Shoulder Pain

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Shoulder Pain 2017-08-15T17:58:25+00:00

What Is Shoulder Pain?

If you suffer from pain in your shoulders, upper back, or neck, they could all be related. Diagnosing the cause of your shoulder pain is your first step towards effective treatment. Here’s what you need to know.

This type of pain is characterized by soreness and discomfort within the area of your shoulder joint. Many people also experience neck pain as well. Your shoulder joint includes the:

  • Clavicle (i.e., collarbone)
  • Scapula (i.e., shoulder blade)
  • Upper arm bones (i.e., humerus)

The shoulder joint itself is a ball and socket joint that is one of the more mobile joints within the body. It joins the scapula at the head of the humerus. Interestingly, there is very little interface between these two bones, which likely accounts for its high degree of mobility. The shoulder joint is also comprised of four groups of muscles and tendons whose function is to stabilize the joint.

Your shoulder joint is in constant motion. As such, it can be the source of pain and discomfort for many adults. Indeed, prevalence rates for for this type of pain are 4.7 to 46.7% for 1-year prevalence, and 6.7 to 66.7% for lifetime prevalence.

Shoulder Pain | PainDoctor.com

Shoulder Pain Symptoms

The most commonly reported shoulder pain symptoms include:

  • Aching pain
  • Swelling
  • Redness
  • Joint tenderness
  • Weakness
  • Limited mobility
  • Sensation of warmth around the joint
  • Sensitivity to temperature or touch

Causes Of Shoulder Pain

There is a wide range of causes that underlie an episode of pain in the shoulder. In most instances, the symptoms of pain and discomfort are an indication of:

  • A possible hidden injury
  • Inflammation
  • Other damage to the muscles, connective tissue, or musculoskeletal tissue

Common causes of pain in the shoulder include:

  • Rotator cuff tendinitis
  • Injury or fracture
  • Dislocated joint
  • Repetitive stress injuries
  • Arthritis, especially osteoarthritis
  • Pinched nerve
  • Associated neck pain, or “schneck pain”
  • Adhesive capsulitis, or frozen shoulder
  • Infection or tumors, in rare cases

Rotator cuff tendinitis

One of the most common conditions that causes pain is rotator cuff tendinitis. This condition occurs when the tendons of the rotator cuff become irritated or inflamed, generally as the result of overuse, strain, or repetitive overhead movements (e.g., washing windows or throwing).

Injuries and instability

Fractured bones or a dislocated joint can also result in redness, swelling, and high degrees of pain in the shoulder area. These typically occur as the result of a fall, sports injury, or even injury sustained during a motor vehicle accident.

Pain also can be reported more frequently among workers of specific types of jobs. For instance, construction workers, welders, or professional athletes are constantly using their shoulder joint, in particular, for extreme exertion or weight lifting.  Thus, this exertion and overuse may lead to chronic symptoms of pain and discomfort.

Shoulder instability can also be a source of great degrees of pain. This condition occurs when the shoulder joint is dislocated from an injury or overuse. This type of injury places the connective tissue and muscles of the joint at risk for injury as well. Indeed, dislocations that occur frequently can further damage the surrounding structures, making it more likely to continue to occur. Moreover, this may lead to arthritis or other tissue damage and symptoms of chronic pain.

Arthritis

Another highly common source of pain is arthritis, specifically osteoarthritis. Osteoarthritis typically develops in the shoulder and slowly progresses as a person ages. This deterioration is believed to be the result of typical wear and tear from daily use; however, a portion of patients suffer from osteoarthritis as the result of infection and inflammation.

Pinched nerve

Some individuals may suffer from severe symptoms of painful shoulders as a result of a pinched nerve within the shoulder. This can occur as the consequence of nerve impingement from the nearby muscles or tendons. Compression placed on the nerve can cause damage to the nerve’s ability to transmit information. This can lead to:

  • Numbing sensations
  • Weakness
  • Restricted mobility in the shoulder joint

This is most often the case with pain that originates in the shoulder, due to a pinched nerve in the cervical spine. As Spine-Health explains: “If a cervical nerve root becomes compressed or irritated in the neck, it can cause pain and symptoms that radiate along the path of the nerve into the shoulder, arm and/or hand. This is medically termed cervical radiculopathy.”

Adhesive capsulitis

Also known as adhesive capsulitis, frozen shoulder is characterized by the loss of mobility owing to a thickening of the various connective tissue structures surrounding the joint of the shoulder. Individuals with diabetes, heart disease, and other thyroid conditions are believed to be more at risk for developing symptoms of frozen shoulder. Further, individuals whose shoulder has been immobilized for a long period of time are also at an increased risk. You can learn more about frozen shoulder here.

Shoulder Pain Diagnosis

As with many other pain conditions, your doctor will recommend different treatments based on the cause of your pain. This follows their diagnosis. If you’re suffering from pain that greatly effects your overall quality of life, it’s wise to talk to a pain specialist for a diagnosis and treatment options. Other healthcare practitioners that can help include physical therapists, chiropractors, your general physician, or an orthopaedic surgeon in extreme cases.

