What To Know About Shoulder Pain

The shoulder is the most mobile joint in your body since it is a ball-and-socket joint. The shoulder is easily torn or injured due to its range of motion. That’s why a lot of individuals worry about developing shoulder discomfort at some time in their life. However, the intensity of your discomfort may range from manageable to incapacitating.

Shoulder discomfort is a common complaint, and it can have several causes, including overuse, injury, bad posture, and even medical issues. Most cases of shoulder discomfort may be treated at home, but if the pain persists or worsens, it may be time to see a doctor.

Causes

Shoulder discomfort might be due to a variety of factors. Understanding the potential causes of symptoms can help you decide whether to seek medical attention and what you can do in the meantime to alleviate discomfort.

Rotator Cuff Problems

The rotator cuff is a group of tendons and muscles that enable shoulder movement. Damage to this area can result in pain, limited range of motion, and muscle weakness. Rotator cuff tendonitis is the most common cause of shoulder pain, characterized by irritation and inflammation of the tendons over time. Several factors can contribute to rotator cuff tendonitis, including aging, poor posture, repetitive movements, certain sports, and sleeping on one arm. Symptoms typically include pain in the front of the shoulder and down the arm, which worsens when raising the arms overhead. Rotator cuff tears, whether acute or chronic, can also cause intense shoulder pain, which may be more noticeable at night.

Shoulder bursitis, also known as impingement syndrome, is another condition that affects the rotator cuff. It involves inflammation of the bursa, a fluid-filled sac that protects the shoulder joint. This condition can lead to tenderness, redness, stiffness, and swelling around the joint. Causes of shoulder bursitis may include intense athletic activity, gout, infection, rheumatoid arthritis, and obesity.

Arthritis

Arthritis is a condition characterized by inflammation in the joints, and it can affect the shoulder as well. When arthritis occurs in the shoulder, it often leads to symptoms such as swelling, stiffness, redness, and warmth around the joint. These symptoms may be more noticeable in the morning upon waking up. Arthritis in the shoulder can also result in the formation of bone spurs, which are tiny bone growths within the joint.

There are different types of arthritis that can affect the shoulder, including:

• Osteoarthritis: This type of arthritis typically develops due to the natural wear and tear of the shoulder joint, which occurs with aging and repetitive use.
• Rheumatoid arthritis: It is an autoimmune condition in which the immune system mistakenly attacks the joints, including those in the shoulder. This can lead to inflammation, pain, and joint damage.
• Psoriatic arthritis: This condition is associated with psoriasis, a skin disorder characterized by inflamed patches. Psoriatic arthritis can affect the shoulder and cause joint pain, stiffness, and swelling.

Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by intense pain, stiffness, and limited range of motion in the shoulder joint. It occurs when the capsule surrounding the shoulder joint becomes thickened and inflamed, leading to a decrease in joint space and increased stiffness.

Frozen shoulder commonly affects individuals who are over the age of 40, particularly women. People with certain underlying conditions, such as diabetes, have a higher risk of developing adhesive capsulitis. In some cases, an acute trauma or injury to the shoulder can trigger the onset of frozen shoulder.

The condition typically progresses through three phases:

1. Freezing phase: During this phase, the shoulder gradually becomes more painful and stiff, making it difficult to perform everyday activities.

2. Frozen phase: The pain may begin to subside during this phase, but the stiffness and limited range of motion persist. Activities that involve reaching or lifting the arm become challenging.

3. Thawing phase: In this phase, the shoulder gradually regains its range of motion and function. The recovery can take several months to years.

Treatment for frozen shoulder may involve a combination of pain management, physical therapy, and stretching exercises to improve range of motion. In some cases, corticosteroid injections or, rarely, surgical intervention may be necessary to alleviate symptoms and restore shoulder function.

Fractures

Broken bones, or fractures, can lead to acute shoulder pain. Fractures can occur in different bones of the shoulder, including the humerus (upper arm bone), shoulder blade (scapula), or collarbone (clavicle). Shoulder fractures are more common in older adults, particularly those with osteoporosis, a condition characterized by weakened bones.

Various factors can contribute to shoulder fractures. High-contact sports, such as football or rugby, and physical labor that involves repetitive stress on the shoulder joint may increase the risk of fractures. Additionally, traumatic events like car accidents or falls can result in shoulder fractures.

