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Guide to Shoulder Pain

What is Shoulder Pain?

·         Shoulder pain can be described as any pain inside and around the patient’s shoulder joints, bones, and soft tissues.

·         Shoulder pain can affect the tendons and ligaments surrounding the shoulder’s soft tissues and joints. Pain can also affect the cartilage, menisci, bones, and ligaments of the joints.

·         Shoulder pain can be the result of disease or injury of the shoulder joint such as:

o    Fractures

o    Adhesive Capsulitis

o    Arthritis

o    Synovitis

o    Tendinitis

o    Torn Rotator Cuff

o    Dislocation

Who Suffers From Shoulder Pain?

·         You are not the only sufferer of shoulder pain.

·         Men and women, children, adolescent, adult and elderly can all have shoulder pain. It can occur in all people regardless of races, ethnic background and nationality.

·         Shoulder pain is a common condition that affects 10% of the total population at some point in their lives.

·         50% of all the people with shoulder pain do not seek any medical help

·         Shoulder pain may take several weeks to heal, 23% of shoulder pain cases get better in the 1^st month while 44% of shoulder pain cases get better in the 2^nd or 3^rd month.

Your Body and Shoulder Pain

Your shoulder joint includes three bones: humerus, scapula, and clavicle with 2 joints. These 2 joints are AC joint or acromioclavicular and the glenohumeral joint which allows complete ROM. The bones of the shoulder joint are held together by ligaments, muscles, and tendons. These tendons and ligaments provide stability and strength. On the other hand, the muscle particularly the rotator cuff muscle is responsible for maintaining the ball and socket in place. In addition, the rotator cuff muscle provides the shoulder strength and stability.

The following are links about the anatomy and physiology of the shoulder:

·         http://en.wikipedia.org/wiki/Shoulder

·         http://www.human-anatomy.net/anatomy-shoulder-pictures.html

Causes of Shoulder Pain:

Naturally, the tendon passes below the rigid bone arch inside the shoulder. The most frequent cause of shoulder pain is the time when the tendons become trapped underneath the bone arch. This will result to rotator cuff tendinitis, or damaged and inflamed tendons. This can happen from:

·         Wear and Tear phenomenon

·         Activities that require frequent shoulder use such as playing tennis, heavy lifting, and baseball pitching

·         Injury and Fall

Shoulder pain may also be due to:

·         Arthritis

·         Bursitis

·         Frozen shoulder syndrome

·         Inflammation

·         Fractures

·         Dislocation of shoulder

Can Shoulder Pain Be Prevented?

Almost all of us will suffer from shoulder pain at some time in our lives. It is important to know that being active is one of the best ways to prevent shoulder pain. Some other ways to prevent shoulder pain are:

·         Maintain a good posture by keeping your head up and shoulders back. Allowing the shoulders to slouch forward can lead to increased joint pain.

·         Perform Stretching and have a regular exercise to improve and restore the body flexibility.

·         Take a 10 to 15 minutes break, every 1 to 2 hours when driving or sitting in the office for long periods. Staying at the same position for long periods can lead to severe shoulder pain.

·         Sleep on your side or back to minimize the pressure on your neck and shoulder.

·         Avoid overusing your shoulders in order to prevent injury and muscle strains.

Symptoms of Shoulder Pain, How Shoulder Pain Diagnosed?

Consult immediately with your doctor if you have:

·         Severe pain

·         Pain, heaviness, and tightness in the chest

·         Sweating

·         Lightheadedness or dizziness

·         Nausea and Vomiting

·         Pain in the jaw, neck, throat, teeth, and upper abdomen

·         Redness, warmth, fever, and swelling

·         Numbness and weakness

In order to diagnose shoulder pain, your doctor may order series of laboratory and diagnostic exam such as the following:

·         Blood Tests

·         X-ray

·         Ultrasound scan

·         MRI scan

·         Nerve Conduction Studies

Who Treats Shoulder Pain?

·         Primary healthcare professional

·         Alternative medicine practitioners

·         Physical therapist

·         Naturopaths

·         Chiropractors

Treatment for Shoulder Pain:

Acute shoulder pain can get better even without medical intervention. Maintaining good posture, stretching, performing regular exercise, over the counter pain medication and having an active lifestyle plays an important role in alleviating the shoulder pain.