To start, your shoulder pain doctor will speak with you about your current episode of pain, including severity, description, and course. Next, your doctor will:

  • Conduct a physical examination
  • Review all of your previous and available medical documents
  • Order imaging tests, such as X-rays, MRI, ultrasound, or CT scans

These imaging tests are typically used to assist with determining the degree of severity of your condition. They can also help pinpoint conditions stemming from issues in the cervical spine. Once your doctor finds the appropriate diagnosis, your treatment planning can begin.

Shoulder Pain | PainDoctor.com

Shoulder Pain Treatments

If you’re suffering from painful shoulders, there are treatments that do work for a large number of patients. These treatments range from at-home options to more advanced therapies or surgery.

Common treatments include:

  • Ice or heat therapy
  • Checking your ergonomic set-up
  • Massage
  • Over-the-counter medications
  • Physical therapy
  • Shoulder stretches or exercises
  • Joint injections
  • Alternative treatments
  • Surgery

At-home treatments 

For instances of pain that are more mild in severity, you may try at-home remedies before reaching for prescription medication. For instance, your doctor may recommend either ice or heat therapy. With this therapy, you simply place a hot or cold compress on the area for no more than twenty minutes.

Other at-home treatments include exercises or stretches to strengthen the muscles surrounding the joint. Talk to your doctor about options you can try. FamilyDoctor.com also recommends a few accessible stretches.

You may also need to check your office set-up. Often an improperly fitted chair or desk can lead to symptoms from the repetitive stress. This type of pain has actually been named “mouse shoulder.” You can learn more about mouse shoulder here.

Massage may also play a role in reducing the strain and tension in your shoulder muscles. Ask your doctor for recommendations for a massage therapist who commonly works with sport injury patients or those with pain.

Another simple option if you’re suffering from pain that originates in the neck is a series of exercises for reducing tension. The following video gives four of our favorites.

 

Physical therapy 

Physical therapy can be incredibly helpful in providing relief from your pain. In this treatment technique, your therapist will teach you several highly specified stretches and exercises. These will help strengthen and loosen the tight connective tissue and muscle underlying your shoulder.

If you do undergo physical therapy, you can go towards correcting the issue with your shoulder in the first place. Some patients may need to take medications to help them through this initial round of therapy, but this is most effective for shorter periods of time.

Medications

If these non-invasive, at-home options haven’t worked, you may want to consider medication. For brief flare-ups of pain, try a non-steroidal anti-inflammatory (NSAID) medication, such as naproxen or ibuprofen.

In instances of more severe forms of pain, a trial of opioid medications may be warranted. However, you are strongly cautioned against taking these medications for an extended period of time. They run a very high risk for dependence and overdose, and since they don’t address the underlying cause of your pain, don’t help you prevent pain in the future.

Interventional pain management

If less invasive treatment options haven’t helped your pain, there are some minimally-invasive options that can help you avoid surgery. These are largely safe, with few side effects, and can be done in an outpatient setting.

Intra-articular peripheral joint injections, in particular, are an option. These injections typically contain corticosteroids that help reduce inflammation. This, in turn, can help reduce pain and increase your range of motion. They’re another great option to do along with physical therapy.

The following video shows a joint injection in the knee. It’s not the same procedure, obviously, but it can give you an idea of what you can expect.

 

Alternative treatments

There are a couple of alternative methods of treatment available that do not involve the use of prescribed medications. These methods include acupuncture and platelet rich plasma therapy injections. These interventions can provide patients with relief, with relatively few side effects. However, many of these alternative treatment options don’t have the same research support as other proven methods for pain relief.

Surgery

In cases of severe and refractory pain, surgical correction may be the only option in order to return the individual to their previous state of functioning. The American Academy of Orthopaedic Surgeons explains:

“Surgery may be required to resolve some shoulder problems; however, 90 percent of patients with shoulder pain will respond to simple treatment methods such as altering activities, rest, exercise, and medication. Certain types of shoulder problems, such as recurring dislocations and some rotator cuff tears, may not benefit from exercise. In these cases, surgery may be recommended fairly early. Surgery can involve arthroscopy to remove scar tissue or repair torn tissues, or traditional, open procedures for larger reconstructions or shoulder replacement.”

Conclusion

Commonly shoulder pain is defined as pain or discomfort that occurs within the shoulder region. The shoulder is an extremely frequently used joint and, as such, it is at an increased risk for injury. Symptoms of this type of pain tend to vary widely. Treatment options available for managing symptoms can range from at-home methods, such as ice therapy or heat therapy, to more interventional approaches, such as intra-articular peripheral joint injections. Speak with your physician about the risks and benefits for each treatment.

If you’re ready to talk to a pain specialist who can help, click the button below to find a doctor in your area.

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References

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  4. Pope DP, Croft PR, Pritchard CM, et al. Prevalence of shoulder pain in the community: the influence of case definition. AnnRheum Dis.1997; 56:308–312.
  5. Roquelaure Y, Ha C, Leclerc A, Touranchet A, Sauteron M, Melchior M, Imbernon E, Goldberg M: Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. Arthritis Rheum. 2006;55:765–778.
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  7. Winters JC, Sobel JS, Groenier KH, Arendzen HJ, Meyboom-de Jong B. Comparison of physiotherapy, manipulation, and corticosteroid injection for treating shoulder complaints in general practice: randomised, single blind study. 1997;314:1320-5.

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