pain.
Depending on the initial findings from this diagnosis, the doctor may administer the following:
- Perform an X-ray to determine if there is any narrowing of the spaces between the two shoulder joint bones, check for any damage to the bone, and also detect arthritis infection.
- Perform the Magnetic Resonance Imaging (MRI) procedure to reveal the detail of the shoulder.
- Perform a blood test to rule out any inflammatory conditions such as Polymyalgia Rheumatica (PRM)
How is Shoulder Pain Treated?
The treatment of the soft tissue shoulder pain can be done by the use of anti-inflammatory medication or by using pain relievers that contain paracetamol. The pain may also be treated by application of moist heat or ice to the shoulder.
Powerful anti-inflammatory injections known as corticosteroid are administered to the shoulder with an aim to relieve the pain if it is severe. This is used in instances where the use pain relievers have been ineffective. Physiotherapy procedures combined with light exercises may also come in handy.
For severe cases involving ligaments and tendons, surgery can be performed on the patient.