However, chronic shoulder pain may require additional treatment. Your healthcare provider may recommend the following intervention to treat your shoulder pain:

Medical

·         The following are steps to follow when you have shoulder pain:

o    Rest- stop or relax using the injured shoulder for 2 days

o    Ice- Apply icepack to the injured shoulder for 20 minutes, 4 to 8 times a day.

o    Compression- Compress the injured shoulder with the use of elastic bandage in order to reduce swelling.

o    Elevation- Keep the injured shoulder elevated above the heart.

·         Over the counter medications that may help you to treat shoulder pain are Nonsteroidal anti-inflammatory drugs and corticosteroids.

·         Physical therapy may be the answer to all your shoulder pain and problems. A physical therapist involves activities to reduce pain and restore your shoulder’s mobility.

Alternative

·         Chiropractic treatment- The treatment involves manipulation of affected bones, muscles, ligaments, and tendons to alleviate shoulder pain and restore strength.

·         Acupuncture- A type of alternative therapy wherein the patients are treated by needle insertion and manipulation.

·         Acupressure- Uses the fingers to manipulate key points of the body to stimulate the patient’s natural curing ability.

·         Naturopathy- A form of alternative therapy that is based on natural treatments such as sunlight, water, and air. It may also be supplemented with a healthy diet and massage.

Surgical

·         If the medical and alternative interventions still do not work, your healthcare provider may recommend surgery. You may have a choice to undergo with arthroscopic procedure or with an open surgical procedure. However, it is important to consider that there will always be some risks that are involved with any surgery. The following are some signs and symptoms to watch out for that may imply the development of various complications:

o    Fever

o    Increased swelling

o    Increased pain

o    Unusual bleeding

o    Warmth, redness, and tenderness

o    Tingling and numbness

Specific Conditions that Cause Shoulder Pain:

·         Arthritis is a condition wherein there is a damage or loss of joint cartilage inside the body system. When the cartilage deteriorates, the body suffers from severe pain and limited ROM. In addition, the muscles, ligaments and tendons become can become very weak and unable to execute its role and function.

·         Shoulder fractures usually involve the collarbone and humerus. It may be a result from fall or trauma in shoulder. Almost 80% of all shoulder fractures are nondisplaced wherein the broken pieces lie on each side of the breaks. The remaining 20% of all shoulder fractures are considered displaced wherein the pieces break out in the line.

·         Shoulder separation and dislocation frequently happen in athletic and younger individuals. If you suffered from shoulder dislocation before, it puts you more at risk for redislocation.

·         Adhesive Capsulitis or frozen shoulder is a medical condition that creates stiffness and pain in the shoulder joint. It usually occurs when there is a problem in the shoulder capsule that surrounds the shoulder joint.

·         Synovitis may cause swollen, warm, and painful shoulder joints regardless if the shoulder is at rest or in motion. Your doctor may withdraw synovial fluid sample from your shoulder joints to test for infection. Treatment of synovitis may include oral steroids, cortisone steroid injection, and anti inflammatory medications.

·         Tendinitis is considered as the most common shoulder problem. It is an inflammation of tendon wherein the rotator cuff tendons are damaged and inflamed. Overtime, tendinitis usually disappears without any help from medical intervention. However, if the problem persists, your doctor may give additional medical options.

·         Generally, the torn rotator cuff causes pain over the top and side of the shoulder joints. The pain can also be felt around the upper and lower arm. This becomes obvious when the individual raises or extends his arms.

The following are some good links to get additional information about medical conditions that can cause shoulder pain:

·         http://www.nlm.nih.gov/medlineplus/ency/article/003171.htmRelevant link

·         http://www.freeuniquearticles.com/health/diseases-conditions/arthritis-shoulder-pain-causes-treatments/

References:

1.     Fauci, Anthony. Harrison’s Principle of Internal Medicine. United States. McGraw-Hill Professional. 2008.

2.     Cailliet, Rene. Shoulder Pain. United States. F.A. Davis Companay. 1991.

3.     Kirsch, John. Shoulder Pain? The Solution and Prevention. United States. Bookstand Publishing. 2010/