The shoulder has a wide and versatile range of motion. When something goes wrong with your shoulder, it hampers your ability to move freely and can cause a great deal of pain and discomfort.
The shoulder is a ball-and-socket joint that has three main bones: the humerus (long arm bone), the clavicle (collarbone), and the scapula (also known as the shoulder blade). These bones are cushioned by a layer of cartilage. There are two main joints. The acromioclavicular joint is between the highest part of the scapula and the clavicle. The glenohumeral joint is made up of the top, ball-shaped part of the humerus bone and the outer edge of the scapula. This joint is also known as the shoulder joint.
The shoulder joint is the most mobile joint in the body. It moves the shoulder forward and backward. It also allows the arm to move in a circular motion, and to move up and away from the body.
Shoulders get their range of motion from the rotator cuff. The rotator cuff is made up of four tendons. Tendons are the tissues that connect muscles to bone. It may be painful or difficult to lift your arm over your head if the tendons or bones around the rotator cuff are damaged or swollen.
You can injure your shoulder by performing manual labor, playing sports, or even by repetitive movement. Certain diseases can bring about pain that travels to the shoulder. These include diseases of the cervical spine of the neck, as well as liver, heart, or gallbladder disease.
You’re more likely to have problems with your shoulder as you grow older. It is especially common after age 60. This is because the soft tissues surrounding the shoulder tend to degenerate with age.
In many cases, you can treat shoulder pain at home. However, physical therapy, medications, or surgery may also be necessary.
What causes shoulder pain?
A number of factors and conditions can contribute to shoulder pain. The most prevalent cause is rotator cuff tendinitis. This is a condition characterized by inflamed tendons. Another common cause of shoulder pain is an 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 bicep. This is known as referred pain. Referred pain generally doesn’t get worse when you move your shoulder.
Other causes of shoulder pain include several forms of arthritis, torn cartilage, or a torn rotator cuff. Swelling of the bursa sacs (which protect the shoulder) or tendons can also cause pain. Some people develop bone spurs, which are bony projections that develop along the edges of bones.
Pinching a nerve in the neck or shoulder, or breaking a shoulder or arm bone, are also causes of pain. A frozen shoulder is when tendons, ligaments, and muscles stiffen and become difficult or impossible to move. A dislocated shoulder is when the ball of the humerus pulls out of the shoulder socket. An injury due to overuse or repetitive use can cause injury.
Serious conditions such as a spinal cord injury or a heart attack may lead to shoulder pain.
How is the cause of shoulder pain diagnosed?
Your doctor will want to find out the cause of your shoulder pain. They’ll obtain a history and do a physical examination. They’ll feel for tenderness and swelling, and will also assess your range of motion and joint stability. Imaging tests, such as an X-ray or MRI, can produce detailed pictures of your shoulder to help with the diagnosis.
Your doctor may also ask questions to determine the cause. Be prepared to answer the following questions:
- Is the pain in one shoulder or both?
- Did this pain begin suddenly? If so, what were you doing?
- Does the pain move to other areas of your body?
- Can you pinpoint the area of pain?
- Does it hurt when you’re not moving?
- Does it hurt more when you move in certain ways?
- Is it a sharp pain or a dull ache?
- Has it been red, hot, or swollen?
- Does it keep you awake at night?
- What makes it worse and what makes it better?
- Have you had to limit your activities because of your shoulder?
When should I seek medical help?
If your shoulder pain is sudden and not related to an injury, consult a doctor immediately. It may be a sign of a heart attack. Other signs of a heart attack include trouble breathing, chest tightness, dizziness, excessive sweating, and pain in the neck or jaw. Call 911 immediately if you experience these symptoms.
Go to an emergency room if you injured your shoulder and are bleeding, swollen, or you can see exposed tissue.
Additionally, you should contact your doctor if you experience fever, inability to move your shoulder, lasting bruising, heat and tenderness around the joint, or pain that persists beyond a few weeks of home treatment.
What are the treatment options for shoulder pain?
Treatment will depend on the cause and severity of the shoulder pain. Some treatment options include physical or occupational therapy, a sling or shoulder immobilizer, or surgery. Your doctor may also prescribe medication such as nonsteroidal anti-inflammatory medications (NSAIDs) or corticosteroids. Corticosteroids are powerful anti-inflammatory drugs that your doctor may inject into your shoulder or give by mouth.
If you’ve had surgery on your shoulder, follow after-care instructions carefully.
Some minor shoulder pain can be treated at home. Icing the shoulder for 15 to 20 minutes three or four times a day for several days can help reduce pain. Use an ice bag or wrap ice in a towel because putting ice directly on your skin can cause frostbite and burn the skin.
Resting the shoulder for several days before returning to normal activity and avoiding any movements that might cause pain can be helpful. Limit overhead work or activities. Other home treatments include using over-the-counter nonsteroidal anti-inflammatory medications to help reduce pain and inflammation and compressing the area with an elastic bandage to reduce swelling.
Read more: How to get wide shoulders »
How can I prevent 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 issues with your shoulders, use ice for 15 minutes after exercising to prevent future injuries.
After a bout of bursitis or tendinitis, performing simple range-of-motion exercises every day can keep you from getting frozen shoulder.
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