Shoulder Pain: How To Identify and Treat Shoulder Problems


What are Shoulder Problems?


Shoulder pain and problems related to it are common these days. There are a variety of shoulder problems that are caused by injuries and chronic (long-lasting) or acute (sudden) inflammation of the shoulder joint. The shoulder is a pretty complex joint that has excellent mobility. Although this ability is good to have, at the same time this also increases the chances of getting injured.


The shoulder is build with the help of several layers, including the following:


Bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle).


Joints: These help with everyday movement for daily activities.


Acromion: Formed by a part of the scapula, this is the highest point (roof) of the shoulder.


Ligaments: A flexible, shiny, white band of fibrous tissue that helps in binding joints together and also connects the cartilage and bones


Rotator cuff: The rotator cuff (along with related muscles) holds the ball of the glenohumeral joint at the top of the humerus (upper arm bone) and is made up of tendons.


Tendons: The tough cords of tissue that connect the bones and muscles. The tendons in the rotator cuff are a group of tendons that help in connecting the deepest layer of muscles with the humerus.


Muscles: These help rotate and support the shoulder in many directions.


Bursa: This refers to a closed space in the middle of 2 moving surfaces that consists of a small amount of lubricating fluid inside. It is located between the outer layer of bulky, large muscles and the rotator cuff muscle layer.


What Causes Shoulder Problems?


The shoulder is the joint in the body that is capable of most motion. But because of its range of motion, it is also an unstable joint. It is at risk of injury as the ball of the upper arm is much larger than the socket that comprises the shoulder. This shoulder joint is in turn supported by soft tissues. These are the ligaments, tendons, and muscles. They are also subject to degeneration, overuse and injury.


Over time progressive diseases could break down tissues in the body and might also play a role in shoulder problems. Or they could even result in pain that travels along the nerves to the shoulder.


Some of the most common causes of shoulder problems include:


Separation: The AC joint gets separated when the ligaments attached to the clavicle (collarbone ) are partially, or completely torn away from the shoulder blade (scapula). Shoulder separation could also be the result of a fall or a strong blow to the shoulder.


Dislocation: Generally, the most commonly dislocated major joint of the body is the shoulder joint. This is usually the result of a strong force that separates the joint's socket and the shoulder joint's ball. The socket is called the glenoid.


Tendinosis: Tendinosis of the shoulder occurs when the biceps tendon or rotator cuff become inflamed and worn out. This is generally the result of getting pinched by closeby tissues. The injury may differ from mild inflammation to covering most of the rotator cuff. When the rotator cuff tendon becomes thickened and inflamed, it can become trapped under the acromion.


Bursitis: Bursitis often occurs when impingement syndrome and tendonitis lead to inflammation of the bursa sac that helps in protecting the shoulder.


Impingement syndrome: This can be the result of rubbing of the rotator cuff and shoulder blade or excessive squeezing. The pain is from an inflamed lubricating sac (bursa) over the rotator cuff. Or it could also be the result of inflammation of the rotator cuff tendons.Impingement syndrome can result in a torn rotator cuff.


Adhesive capsulitis (frozen shoulder): This condition is usually the result of an injury that results in lack of use due to pain. Insufficient use may result in the scar tissue growing between the joint surfaces and inflammation. This further restrains motion, reducing the synovial fluid used to lubricate the gap between the socket and arm bone. This fluid generally helps the shoulder joint to move.


Rotator cuff tear: A rotator cuff tear includes one or more rotator cuff tendons getting torn from overuse and inflamed, a fall on an outstretched hand, ageing, or a collision.


Fracture: A fracture is a total or partial crack or break through a bone. It usually occurs due to an impact injury.


What are the Symptoms of Shoulder Problems?


Shoulder pain may either be only in one area or it may also spread to many different areas down the arm or around the shoulder. The type and location of symptoms depend on the location of the inflammation or the injury. Below are a few symptoms of some commonly seen shoulder problems.


A rotator cuff injury can usually cause pain on the outside of the shoulder or in the front. The pain gets worse when you try to lift an object over your head or raise your arm. Rotator cuff pain could be pretty severe. It can wake you up at night and make even simple tasks seem impossible.


Pain can start suddenly if you have unstable shoulders, for instance, just as you throw a ball. You may feel numbness all the way down your arm. Your shoulder may feel sore and weak when you move it, or it may feel “loose” in your joint. Having shoulder instability is different compared to shoulder dislocation.


The symptoms of a dislocated shoulder include inability to move the joint, intense pain, swelling or bruising, and a visibly out of place shoulder. The dislocation can lead to numbness, weakness or tingling down your arm or near the injury. A dislocated shoulder needs medical care immediately.


If shoulder pain is the result of inflammation, like bursitis, it may feel achy, stiff, and painful when you move it. Sometimes it may look red or swollen.


How are Shoulder Problems Diagnosed?


An orthopaedic or doctor will ask about your health history. They might also give you a physical exam to look at the level of joint stability, area of pain, and range of

motion. You may be recommended tests such as:


CT scan: This imaging test makes use of a computer and a series of X-rays to create horizontal images of the body. A CT scan gives us detailed images of any part of the body, including the fat, organs, bones, and muscles. CT scans are recommended as they are more detailed than general X-rays.


X-ray: This imaging test uses a tiny amount of radiation in order to make images of organs, tissues, and bones onto film.


Electromyogram (EMG): This test is done to evaluate muscle and nerve function.


MRI: This imaging test makes use of a computer, radio waves, and large magnets to create detailed images of tissues in the body. It usually finds disease or damage in and around muscle, tendon or ligament.


Arthroscopy: This is a least invasive procedure utilised for joint conditions. This procedure makes use of a lighted, small, optic tube called arthroscope which is later put into the joint through an incision (small cut). Images of the inside are projected onto a screen. It is used to find bone diseases and tumours or to look at any changes in the joint.


Laboratory tests: These can assist in figuring out if other problems could be the cause.


Ultrasound: Image of the internal organs are created using High-frequency sound waves.


How are Shoulder Problems Treated?


The aim of treatment is to restore your shoulder to normal function and ease pain. To accomplish this, a variety of treatments might be used, including:


● Anti-inflammatory steroids injections

● Changing your routine or how you do some daily activities

● Medicines such as naproxen, ibuprofen, and other nonsteroidal anti-inflammatory medicines (NSAIDs)

● Rest

● Physical therapy

● Surgery (when all the other options fail)


If you’re in search of an experienced professional who can relieve you of pain in your elbow, knee, shoulder, hamstring, hand, ankle, hip, neck or back. Get in touch with our expert Orthopaedists and Physical therapists at 1 Health Medical Centre to get the best Diagnosis and Treatment plans for your condition in Bangalore!

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