Shoulder Pain, Conditions & Injury

shoulder pain and injuryThe shoulder is a very complex part of the body. The elegant design of the shoulder joint allows for great range of motion but not much stability. As long as the parts of the shoulder joint are in good working order, the shoulder can move freely and painlessly.

Some of the common symptoms of shoulder pain include pain, swelling, and stiffness. Shoulder pain may be isolated in the joint, or felt within the muscles and tendons that surround and support the joint. Typically, shoulder pain will intensify when the joint is used.

Common causes of shoulder pain include wear and tear from overuse and repetitive motions, and injuries to the joint or surrounding tissues from sports activities, falls, or other accidents.

Sometimes, pain from conditions that affect the heart or abdomen (such as gall bladder disease) will lead to referred shoulder pain. This type of shoulder pain will not become worse when the joint is used. Referred shoulder pain may be a sign of a pressing health concern, and should be evaluated by a physician.

Shoulder anatomy

At the simplest level, the shoulder is a ball and socket joint. The upper part of the humerus (ball) fits into the socket portion of the scapula called the glenoid.

The shoulder is made up of three bones: the scapula (shoulder blade), the humerus (upper arm bone) and the clavicle (collarbone). The part of the scapula that makes up the roof of the shoulder is called the acromion.

The rotator cuff is responsible for the motion, stability, and power of the humerus.

The joint where the acromion and the clavicle join together is known as the acromioclavicular (AC) joint. There are ligaments that provide stability to this joint. The true shoulder joint is called the glenohumeral joint and consists humeral head and the glenoid. The rotator cuff muscles and their tendons play an important role in the correct functioning of this joint.

Common causes of shoulder pain and injury treated at MOS:

Arthritis

Arthritis is painful inflammation and stiffness of the joints, which can be caused by many types of degenerative joint conditions. There are over 100 types of arthritis, including osteoarthritis, rheumatoid, gout, psoriatic, septic, post-traumatic, and lupus. Arthritis symptoms can include swelling, tenderness, sharp pain, stiffness, and sometimes fever and chills.

Bursitis

Bursitis is painful inflammation of the bursae, the fluid-filled sacs that reduce friction between bones, tendons, and muscles. Bursitis in the shoulder is commonly caused by an injury, infection or other condition. Pain may be accompanied by swelling, tenderness or loss of movement.

Dislocated shoulder

A dislocated shoulder occurs when the upper arm bone (humerus) is forced out of its natural position inside the shoulder socket. Symptoms include severe pain, swelling, bruising, and a visible deformity of the shoulder. Patients with dislocated shoulders will also find it impossible to move the affected joint.

Injuries from sports activities like gymnastics, hockey, or lacrosse often cause shoulder dislocation. Car accidents and falls also may cause a hard blow that dislocates the shoulder joint. A dislocation is a serious injury that requires medical attention. A physician will put the arm bone back into the socket either manually or surgically. The joint will be immobilized in a sling, and medication may be prescribed to help manage the pain.

Rotator cuff tear

A rotator cuff tear is an injury to any of the four rotator cuff tendons in the shoulder. Tears are caused by repetitive motion or sudden injury. Sudden tears are usually caused by exerting excessive force on the shoulder when falling on an extended arm or lifting extremely heavy objects. This injury often occurs in sports activities like baseball, tennis and football.

Symptoms include pain, weakness in the shoulder, and difficulty raising the arm overhead. Treatment for a rotator cuff tear depends on the severity of the damage, and may include rest, ice, over-the-counter pain medication, physical therapy or surgery. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.

Fractures

A fracture is a break in a bone. Broken bone symptoms include pain (intensified when the area is moved or pressure is applied), swelling, bruising, and loss of function. Fractures may also cause the area around the bone to appear distorted or deformed, especially in open fractures where the bone protrudes from the skin.

Frozen shoulder

Frozen shoulder, or adhesive capsulitis, is a condition in which the capsule of connective tissue around the shoulder joint becomes thicker or tighter, restricting movement. Symptoms typically develop in several stages, and resolve within one or two years.

