Shoulder Pain

Shoulder Anatomy
Shoulder Anatomy

Anatomy of Shoulder Joint

The shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). Two joints facilitate shoulder movement. The acromioclavicular joint is located between the acromion and the clavicle. The glenohumeral joint, commonly called the shoulder joint, is a ball-and-socket-type joint that helps move the shoulder forward and backward and allows the arm to rotate in a circular fashion or hinge out and up away from the body. Shoulder Pain may originate in the joint itself, or from any of the many surrounding muscles, ligaments or tendons. Shoulder pain usually worsens with activities or movement of your arm or shoulder.

Shoulder Pain Causes

Many shoulder problems are caused by the breakdown of soft tissues in the shoulder region. Using the shoulder too much can cause the soft tissue to break down faster as people get older. Doing manual labor and playing sports may cause shoulder problems. Pain that travels along nerves to the shoulder can be caused by diseases such as:-

  1. Gallbladder disease
  2. Liver disease
  3. Heart disease
  4. Disease of the spine in the neck.

Shoulder Pain Diagnosis

Physician diagnoses shoulder problems by using:

  1. Medical history
  2. Physical examination
  3. Tests such as x rays, ultrasound, and magnetic resonance imaging (MRI).

Common Shoulder problems

The most common shoulder problems are:

  1. Dislocation
  2. Separation
  3. Rotator cuff disease
  4. Rotator cuff tear
  5. Frozen shoulder
  6. Fracture
  7. Shoulder Arthritis

The symptoms and treatment of shoulder problems vary, depending on the type of problem.

  1. Shoulder Arthritis. A medical condition affecting a joint or joints, causing pain, swelling, and stiffness. Osteoarthritis in the shoulder joints is a common cause of shoulder pain. Shoulder osteoarthritis can affect a person’s range of movement and daily life.
  • Treatment of Shoulder Arthritis. Osteoarthritis of the shoulder is often treated with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. People with rheumatoid arthritis may need physical therapy and medicine such as corticosteroids. If these treatments for arthritis of the shoulder don’t relieve pain or improve function, surgery may be needed.
  1. Shoulder Fracture. Shoulder fracture usually means fracture of the upper part of the humerus bone that forms the shoulder joint. In the shoulder, a fracture usually involves the collarbone or upper arm bone.

         Treatment of Shoulder Fracture. Treatment for a fracture may include:

  • A doctor putting the bones into a position that will promote healing.
  • A sling or other device to keep the bones in place.
  • After the bone heals, exercise to strengthen the shoulder and restore movement.
  1. Frozen Shoulder. Frozen shoulder is when the shoulder is painful and loses motion because of inflammation. Adhesive capsulitis (also known as Frozen Shoulder) is a painful and disabling disorder; it affects 3-5% of the general population and increases to 10-20% for people with Diabetes.

       Treatment of Frozen Shoulder. Treatment for frozen shoulder includes:

  • Medicines to reduce pain and swelling
  • Heat
  • Gentle stretching exercise
  • Electrical stimulation of muscles and nerves
  • Cortisone injection
  • Surgery if the shoulder does not improve with other treatments.
  1. Rotator Cuff Tear. A rotator cuff tear is a tear of one or more of the tendons of the four rotator cuff muscles of the shoulder. Most rotator cuff tears are largely caused by the normal wear and tear that goes along with aging; people over 40 are at greater risk. Some tears are not painful, but others can be very painful.

          Treatment of Rotator Cuff Tears. Treatment for a torn rotator cuff depends on age, health, how severe the injury is, and how long the person has had the torn rotator cuff. Treatment for torn rotator cuff includes:

  • Rest
  • Heat or cold to the sore area
  • Medicines that reduce pain and swelling
  • Electrical stimulation of muscles and nerves
  • Ultrasound
  • Cortisone injection
  • Exercise to improve range-of-motion, strength, and function
  • Surgery if the tear does not improve with other treatments.
  1. Rotator Cuff Disease. Rotator cuff tendon tears are a common, degenerative problem. A rotator cuff tear is a tear of one or more of the tendons of the four rotator cuff muscles of the shoulder. Shoulder pain and tenderness are common symptoms

          Treatment of Rotator Cuff Disease. Tendinitis and bursitis may occur alone or at the same time. Treatment for tendinitis and bursitis includes:

  • Rest
  • Ice
  • Medicines such as aspirin and ibuprofen that reduce pain and swelling
  • Ultrasound (gentle sound-wave vibrations) to warm deep tissues and improve blood flow
  • Gentle stretching and exercises to build strength
  • Injection of corticosteroid drug if the shoulder does not get better
  • Surgery if the shoulder does not get better after 6 to 12 months.
  1. Shoulder Separation. A shoulder separation is an injury to the AC joint on the top of the shoulder. These injuries occur with a fall on the outside of the shoulder. A shoulder separation occurs after a fall or a sharp blow to the top of the shoulder.

         Treatment of Shoulder Separation. Treatment for a shoulder separation includes:-

  • Rest
  • A sling to keep the shoulder in place
  • Ice to relieve pain and swelling
  • Exercise, after a time of rest
  • Surgery if tears are severe.

 

  1. Dislocation. The shoulder joint is the body’s most mobile joint. It can turn in many directions. But, this advantage also makes the shoulder an easy joint to dislocate. The main symptom of a shoulder dislocation is severe pain at the shoulder joint. The patient will have great difficulty moving your arm even a little bit.
  • Treatment of Dislocated Shoulder. To treat a dislocation, a doctor performs a procedure to push the ball of the upper arm back into the socket. Further treatment may include:
  1. Wearing a sling or device to keep the shoulder in place
  2. Rest
  3. Ice three or four times a day
  4. Exercise to improve range of motion, strengthen muscles, and prevent injury
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