Shoulder pain can be disabling and can interfere with your ability to perform day-to-day activities.It may also bench you from your favorite sports activities. Learn about the potential causes of shoulder pain and what can be done to relieve shoulder pain
What Causes Shoulder Pain?Shoulder pain is a common complaint. It is important to determine the cause of shoulder pain, as treatment for one type of pain may not be appropriate for all types of pain. The following are some common conditions affecting the shoulder:
Bursitis - bursitis of the shoulder occurs when there is inflammation of the bursa surrounding the rotator cuff tendons. The bursa of the rotator cuff become inflamed between the bones of the shoulder, leading to reduced space and pain. Bursitis can cause shoulder pain on the outside of the upper arm and shoulder, pain while sleeping and pain while doing activities where the arm is raised above your head.
Frozen shoulder (adhesive capsulitis) - the causes of frozen shoulder are not always clear. Frozen shoulder causes the capsule surrounding the shoulder joint to decrease and cause scar tissue. The pain of a frozen shoulder may be described as a dull ache and may impede activities such as brushing hair and putting on your shirt. Your shoulder may also hurt when you sleep on it. Frozen shoulders may occur for no apparent reason and may take months to resolve.
Shoulder instability- shoulder instability occurs when the structures surrounding the shoulder joint become weakened, failing to keep the ball of the shoulder joint firmly within the socket. This may lead to a condition called subluxation, in which the ball comes partially out of the joint, or complete dislocation, in which the ball of the shoulder joint is completely out of the socket. This condition is more common in patients who have sustained a prior dislocation, in young athletes and in patients who have a connective tissue disorder.
Labral tears- the labrum is a cuff of cartilage that lines the socket of the shoulder joint. Trauma to the shoulder can cause a tear in the labrum, resulting in an aching in the shoulder joint, pain with certain activities and a sensation of “catching” when the shoulder is moved.
Arthritis- the shoulder can be affected by both osteoarthritis and rheumatoid arthritis, generally in patients over the age of 50. Arthritis leads to a wearing down of the cartilage of the shoulder joint. The shoulder may ache and movement of the shoulder may become painful.
When Should You Call Your Doctor About Your Shoulder Pain?The shoulder is a complicated joint; as such, pinpointing the cause of your shoulder pain can be difficult. If pain is severe, is accompanied by bruising or swelling or there is obvious deformity of your shoulder, you should seek medical care. In addition, the inability to carry any objects, pain that awakens you from your sleep or signs of infection (redness, swelling or warmth) warrant a doctor’s visit.
Your doctor will perform an exam of your shoulder to try to determine the cause of your shoulder pain. He/she will ask you about the nature of your pain and the specific activity that may have precipitated your pain, if known. Your doctor may decide that an x-ray is needed to help determine the nature of your injury. If the cause of your pain is still uncertain after a physical exam and an x-ray, and does not improve with time, an MRI may be necessary.
An MRI (magnetic resonance imaging) uses a magnetic field and a type of radio frequency energy that enables doctors to view structures of the body in three dimensional computer images. There is no radiation involved in this test, unlike a CT scan. MRIs can show tendons, ligaments, bones, organs and other structures clearly to allow for diagnosis of various conditions.
If after these tests are performed and no cause to explain your shoulder pain can be found, your doctor may choose to send you to a specialist, such as an orthopedic specialist or a rheumatologist, who may be better equipped to diagnose the problem.
How is Shoulder Pain Treated?There are several treatments that can help to relieve shoulder pain, as outlined below:
Rest- if you suffer acute shoulder pain, rest is warranted for a few days to allow inflammation in your shoulder to subside. However, you should not rest your shoulder for too long; doing so may result in a frozen shoulder and a prolonged recovery.
Ice/Heat- for the first few days following an acute injury, ice should be applied to the shoulder joint several times a day for 20 minutes at a time. A bag of frozen peas or frozen corn makes an excellent ice bag and can be refrozen and used again. Once a few days have passed, you may use heat to relieve shoulder pain. A heating pad may provide soothing relief.
Stretching- you should not baby your shoulder for longer than a few days unless advised by your physician. You should begin gentle stretching of the shoulder joint after a few days to prevent a frozen shoulder form occurring. Gentle stretching may alleviate some of your discomfort. Ask your doctor to demonstrate what type of stretches you should be doing.
Physical therapy- your physician may prescribe physical therapy to help with your shoulder pain, depending on the type of injury you have sustained. Physical therapists use ice, heat, ultrasound and various other methods of pain relief to alleviate pain. In addition, a physical therapist may prescribe an exercise regimen for you to follow at home.
Medications- anti-inflammatory medications are often prescribed for orthopedic conditions, both to relieve pain and reduce inflammation. Be sure to follow dosage instructions carefully. Some anti-inflammatories can cause stomach irritation and may need to be taken with food. If you have questions about any medications prescribed for you, ask your pharmacist.
Cortisone injections- cortisone injections are sometimes used to relieve shoulder pain. Cortisone is a powerful anti-inflammatory that can relieve pain for months at a time. There are some dangers associated with the use of cortisone injections; cortisone injections are not indicated for all conditions that may affect the shoulder.
Shoulder pain may be acute or chronic and may be caused by several different conditions. It is important to obtain a diagnosis for any shoulder pain that persists beyond a few days, particularly if pain is severe and causes problems with using the shoulder. When in doubt, consult your physician for advice and treatment options for shoulder pain.