The human body has a multitude of complex joints, with their own range of motion, stability, and function. Some joints’ function is to absorb shock while others are designed to transmit motion from one joint to another in order to produce the desired movement. Everyday tasks would be difficult or impossible without the flexibility and mobility that most joints provide. The shoulder is one of these types of joints that provides versatility. It can rotate, extend, flex and raise the arm at the shoulder. It is able to accommodate a wide range of movements when you are in an upright or sitting position.
However, each joint has its own unique anatomy and function that makes it vulnerable to injury and disease. The shoulder is a more commonly injured joint because of its mobility. Common shoulder injuries include:
Shoulder impingement can occur when certain structures in or around the joint are pinched or compressed, resulting in pain and loss of function. Patients who have had previous shoulder surgery are at a higher risk for shoulder impingement syndrome. This is because scar tissue can create abnormal changes in their joint mechanics and make it more difficult for the rotator cuff muscle to do its job. Smoking also makes it harder for tissue to heal after surgery. Some common symptoms of shoulder impingement include paresthesia, or pins and needles sensation, pain during activity, pain at night, and sometimes swelling.
Frozen Shoulder Syndrome
Frozen shoulder is another condition that can occur with age. It is believed to be caused by deposits of calcium around the joint capsule which can cause stiffness and a decrease in range of motion. There is a condition known as shoulder internal derangement which also occurs with age. This is when the connective tissue within the shoulder changes, causing stiffness and loss of function. Formation of callus at the end range of motion can also cause frozen shoulder; it is called impingement callus formation.
Rotator Cuff Injuries
A rotator cuff is a group of muscles and tendons deep in the shoulder that control movements of the joint. This group of muscles helps protect the shoulder from internal and external rotation. The rotator cuff consists of a series of tendons, which attach to the upper arm or humerus bone and connect to other structures in this area. The weakest tendons are the supraspinatus, infraspinatus, subscapularis, and teres minor. They attach to the bone at the top and front of the humerus. When the rotator cuff tendons become strained or overworked, they can tear their attachment to the bone and cause pain and loss of function in that area. In addition to a torn rotator cuff, injuries may occur to ligaments and other structures in this area as well.
Common treatments for shoulder pain
Numerous treatment options are used for shoulder pain. There is no specific treatment because each individual will have a different cause or source of their pain. According to Dr. Kevin Kruse, a shoulder specialist your doctor will recommend treatment based on results from an MRI, whilst taking into account what your symptoms and activity levels are, to reduce your pain and increase your function. Treatment may include medications, surgery, and physical therapy for strengthening the arm and shoulder muscles. Chiropractic has also been shown to be effective in treating shoulder pain.
Physiotherapy can help with shoulder pain, especially after surgery. Physiotherapy is a rehabilitation program based on the patient’s condition, medical history, and what the patient wants to achieve. It is more than just physical treatment; it involves psychological factors as well to help improve the patient’s state of mind while they are recovering. Before the assessment, a physiotherapist will ask you about your symptoms and any previous injuries. They will also ask about your medication including painkillers and other medications, your medical history, and any previous surgeries or injuries to the shoulder.
The physiotherapist will then assess your condition and design a treatment program for you based on the results of their assessment. This program may include different stretches or exercises to help with pain, muscle strengthening, joint mobilization, and rehabilitation for nerve-related pains. They may request x-rays so they can see exactly where the pain is coming from in your shoulder. The treatment plan may last for an hour or more and is adjusted to meet your needs and your goals for recovery. Physiotherapy may be done as an outpatient, in the home, or in a hospital, depending on your particular case.
Occupational therapy can help with shoulder pain by improving daily living activities. Occupational therapists help patients regain motion and learn how to cope with the pain. Occupational therapists focus on activities that you do on a daily basis, including eating, dressing, bathing, and grooming. A patient learns how to perform their jobs or tasks without putting excess stress on their shoulder. It also involves certifying patients to return to their job or a new position that is less stressful on the joint. Occupational therapy helps people of all ages with their physical, mental, and emotional well-being. It is beneficial even if there is no previous injury or pain.
Surgery may be recommended for larger tears from the rotator cuff muscle or when there are older tears from repetitive injuries. Surgery is usually recommended when there is a considerable loss of range of motion or pain that is not responding to conservative treatments. The orthopedic surgeon may be able to repair the tear and prevent further damage to the joint. If a large section of torn muscle has been removed, then surgery may help rebuild the muscles and tendons to regain strength and mobility. In some cases, surgery can also be used for the relief of pain caused by nerve impingement.
Medications can effectively treat shoulder pain, but they should not be used as a bandage when you have a serious shoulder condition. It is recommended that you always work with your primary care provider and physical therapist on finding the most appropriate treatment for your shoulder. Taking pain medications, also known as analgesics, for more than a few days can cause many side effects including stomach ulcers and even more severe conditions such as liver damage.
How to prevent shoulder pain?
A little bit of prevention goes a long way in treating your shoulder pain. Here are some tips on how to keep your shoulder healthy and how to prevent injuries:
- Make sure you are healthy – If you have a condition that makes you more susceptible to shoulder pain, such as arthritis, it can be very helpful to get your blood pressure checked and have your cholesterol levels checked.
- Avoid trauma and inflammation – Trauma and inflammation can cause the muscles around the shoulder to tighten up and become inflamed. This can trigger pain in the shoulder. A cortisone shot or steroid injection is sometimes needed to help with this condition.
- Prevent muscle strain – This can be caused by working out too hard, lifting heavy objects, or being out in the sun too long. These activities can cause your muscles to become strained and can lead to injury or pain.
- Stretching and strengthening – Often when the muscles around our shoulders are tight, we do not stretch them properly or at all, which leads to strains or injuries. Stretching works to keep your muscles loose and limber so you can use them as much as possible without causing pain.