Source: InjuryMap

Common Causes of Shoulder Pain

If you are suffering from shoulder pain caused by osteoarthritis or injury, it is possible to restore your mobility and quality of life.  Learn more about shoulder pain and some of the shoulder treatment options available at Arkansas Surgical Hospital.

A version of this article featuring Dr. Brent Lawrence appeared in the August 2019 issue of the Arkansas Senior Resource DirectoryThe above image is sourced from InjuryMap.

The Parts of Your Shoulder

Your shoulder joint has three bones: the scapula (shoulder blade), the clavicle (collarbone), and the humerus (upper arm bone).  Your shoulder also contains muscles, tendons, ligaments, and cartilage that provide strength, stability, and flexibility.  Damage to these parts of your shoulder can lead to persistent pain and stiffness.

Common Causes of Shoulder Pain

Most shoulder problems fall into four major categories: tendon inflammation (including rotator cuff tears), instability, arthritis, or fractures.

Tendon Inflammation & Rotator Cuff Tears

Tendon inflammation commonly occurs due to bursitis, tendinitis, or shoulder impingement.

  • Bursitis: The bursa, a small fluid-filled sac located above the shoulder joint, acts as a cushion between the bones and the overlying soft tissue.  This helps reduce friction as you move your shoulder.  Sometimes, injury or excessive use of your shoulder can lead to swelling of the bursae between the rotator cuff and the acromion (part of the shoulder blade).  This results in a condition known as bursitis.
  • Tendinitis: Bursitis commonly occurs in association with tendinitis.  Tendinitis is a result of inflammation in the rotator cuff tendons and may be acute or chronic in nature.
    • Acute injuries of the shoulder can be caused by excessive throwing or other repetitive overhead activities.
    • Chronic injuries of the shoulder occur over time and are degenerative in nature.
  • Impingement: Shoulder impingement occurs when you lift your arm over your head or away from your body and the acromion impinges on the bursa and the rotator cuff tendons beneath.

Rotator cuff tears may develop from acute injury or degenerative changes in the shoulder due to advancing age, long-term overuse, wear and tear, or sudden injury.

Shoulder Instability

Shoulder instability occurs when the ball or head of the proximal humerus is forced out of the shoulder socket.  This may be partial (subluxation) or complete (dislocation) and may be caused by acute trauma or degenerative processes.  Some people are even born with general laxity in their shoulders and other joints.  Damage to the ligaments, tendons, and muscles around the shoulder may lead to recurring dislocations and even arthritis.

Arthritis

Arthritis is a common term used to refer to inflammation in a joint.  There are many types of arthritis, but the most common type of arthritis in the shoulder is osteoarthritis (also known as “wear and tear” arthritis).  Other types of arthritis may be related to rotator cuff tears, inflammation, or history of trauma.

Osteoarthritis develops slowly over time and results from cartilage being worn down to bone, causing increased friction and inflammation in the shoulder.  Symptoms of osteoarthritis of the shoulder include stiffness, swelling, pain, limited motion, and weakness.

Fractures

Fractures occur when bones around the shoulder are broken.  In older patients, this usually results from a fall.  In younger patients, it is usually the result of high-energy trauma such as a motor vehicle accident or a sports injury.  Fractures result in severe pain, swelling, and bruising around the shoulder.

Diagnosing Shoulder Pain

Consult an orthopedic surgeon for diagnosis of your shoulder problems.  An orthopedic surgeon will evaluate your medical history and your daily activities.  He or she will also physically examine you, which may include x-rays, ultrasounds, or an MRI.

Your surgeon will also ask you to describe your shoulder pain.  If the pain travels down your arm to your elbow or fingertips, for example, it may indicate that a disease is responsible for your discomfort.  Diseases that can cause shoulder pain include disorders of the spine, liver disease, heart disease, and diabetes.

Shoulder Surgery

The large majority of patients with shoulder pain will respond to simple, non-surgical treatment methods.  However, depending on your injury or condition, you may require shoulder surgery.

Examples of non-surgical treatments for shoulder pain include NSAIDs (non-steroidal anti-inflammatory drugs), physical therapy, and steroid injections.  Once non-surgical options have failed and your activities remain painful or limited, your orthopedic surgeon may recommend shoulder surgery.

Surgery may be performed with a shoulder scope for conditions such as impingement, rotator cuff tears, or instability.  In the case of arthritis, you may require shoulder replacement.  Shoulder replacement surgery has excellent success rates, and new surgical techniques have made it even more effective at eliminating your shoulder pain, improving your mobility, and restoring your quality of life.

Recovery from Shoulder Surgery

Full recovery from shoulder surgery is a long process.  Your specific recovery protocol will vary depending on your orthopedic surgeon, but here is a general outline of what to expect:

  • While you are recovering in the hospital from your shoulder surgery, you will be given IV antibiotics to prevent infection and medications to relieve your pain.
  • For the first two weeks you are home, you will need to be assisted 24 hours a day by a family member, friend, or other caregiver.
  • Physical therapy will usually start around week four and will focus on improving your shoulder’s range of motion.  Then, once your tissues have had time to heal, you will advance to strengthening exercises.
  • You will be confined to a sling for about the first six weeks after surgery.
  • Your mobility should continue to improve over the first three to six months after surgery.

Living with Shoulder Pain

There are many treatment options for shoulder pain.  To learn more about different solutions, contact Arkansas Surgical Hospital at (877) 918-7020 for help making an appointment with one of our specialists.

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