Shoulder Pain and Common Shoulder Problems

What the majority of people consider the shoulder is actually a couple of joints that combine with tendons and muscular tissues to allow a large range of motion within the arm-- from scratching your back to throwing the perfect pitch.

Mobility has its price, however. It might result in increasing issues with instability or impingement of the soft tissue or bony structures within your shoulder, producing pain. You might feel pain just when you move your shoulder, or all the time. The pain might be temporary or it might continue and call for medical diagnosis and treatment.

This article offered you by Audrain Orthopaedics of Mexico, MO reveals a number of the common causes of shoulder pain, as well as some basic orthopedic treatment options. Your doctor can give you more detailed information about your shoulder pain.

Anatomy

Your shoulder is comprised of 3 bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle). The head of your upper arm bone fits right into a rounded socket in your shoulder blade. This socket is called the glenoid. A combination of muscles and tendons helps keep your arm bone centered within your shoulder socket. These kinds of tissues are referred to as the rotator cuff. They cover the head of your upper arm bone and affix it to your shoulder blade.

Cause

Most shoulder issues fall into four primary categories:

  • Tendon inflammation (bursitis or tendinitis) or tendon tear
  • Instability
  • Arthritis
  • Fracture (broken bone)

Other significantly less common sources of shoulder pain are tumors, infection, and nerve-related issues.

Bursitis

Bursae are compact, fluid-filled cavities which are located within joints throughout the body, including the shoulder. They serve as cushions in between bones and the overlying soft tissues, and help reduce friction between the gliding muscle groups and the bone tissue.

Sometimes, too much utilization of the shoulder results in irritation and swelling of the bursa in between the rotator cuff and part of the shoulder blade known as the acromion. The result is a condition referred to as subacromial bursitis.

Bursitis typically develops in association with rotator cuff tendinitis. The many tissues in the shoulder may become inflamed and painful. Several daily activities, such as combing your hair or getting dressed, may become very difficult.

Tendinitis

A tendon is a cord that connects muscle to bone. Most cases of tendinitis in Central Missouri are an end result of inflammation in the tendon.

Normally, tendinitis belongs to two kinds:

  • Acute. An excessive amount of ball throwing or many other overhead activities during work or sport may lead to acute tendinitis.
  • Chronic. Degenerative diseases such as arthritis or repeated wear and tear due to age can result in chronic tendinitis.

The most commonly impacted tendons within the shoulder are the 4 rotator cuff tendons and one of the biceps tendons. The rotator cuff is comprised of four small muscles and their tendons which cover the head of your upper arm bone and always keep it in the shoulder socket. Your rotator cuff helps provide shoulder motion and stability.

Tendon Tears

Splitting and tearing of tendons may result from acute injury or degenerative changes in the tendons as a result of advancing age, long-term overuse and wear and tear, or a sudden injury. These tears could be partial or may totally separate the tendon from its attachment to bone. In most cases of total tears, the tendon is pulled away from its attachment to the bone. Rotator cuff and biceps tendon injuries are among the most popular of these traumas.

Impingement

Shoulder impingement takes place when the top of the shoulder blade (acromion) places pressure on the underlying soft tissues whenever the arm is lifted away from the body. As the arm is raised, the acromion rubs, or "impinges" on, the rotator cuff tendons and bursa. This can result in bursitis and tendinitis, causing pain and limiting movement.

Instability

Shoulder instability develops whenever the head of the upper arm bone is forced out of the shoulder socket. This could happen because of a sudden injury or from overuse.

Shoulder dislocations may be partial, with the ball of the upper arm coming just partly out of the socket. This is called a subluxation. A total dislocation means the ball comes completely out of the socket.

Once the ligaments, tendons, and muscles about the shoulder become loose or torn, dislocations can take place repeatedly. Repeating dislocations, which may be partial or complete, cause pain and unsteadiness when you raise your arm or move it away from your body. Repeated episodes of subluxations or dislocations lead to an increased risk of developing arthritis within the joint.

Arthritis

Shoulder pain can also arise from arthritis. There are many types of arthritis. The most common type of arthritis within the shoulder is osteoarthritis, also known as "wear and tear" arthritis.

Symptoms such as swelling, pain, and stiffness, usually begin during middle age.

