Shoulder pain is a common cause for individuals visiting a doctor’s office. There are many causes of shoulder pain. When shoulder pain interferes with your ability to do the things you need to, each day, it is time to seek medical advice.
What is shoulder pain?
Shoulder pain is any pain in or around the shoulder joint. The shoulder is the most moveable joint in the human body. It is composed of a group of four muscles and their tendons. This group is called the rotator cuff, a group of muscles which connect the shoulder to the arm, and it is the rotator cuff which gives the shoulder such a wide range of movement.
Causes of shoulder pain
The most common cause of shoulder pain is when rotator cuff tendons become inflamed or trapped in your shoulder. This is called rotator cuff tendinitis, or irritation of these tendons and inflammation of the bursa, small slippery fluid filled sacs that the tendons glide over. A rotator cuff tear, when one of the tendons is torn from overuse or injury, can also cause intense shoulder pain.
Shoulder pain may also be caused by:
• Arthritis in the shoulder joint
• Bone spurs in the shoulder area
• Bursitis, which is inflammation of a fluid-filled sac (bursa) that normally protects the joint and helps it move smoothly
• Broken shoulder bone
• Dislocation of the shoulder
• Shoulder separation
• Frozen shoulder, which occurs when the muscles, tendons, and ligaments inside the shoulder become stiff, making movement difficult and painful
• Overuse or injury of nearby tendons, such as the bicep muscles of the arms
• Nerve injury that leads to abnormal shoulder movement
• Tears of the rotator cuff tendons
• Poor shoulder posture and mechanics
Shoulder pain may be due to a problem in another area of the body, such as the neck or lungs. This is called referred pain. There is usually pain at rest and no worsening of pain when moving the shoulder.
What can you do if you have shoulder pain?
In some cases you can take care of your shoulder pain at home. Try putting ice on your shoulder for 15 minutes, then leave it off for 15 minutes, three or four times a day for a few days. Make sure you wrap the ice in cloth so it does not give you frostbite. Take ibuprofen to reduce pain and swelling. Slowly return to your regular activities once you start feeling less pain.
Sudden shoulder pain can be a sign of a heart attack. Call Emergency Services if you have sudden pressure or crushing pain in your shoulder, especially if the pain starts in your chest, jaw or neck. If you fall on your shoulder and feel sudden intense pain, you should see a doctor because you may have torn rotator cuff or dislocated your shoulder. If you have had shoulder pain before, try using ice and ibuprofen after exercising. Learn proper exercises to stretch and strengthen your rotator cuff tendons and shoulder muscles. Also, physical therapy can help. Make an appointment and talk about your options.
If you have shoulder pain the following are recommended:
• do not completely stop using your shoulder – this can stop it getting better
• do not do things that make it worse
• do not make up your own strenuous exercises or use heavy gym equipment
• do not slouch when sitting – do not roll your shoulders or bring your neck forward
Medical treatment
The most common cause of shoulder pain is related to rotator cuff problem. Your doctor might make the diagnosis or refer you to a specialist. In coming to a diagnosis your doctor will check your shoulder for tenderness and lift your arm to see in which position you have pain. Blood or imaging tests, such as x-rays or MRI, may be ordered to help diagnose the problem. Treatment for rotator cuff tendinitis involves resting your shoulder and avoiding the activities that cause you pain. You can also try applying ice packs 20 minutes at a time, 3 or 4 times a day. Medicines like Non-steroidal anti-inflammatory drugs (NSAIDs) might reduce swelling and inflammation. Injection of an anti-inflammatory medicine called corticosteroid might be required.
Eventually, you should start physical therapy to learn to stretch and strengthen the muscles of your shoulder. Surgery can remove inflamed tissue and part of the bone that lies over the rotator cuff – which may help relieve the pressure on your tendons. Someone with a partial rotator cuff tear can try rest and exercise, if he/she does not normally put a lot of demand on his/her shoulder. If there is a complete tear, or if the symptoms do not improve with therapy, you may need surgery to repair the tendon. With rest or exercise, symptoms of most shoulder problems often improve or go away, though it may take months.
Conclusion
Pain in the shoulder is very common and can occur throughout adult life. Many cases of shoulder pain respond to simple treatments / self-management. If pain persists or is very severe you should seek medical attention.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
