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The Truths Behind Shoulder Pain

Symptoms and diagnosis

By Neurosurgery Singapore

How our shoulder works?

  • Your shoulder is a complex, highly mobile structure made up of several components. There are two joints:

    • glenohumeral joint – where your upper arm bone (the humerus) connects with your shoulder blade (scapula)
    • acromioclavicular joint – where the top of your shoulder blade meets your collarbone (clavicle).

    Strong connective tissue forms your shoulder capsule. This keeps the head of the humerus in place in the joint socket. The joint capsule is lined with a synovial membrane. It produces synovial fluid which lubricates and nourishes the joint.

    Strong tendons, ligaments and muscles also support your shoulder and make it stable.

What are some causes related to shoulder pain?

Several factors and conditions can contribute to shoulder pain. The most prevalent cause is rotator cuff tendinitis.

This is a condition characterized by swollen tendons. Another common cause of shoulder pain is impingement syndrome where the rotator cuff gets caught between the acromium (part of the scapula that covers the ball) and humeral head (the ball portion of the humerus).

Sometimes shoulder pain is the result of injury to another location in your body, usually the neck or biceps. This is known as referred pain. Referred pain generally doesn’t get worse when you move your shoulder.

Other causes of shoulder pain include:

  • arthristis
  • torn cartilage
  • torn rotator cuff
  • swollen bursa sacs or tendons
  • bone spurs (bony projections that develop along the edges of bones)
  • pinched nerve in the neck or shoulder
  • broken shoulder or arm bone
  • frozen shoulder
  • dislocated shoulder
  • injury due to overuse or repetitive use
  • spinal cord injury
  • heart attack

“Shoulder pain is common in our community. In younger people, pain is more likely to be due to an accident or injury. However as you age natural wear and tear occurs in the shoulder joint and the rotator cuff tendon. This may become persistently painful over time.”

What types of treatments?

  • People can manage many types of shoulder problem at home.

    Treatment typically involves a period of rest and avoidance of activities that aggravate the pain.

    A doctor may also recommend applying heat or ice to the injury for pain relief, as well as placing pressure on the area to reduce swelling. Physical therapy improves shoulder strength and flexibility.

    Slings can be helpful in managing shoulder dislocations, separations, and fractures, as they keep the structures of the joint in position. Before applying a sling, a doctor will put the bones back into place.

    Sometimes, doctors recommend medication to reduce pain and inflammation. Over-the-counter drugs, such as ibuprofen and aspirin, are available. Doctors can also prescribe medications and inject steroids or numbing medicine directly into the shoulder to relieve pain.

    Some injuries require surgery for treatment. For example, rotator cuff tears and adhesive capsulitis do not always improve with rest and medicine. Severe rotator cuff tears or recurrent dislocations may warrant early surgical consultation rather than a trial of at-home management.

Things to take note if you have shoulder pain

Simple shoulder exercises can help stretch and strengthen muscles and rotator cuff tendons. A physical therapist or occupational therapist can show you how to do them properly.

If you’ve had previous shoulder issues, use ice for 15 minutes after exercising to prevent future injuries.

After having bursitis or tendinitis, performing simple range-of-motion exercises every day can keep you from getting frozen shoulder.

Shoulder pain is a common complaint. The unique anatomy and range of motion of this joint make it susceptible to injury. Common triggers for injury include accidents, repetitive movements, manual labor, sports, and aging.

An injury that causes severe pain requires immediate care. A person should also see a doctor right away if they have any joint deformity, sudden swelling, an inability to use the joint, weakness or numbness in the arm or hands, or intolerable pain.

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