Shoulder Dislocation

A dislocated shoulder happens when the ball-shaped head of the upper arm bone (humerus) pops out of the shoulder socket (glenoid). This can occur as a result of accidents, falls, sports injuries, seizures, or severe muscle spasms.

The signs and symptoms of a dislocated shoulder may include:

• Severe pain: You may experience intense pain in your shoulder, which can worsen with movement.
• Muscle weakness: The affected arm may feel weak, making it difficult to move or lift objects.
• Numbness: Numbness or tingling sensations may be present in the shoulder, arm, or hand due to nerve involvement.
• Swelling: The shoulder may appear swollen or visibly deformed due to the dislocation.
• Bruising: Bruising around the shoulder or upper arm can occur as a result of injury to blood vessels.
• Feeling that your arm isn’t in the right spot: You may have a sense that your arm is out of place or not properly aligned with your shoulder socket.

Shoulder Separation

A dislocated shoulder happens when the ball-shaped head of the upper arm bone (humerus) pops out of the shoulder socket (glenoid). This can occur as a result of accidents, falls, sports injuries, seizures, or severe muscle spasms.

The signs and symptoms of a dislocated shoulder may include:

• Severe pain: You may experience intense pain in your shoulder, which can worsen with movement.
• Muscle weakness: The affected arm may feel weak, making it difficult to move or lift objects.
• Numbness: Numbness or tingling sensations may be present in the shoulder, arm, or hand due to nerve involvement.
• Swelling: The shoulder may appear swollen or visibly deformed due to the dislocation.
• Bruising: Bruising around the shoulder or upper arm can occur as a result of injury to blood vessels.
• Feeling that your arm isn’t in the right spot: You may have a sense that your arm is out of place or not properly aligned with your shoulder socket.

Referred Pain

Referred pain is a phenomenon where pain is perceived in a different location than its actual source. It occurs when sensory nerves from different areas of the body converge onto the same pathway in the spinal cord, leading to a confusion of pain signals. As a result, pain originating from one area can be felt in another area.

In the case of shoulder pain, referred pain can occur when there is an issue or irritation in structures near the shoulder, such as the neck, upper back, or chest.

Heart Attack

In rare instances, shoulder pain can indicate a heart attack, and it is important to seek immediate emergency medical attention if you experience the following symptoms:

• Sudden and intense pain in the left shoulder.
• Shoulder pain that radiates to the arm, neck, or jaw.
• Pain accompanied by other symptoms of a heart attack, such as shortness of breath.

These symptoms may suggest a potential cardiac event, and it is crucial to act promptly by calling the emergency services in your country. Recognizing the signs of a heart attack and seeking immediate medical care can be life-saving.

How To Relieve Shoulder Pain

Following a shoulder injury, it is often recommended to adhere to the RICE protocol, which includes the following steps to aid in the healing process:

• Rest: Refrain from engaging in any physical activities that involve the injured shoulder, allowing it time to rest and recover.
• Ice: Apply a cold compress or ice pack to the affected area for approximately 20 minutes at a time, multiple times a day. This can help reduce pain and swelling.
• Compression: Use an elastic bandage or wrap to provide gentle compression around the shoulder, which can assist in minimizing swelling.
• Elevation: Keep the injured shoulder elevated by propping it up on pillows or using a sling. This helps to reduce swelling and promotes better circulation.

In addition to the RICE protocol, there are several at-home remedies that may help alleviate shoulder pain:

• Taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, as recommended by your healthcare provider.
• Applying ice to the shoulder several times a day, for about 20 minutes each time, to help reduce inflammation and pain.
• Gradually return to your usual physical activities after a period of rest, ensuring you don’t overexert yourself and worsen the injury.
• Taking a warm bath or shower to relax the muscles and relieve discomfort.
• Using a heating pad to apply heat to the affected area, which can help relax muscles and reduce pain.
• Sleeping on the side opposite to the painful shoulder to avoid placing pressure on it during sleep.
• Avoiding heavy lifting or activities that strain the shoulder to prevent further injury.
• Steering clear of repetitive motions or actions that aggravate the shoulder, giving it time to heal.
• Maintaining good posture and incorporating light stretching exercises to promote flexibility and reduce muscle tension.

Is Shoulder Pain Serious?