Osteoarthritis establishes slowly and the pain it causes worsens with time. Osteoarthritis, may be related to sports or work injuries or chronic wear and tear. Other varieties of arthritis can be linked with rotator cuff tears, infection, or an inflammation of the joint lining.

Commonly individuals will stay clear of shoulder movements in an attempt to lessen arthritis pain. This often leads to a tightening or stiffening of the soft tissue portions of the joint, producing a painful restriction of motion.

Fracture

Fractures are broken bones. Shoulder fractures frequently involve the clavicle (collarbone), humerus (upper arm bone), and scapula (shoulder blade). Shoulder fractures in older patients are frequently the consequence of a fall from standing height. In more youthful patients, shoulder fractures are frequently brought on by a high energy injury, such as a motor vehicle accident or contact sports injury. Fractures commonly cause severe pain, swelling, and bruising about the shoulder.

Doctor's Exam

When it comes to an intense trauma resulting in intense pain, get medical treatment immediately. If the pain is much less serious, it might be safe to rest a couple of days to see if time will fix the issue. If symptoms persist, see a Mexico, MO orthopedic doctor. Your physician will carry out a thorough assessment to establish the root cause of your shoulder pain and supply you with treatment options.

Medical History

The initial step in the evaluation is a comprehensive medical history. Your physician might ask how and when the discomfort began, whether it has developed before and how it was treated, and other questions to help determine both your general health and the potential causes of your shoulder problem.

Because most shoulder conditions are aggravated by certain tasks, and eased by particular activities, a medical history may be a valuable tool in discovering the provider of your pain.

Physical Examination

A thorough examination will be required to discover the causes of your shoulder pain. Your doctor will look for physical irregularities, swelling, deformity or muscle weakness, and examine for tender areas. He or she will observe your shoulder range of motion and strength.

Tests

Your doctor may order certain tests in order to help identify the root cause of your pain and any other problems.

  • X-rays. These pictures will reveal any injuries to the bones that comprise your shoulder joint.
  • Magnetic resonance imaging (MRI) and ultrasound. These imaging studies produce better photos of soft tissues. MRI may help your doctor identify injuries to the ligaments and tendons surrounding your shoulder joint.
  • Computed tomography (CT) scan. This tool combines x-rays with computer technology to create a really in-depth perspective of the bones in the shoulder area.
  • Electrical studies. Your doctor may order a test, such as an EMG (electromyogram), to assess nerve function.
  • Arthrogram. During this x-ray study, dye is infused into the shoulder to better show the joint and its neighbouring muscles and tendons. It might be combined with an MRI.
  • Arthroscopy. In this surgical treatment, your doctor looks within the joint with a fiber-optic camera. Arthroscopy may show soft tissue traumas that are not noticeable from the physical exam, x-rays, and other tests. Along with helping find the cause of pain, arthroscopy may be used to remedy the problem.

Treatment

Activity Changes

Treatment normally involves rest, changing your activities, and physical therapy in order to help you improve shoulder strength and flexibility. Common sense solutions like staying clear of overexertion or overdoing tasks where you usually do not participate can help to prevent shoulder pain.

Medications

Your physician may prescribe medication to decrease inflammation and pain. If medicine is suggested to relieve pain, it should be taken only as directed. Your physician might also suggest injections of numbing medications or steroids to relieve pain.

Surgery

Surgery might be necessitated to deal with some shoulder issues. However, the large majority of patients with shoulder pain will react to straightforward treatment methods including altering activities, rest, exercise, and medication.

Certain kinds of shoulder problems, like recurring dislocations and certain rotator cuff tears, might not benefit from exercise. In these cases, surgery might be recommended rather early. Surgery can involve arthroscopy to get rid of scar tissue or repair torn tissues, or traditional open procedures for larger reconstructions or shoulder replacement.

No matter what amount of activity or inactivity you have, the fact of the matter is that having shoulder troubles may be a big issue. Dr. Kathleen Weaver of Audrain Orthopaedics has the expertise and training you can trust to help you relieve your Mexico, MO shoulder injury.

Thanks for your care in the past and especially during my knee replacement.  You made an operation that I dreaded much easier.

B.A. age 81