Common symptoms include pain, stiffness, and restricted range of motion. Treatment options include over-the-counter pain medication, physical therapy, or injections of corticosteroids or sterile water into the affected joint. Most cases of frozen shoulder go away within 18 months, but for some patients, surgery may be necessary.

Inflamed shoulder (impingement)

Inflamed shoulder is caused by frequent rubbing on the tendons and bursa around the shoulder joint from working with the arms raised overhead, repeated throwing activities, or other repetitive actions of the arm. Symptoms include generalized aching of the shoulder, and pain when raising the arm out from the side or in front of the body.

Impingement may also cause a sharp pain when trying to reach into your back pocket, or difficulty sleeping due to pain. Treatment for shoulder impingement usually includes rest, ice, and physical therapy. In some cases, surgery may be necessary to restore functionality.

Polymyositis (PM)

Polymyositis (PM)is an inflammatory muscle disease that leads to weakness and loss of movement control in the skeletal muscles. Symptoms vary, but generally include fatigue, difficulty getting up after falling, difficulty swallowing, and weakness in the muscles close to the center of the body (thighs, hips, shoulders, forearms, neck, back).

Although doctors believe that PM may be an autoimmune disorder, the cause of the disease is still unknown. Treatment for PM includes medication to suppress the immune system, including corticosteroids, physical therapy, and dietary changes.

Shoulder separation

A shoulder separation is an injury to the ligament that connects the shoulder blade (scapula) and the collarbone (clavicle). This injury can vary in severity from a strain to a complete dislocation of the acromioclavicular (AC) joint. Athletes in sports like football, hockey, skiing and other sports activities may experience AC joint strain or dislocation as a result of falling or being hit on the shoulder.

Symptoms include pain, tenderness, swelling, and bruising. Signs of a severe separation are a popping sensation when the loose joint shifts, and a noticeable bump on the shoulder where the collarbone has moved out of place. Treatment for shoulder separation depends on the severity of the injury, but includes pain medication and immobilization of the shoulder with a sling. For more severe separations, surgery may be recommended.

SLAP tear

SLAP tear is an injury to the ring of cartilage that surrounds the shoulder socket, called the labrum. The acronym SLAP stands for superior labrum, anterior to posterior, and means that the top of the labrum is torn from back to front.

This injury is common among athletes, and often occurs when falling on the outstretched arm or the shoulder. SLAP tears can also happen as a result of repeated overhead motions or sudden heavy lifting. Symptoms include aching pain, weakness, and popping or clicking in the shoulder. Treatment for SLAP tears includes over-the-counter anti-inflammatory medicine, physical therapy, and in some cases, surgery.

Sprains & strains

Sprains are stretched or torn ligaments the fibrous bands of tissue in joints that connect bones. Sprains cause pain and swelling and are ranked by three degrees of severity: a slight ligament tear or stretch (first-degree), a partial or incomplete ligament tear (second-degree), or a complete ligament tear or rupture (third-degree).

Strain is a stretched or torn muscle or tendon. Strains cause pain and swelling and are ranked by three degrees of severity: a slight muscle or tendon tear/stretch (first-degree), a partial or incomplete muscle or tendon tear (second-degree), or a complete muscle or tendon tear/rupture (third-degree). 

Tendonitis

Tendonitis (also known as tendinitis) is inflammation of the tendons the thick, rope-like cords of tissue that connect muscle to bone. Tendonitis is caused by overuse (repetitive motion) or sudden injury. Tendonitis symptoms include pain in the tendon area, and sometimes loss of motion.

Biceps tendonitisis inflammation of the tendons that connect the biceps muscle to the top of the shoulder. It may be caused by overuse, wear and tear from aging, or injuries to the shoulder. Sports activities like golf, tennis, and swimming can cause biceps tendonitis, as well as work activities that require frequent overhead motions.

Symptoms of bicep tendonitis include aching pain that increases with use of the arm and shoulder, as well as weakness when bending at the elbow or twisting the arm. Treatment includes rest, over-the-counter anti-inflammatory medicine, and physical therapy. In some cases, surgery may be necessary for patients who are not improving with non-surgical treatments.