In most cases, shoulder pain is not a cause for immediate concern. However, it is important to consult with a healthcare provider if the pain persists beyond two to four weeks or if you experience any of the following symptoms along with shoulder pain:

– Fever

– Sudden swelling

– Discoloration of the skin

– Difficulty moving your arm

While it is uncommon to require immediate attention for shoulder pain, there are certain circumstances that warrant immediate medical attention. If you experience a serious injury or exhibit signs of a heart attack, it is crucial to call 911 or go to the emergency room as soon as possible. Signs of a heart attack may include:

– Extreme pain or pressure in the left shoulder

– Pain in the arm, jaw, back, stomach, or neck

– Dizziness

– Difficulty breathing

– Chest pain

– Excessive sweating

– Nausea

– Vomiting

– Racing heart

Diagnosing Shoulder Pain

If your shoulder pain persists and you decide to see your healthcare provider, they will conduct a comprehensive evaluation to diagnose the cause of your pain. This will typically involve a thorough physical examination, where your provider will assess your symptoms, medical history, and lifestyle factors. They may also ask you to perform certain movements and tasks to evaluate the range of motion and strength in your shoulder.

In some cases, additional testing may be recommended to gather more information about your condition. These tests may include:

– X-rays: These can help visualize the bones and joint structures in your shoulder and detect any fractures, dislocations, or signs of arthritis.

– Magnetic resonance imaging (MRI): An MRI provides detailed images of the soft tissues, such as muscles, tendons, and ligaments, in your shoulder. It can help identify tears, inflammation, or other abnormalities.

– Computerized tomography (CT) scans: CT scans provide detailed cross-sectional images of the shoulder, allowing for a more comprehensive evaluation of bony structures and potential abnormalities.

– Ultrasound: Ultrasound uses sound waves to create real-time images of the structures in your shoulder. It can help assess the condition of tendons, muscles, and other soft tissues.

The decision to order additional tests will depend on the initial evaluation and your specific situation. These tests can provide valuable insights and assist in making an accurate diagnosis and developing an appropriate treatment plan.

Treating Shoulder Pain

If your shoulder pain persists despite self-care measures, there are various medical treatment options available. Your healthcare provider will assess your specific symptoms and determine the most appropriate course of treatment. Some potential treatment options may include:

• Physical therapy: A physical therapist can design a tailored exercise program to improve the strength and flexibility of the muscles and tissues surrounding the shoulder joint. This can help alleviate pain and restore normal shoulder function.
• Range-of-motion exercises: These exercises aim to improve the range of motion and flexibility of the shoulder joint. They can be prescribed by a healthcare provider or performed with the guidance of a physical therapist.
• Steroid injections: Corticosteroid injections can provide temporary relief by reducing inflammation and easing pain. These injections are typically administered directly into the shoulder joint by a healthcare provider.
• Barbotage: This procedure involves using a needle to break up and remove calcium deposits in the rotator cuff. It may be recommended if calcium deposits are causing pain and limiting shoulder movement.
• Extracorporeal shockwave therapy (ESWT): ESWT utilizes high-energy sound waves to stimulate healing and reduce pain in the affected area. It can be beneficial for certain conditions, such as calcific tendonitis or chronic tendinopathies.
• Surgery (in rare cases): Surgery is typically considered when conservative treatments have not provided sufficient relief or in cases of severe shoulder conditions, such as large tears in the rotator cuff or shoulder instability. Surgical procedures may involve repairing or reconstructing damaged structures in the shoulder joint.

A Quick Review

Shoulder pain is often not indicative of a serious health condition, but it can be disruptive and affect your daily activities. It’s essential to prioritize rest and allow your shoulder to recover if you experience pain. Taking steps to protect the shoulder, such as avoiding heavy exercise or activities that aggravate the pain, can aid in the healing process. Applying ice to the affected area may also provide temporary relief.

If your shoulder pain persists or worsens despite self-care measures, it is advisable to consult with a healthcare provider. They can assess your specific symptoms, conduct a thorough examination, and provide a proper diagnosis. Based on their evaluation, they may recommend additional medical treatments, such as physical therapy or further diagnostic tests, to identify the underlying cause and develop an appropriate treatment plan.

Remember to communicate any concerns or changes in your symptoms to your healthcare provider, as they are best equipped to provide guidance and ensure your shoulder pain is properly addressed.