Shoulder Pain Treatment

Shoulder pain is common in our community.

In younger people, shoulder pain is more likely to be due to an accident or injury. However, as you age, there is a natural wear and tear on the shoulder joint and rotator cuff tendon. Over time, this can turn into persistent pain.

The good news is that with the right treatment, the pain in your shoulder will improve so that you can do the things you enjoy again.

The shoulder

The shoulder is a complex and highly mobile structure formed by several components. There are two joints in the shoulder:

Glenohumeral joint: where the upper arm bone (humerus) connects to the shoulder blade (scapula)

Acromioclavicular joint: where the upper part of the scapula meets the clavicle (clavicle).

The strong connective tissue forms the capsule of the shoulder. This keeps the head of the humerus in place in the joint cavity. The joint capsule is lined with a synovial membrane. It produces synovial fluid that lubricates and nourishes the joint.

Strong tendons, ligaments and muscles also support your shoulder and make it stable.

What causes shoulder pain?

There are many causes of pain in the shoulder and not all of these are due to problems of the shoulder joints or associated structures.

Osteoarthritis

Cartilage is a soft, cushioned tissue that covers the ends of the bones where they meet in a joint. Healthy cartilage helps the joints move smoothly. Over time, the cartilage may wear out or be damaged due to injury or accident, leading to the development of osteoarthritis.

Inflammation of the shoulder capsule.

The synovial membrane of the shoulder can become inflamed, which is called "synovitis". Synovitis can occur as a result of another condition (for example, rheumatoid arthritis) or it can occur as a result of an injury, or the cause may be unknown.

The frozen shoulder ('adhesive capsulitis') is a condition that occurs when the shoulder capsule thickens and becomes inflamed and contracts. There may also be less synovial fluid to lubricate the joint. As a result, the shoulder becomes difficult to move.

The frozen shoulder can occur as a result of another condition if the shoulder has been immobilized (for example, due to surgery or injury). Sometimes the cause of shoulder pain may not be known.

Bursa inflamed

The pain associated with an inflamed bursa is also common in the shoulder.

A bursa is a small sac filled with fluid that reduces friction between two structures, such as bones, muscles, and tendons. On the shoulder, the bursa between the tendon of the rotator cuff and the bony tip of the shoulder (acromion) may become inflamed, most commonly with repetitive movements.

Injuries and sprains.

Ligaments are soft tissues that connect bones to bones. They provide stability to the shoulder by keeping the bones where they should be. If the ligaments are injured or twisted, it can cause pain in the short term. This may be because the humerus comes out partially from the joint cavity (subluxation) or if the humerus comes out completely (dislocation).

The flexible tissue that helps keep the shoulder joint in place (labrum) can tear. This is called a 'labral tear'. This can occur as a result of an injury (for example, falling on your outstretched arm) or repetitive actions (for example, due to the practice of sports involving throwing, such as cricket).

A direct blow to the shoulder can cause a sprain in the acromioclavicular joint ("AC joint"). This type of injury often occurs in people who participate in contact sports, such as football, who receive a blow to the shoulder. It can also happen as a result of a fall.

The group of tendons and muscles that keeps the shoulder stable and positioned correctly for the shoulder and arm to move is called the rotator cuff. Tears in the tendons of the rotator cuff can occur as a result of an injury (for example, a broken or broken clavicle) or happen over a period of time as we get older.

Neck and upper back.

Problems with the joints and associated nerves of the neck and upper back can also be a source of pain in the shoulder. Pain in the neck and upper back is often felt in the back of the shoulder joint and on the outside of the upper arm.

Injury to the axillary nerve.

This nerve can be injured as a result of a dislocation of the fractured shoulder or humerus, and causes weakness when moving the arm out of the body.