Shoulder pain is a common ailment of many people, although the incidence of pain tends to increase with age. This pain can be caused by a number of different shoulder conditions, and can be acute or chronic, and caused by injury or overuse. Damage or injury may occur within the muscles, ligaments, tendons and bones. Patients may experience stiffness, pain, loss of strength, limited range of motion and other debilitating symptoms.
Some of the most common shoulder conditions include:
- Labral Tear
- Rotator Cuff Tear
In order to determine the cause of your pain, your doctor will ask for details about your symptoms and medical history, and also perform a physical examination to evaluate the shoulder. An X-ray or CT scan may also be performed in order to examine the bones and soft tissues of the shoulder.
The best treatment for shoulder pain depends on the location and cause of the pain. Your doctor will help decide which treatment is best for you after a thorough evaluation of your condition. Many shoulder conditions can be effectively treated through nonsurgical methods such as rest, applying ice or heat, stretching, physical therapy and anti-inflammatory medication.
Some patients with severe shoulder conditions may require surgery, but most of these procedures can be performed through arthroscopy. Surgery is often successful in repairing shoulder problems and restoring function and strength to the joint.
The clavicle, commonly known as the collarbone, is the bone of the shoulder joint that connects the arm to the rest of the body. Clavicle fractures most frequently occur as a result of trauma from a blow to the shoulder, fall or motor vehicle accident. They are most common in young children and older adults who are more susceptible to fractures.
Clavicle fractures cause the shoulder to slump downward and a bruise to appear over the fractured area. Some patients may hear a snapping sound when the fracture occurs. Pain is often experienced at the time of fracture and when the area is touched. Patients may also experience pain while trying to move the arm.
If you experience a collarbone fracture, you should seek immediate medical attention. Your doctor will take a brief medical history and examine your shoulder to determine whether or not a fracture has occurred. X-rays may be taken to determine the type and severity of the fracture.
Many fractured collarbones can be treated at home through conservative methods such as immobilization, aspirin, ibuprofen and a sling. Your doctor may instruct you to wear a sling at all times until pain subsides, which can take two to eight weeks depending on your age and the severity of your fracture. Patients whose bone has moved after the fracture may require surgery to repair the bone and allow it to heal properly.
Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder, also known as adhesive capsulitis, is a common condition that causes pain and stiffness in the shoulder as a result of a tightening or thickening of the capsule that protects the structures of the shoulder. Although the specific cause of this condition is not known, it most often occurs after recent immobilization of the joint or as a complication of diabetes. Frozen shoulder most often affects patients between the ages of 40 and 60.
Patients with frozen shoulder often experience pain, stiffness and limited range of motion that gradually worsens as the joint becomes more and more frozen. Eventually, the shoulder will shift into its thawing phase, during which pain and stiffness subside and range of motion is slowly restored.
Your doctor can diagnose frozen shoulder after a thorough evaluation of your condition, as well as an X-ray or MRI examination, which helps rule out other possible shoulder conditions.
Treatment for frozen shoulder usually focuses on managing pain and other symptoms as the condition progresses. This may include anti-inflammatory medications, corticosteroids and physical therapy. Minimally invasive surgical procedures, such as distension, arthroscopy and manipulation, may also be performed with a goal of stretching or releasing the contracted joint capsule.
The shoulder is a "ball-and-socket" joint where the "ball" is the rounded top of the arm bone (humerus) and the "socket" is the cup (glenoid) of the shoulder blade. A layer of cartilage called the labrum cushions and deepens the socket. A dislocation occurs when the humerus pops out of its socket, either partially or completely. As the body's most mobile joint, able to move in many directions, the shoulder is most vulnerable to dislocation.
Dislocation causes pain and unsteadiness in the shoulder. Other symptoms may include swelling, numbness, weakness and bruising. The majority of dislocations occur when the humerus slips forward, a condition called anterior instability. This may happen during a throwing motion. The humerus is also capable of dislocating backwards or downwards. In most cases, the dislocated shoulder can be manipulated back into place by a doctor in a process known as closed reduction.
Complications of shoulder dislocation or reduction can include a labrum or cartilage tear, a lesion on the glenoid bone after the humerus strikes it, tendon or ligament injuries, and blood vessel and nerve damage. Shoulders that have dislocated once are more likely to dislocate in the future, potentially resulting in chronic shoulder instability and weakness.