Shoulder

The shoulder is made up of several joints combined with the muscles and tendons. They help the shoulder perform a vast range of motions in the arm—from throwing the perfect pitch to scratching the back. However, mobility has a price. In some cases, it can lead to instability issues and impingement of the bony structures or soft tissue in the shoulder.

Anatomy of the Shoulder

The shoulder is composed of 3 bones: the humerus (upper arm bone), scapula (shoulder blade), and the clavicle (collarbone). The upper bone’s head fits into the shoulder blade’s rounded socket. The socket is known as the glenoid.

A combination of tendons and muscles keeps the arm bone centered in the shoulder socket. The tissues are known as rotator cuff. The rotator cuff covers the head of the upper arm bone and attaches it to the shoulder blade.

Common Causes of Shoulder Pain

Shoulder pain treatment that will be recommended by the doctor will depend on the cause of the condition. That means frozen shoulder treatment recommended will be different from recommended treatment options for shoulder issues caused by arthritis or fracture.

Most problems with the shoulder are classified into 4 categories:

Tendon inflammation or tendon tear (tendinitis or bursitis)
Arthritis
Instability
Broken bone (fracture)

Tendinitis

The cord that connects the muscle to the bone is called the tendon. Tendinitis is often the result of tendon inflammation. There are two types of tendinitis:

Acute – Excessive ball throwing as well as other overhead activities can lead to acute tendinitis.
Chronic – Degenerative diseases like repetitive wear and tear as well as arthritis can lead to chronic tendinitis.

Bursitis

The small fluid-filled sacs that are found in the joints throughout the body (including the shoulder) is called bursae. They also function as cushions between the overlying soft tissues and the bones. They also work by ensuring there is minimal friction between the bone and the gliding muscles.

In some instances, excessive shoulder use can result in swelling and inflammation of the bursa situated between the acromion and the rotator cuff. This condition is referred to as subacromial bursitis.

Impingement

When the acromion puts pressure on the underlying soft tissues, a shoulder impingement can occur. As the arm is lifted, the acromion can impinge on the rotator cuff tendons and bursa. This scenario can result in tendinitis and bursitis which causes pain as well as limited movement.

Arthritis

Shoulder pain can also be attributed to arthritis. While there are many different types of arthritis, the most common type that develops in the shoulder is osteoarthritis. This condition is also commonly referred to as wear and tear arthritis.

Common symptoms of osteoarthritis include stiffness, swelling, and pain. This condition often affects middle-aged individuals. While osteoarthritis can develop gradually, the pain it causes can worsen with time.

Osteoarthritis can be caused by work or sports injuries as well as chronic wear and tear. Other types of osteoarthritis are linked to infection, rotator cuff tears, and joint lining inflammation.

Tendon Tears

The tearing and splitting of tendons can be the result of degenerative changes or acute injury. The tears can be partial or at times, severe enough to completely separate the tendon from the bone. Biceps tendon injuries as well as rotator cuff injuries are considered among the most common.

Instability

Shoulder instability happens when the upper arm bone’s head is forced out of the shoulder socket. This can occur as a result of overuse or sudden injury. Shoulder dislocations can be partial. This condition is called subluxation.

Once the tendons, muscles, or ligaments around the shoulder have become torn or loose, dislocations can happen repeatedly. Recurring dislocations will not only cause pain, it can also result in unsteadiness when the arm is raised or moved away from the body.

The shoulder has a vast and versatile range of motion. That being said, when you have problems with your shoulder like frozen shoulder, your ability to move freely can be hampered. Not only that, you are also likely to experience a great deal of discomfort and pain.

The shoulder is a ball-and-socket joint and it has 3 main components: the long arm bone (humerus), collar bone (clavicle), and the shoulder blade (scapula). The bones are cushioned by a layer of cartilage. The rotator cuff provides the shoulder its range of motion.

Four tendons make up the rotator cuff. If the tendons or bones around the rotator cuff are swollen or damaged, it can become difficult and painful to lift the arm over the head. The shoulder can get injured when playing sports, doing repetitive movements, or performing manual labor.

Certain conditions may also cause severe pain that will cause you to seek shoulder pain treatment. Diseases of the heart, liver, and cervical spine may also cause shoulder pain. However, in similar scenarios, the underlying condition needs to be treated, otherwise the shoulder pain will just continue.

What are some of the common causes of shoulder pain?

Several conditions and factors can cause shoulder pain. The most common cause of shoulder pain is rotator cuff tendinitis. This condition is characterised by the swelling of the tendons.

Yet another cause of shoulder pain is impingement syndrome. This occurs when the rotator cuff gets caught between the humeral head and the acromium.

In some cases, shoulder pain can sometimes occur as a result of an injury sustained in another part of the body, usually the biceps or neck. This is what is commonly known as referred pain. Generally, referred pain does not get worse when the shoulder is moved.

Shoulder pain can also be attributed to other causes including:

Torn cartilage
Arthritis
Pinched nerve (in the shoulder or neck)
Torn rotator cuff
Swollen tendons or bursa sacs
Dislocated shoulder
Spinal cord injury
Heart attack
Injury secondary to repetitive use or overuse
Bone spurs
Broken arm bone or shoulder

How is the cause of shoulder pain diagnosed?

In order to provide the best treatment option for your case, your doctor will need to find the cause of your shoulder pain. In line with this, they’ll look into your medical history. They will also perform a physical exam.

During the physical examination, they will look for swelling and tenderness. They will also carefully assess your joint stability and range of motion. To help with the diagnosis, imaging tests like MRI and X-ray may also be requested.

To help them accurately determine the cause, doctors may also ask the following questions:

Is the pain felt in just one shoulder or in both?
Does the pain travel to other parts of the body?
Was the onset of the pain sudden? If so, what were you doing prior?
Does it hurt when you don’t move?
Does it hurt when you move a specific way?
Is the pain dull or sharp?
Is the painful area swollen, hot, or red?
Does the pain keep you up at night?
What makes the pain worse?
What makes the pain better?

When is seeking medical help recommended?

If the shoulder pain is accompanied by fever, lasting bruising, tenderness or heat around the joint, and inability to move the shoulder, getting medical help is advised.

If the shoulder pain is sudden and not secondary to any injury, seeking immediate medical help is recommended as the pain can be a sign of a heart attack.

A visit to the emergency room is also required if you injured your shoulder and it is swelling or bleeding and you can see exposed tissue.

The Most Common Causes of Shoulder Pain and Shoulder Problems