Understanding shoulder pain

Our most mobile and probably our most hard working joint in the body are our shoulders.  From playing tennis, to carrying a bag of groceries to lifting a child, they get used and abused a lot making them prone to injury. Even though back injuries are the most frequently reported on-the-job injury, shoulder injuries keep people out of work the longest – 30 days compared to the back – 12 days

Each year about 1.2 million Americans make a trip to the emergency room for acute shoulder pain.  The majority of pain in the shoulders can be remedied with rest and rehabilitation at home.  But if the injury is that of a broken or dislocated shoulder, it will need to be examined by a physician.

The composition of our shoulders

The anatomy of our shoulders is complex.  It is composed of three joints making it our most mobile joint with the ability to move up, down, forward, back, and for those who are double-jointed it can be twisted and contorted in unusual ways. 

Three bones make up our shoulder – the clavicle or collarbone, the shoulder blade or scapula, and the humerus, the bone of the upper arm that fits into the other two.  Unlike the tight fitting ball and socket joint of our hips, the bones of our shoulders do not fit tightly but rather are stabilized by various muscles, tendons, and ligaments.

Common causes of shoulder pain

·        Rotator cuff

This part of the shoulder is composed of four muscle and their tendons giving us mobility and strength and keeps the arm bone in place.  Unfortunately it can also be a common site causing shoulder pain.  Conditions such as tendonitis and bursitis can arise when the tendons are overused getting trapped between the bones of the shoulder or the bursa get inflamed.  The tendons and muscles of the rotator cuff can also tear limiting the range of motion of the shoulder.  Aging can be one cause of the pain or an injury such as falling onto your shoulder can be a factor.

·        Frozen shoulder or adhesive capsulitis

Having a frozen shoulder is when the joint loses part of its range of motion.  It could be caused by an injury, aging - it is most common after the age of 40 - and women are far more prone to this than men. Individuals who have diabetes, thyroid problems, and heart disease also have this condition more often with about one-third who have one frozen shoulder will most likely get the condition in the other shoulder eventually.

·        Arthritis

Because the shoulder is a joint, it is also prone to arthritis usually due to cartilage cushioning the joint wearing down causing the bones to rub together.  Painful swelling in the joint linings can also be caused by the autoimmune disease of rheumatoid arthritis.

·        Acute injury

Any sudden, unexpected injury to the shoulder such as a broken collarbone, a separated shoulder (ligaments connecting the collarbone and shoulder blade get stretched or torn), or a dislocated shoulder (where the arm bone is pulled out of place in the socket), will be felt and noticed right away and will need medical treatment as soon as possible.

Treating shoulder pain

If shoulder pain is due to an acute injury, this will necessitate immediate medical intervention by visiting a doctor or going to an emergency room. 

For all other shoulder pain generally developing over time, resting the shoulder, avoiding painful movements, using ice, and taking an over-the-counter pain reliever can often solve and remedy the pain.  Even wearing a sling anchoring the shoulder preventing movement will keep it stabilized and rested while relieving pain.  

If the pain persists or is getting worse after just a few days, go see your doctor or an orthopedic doctor. They will perform tests such as x-rays, ultrasound, or MRI to determine the cause of pain and how to treat it.  Treatment often involves physical therapy will teaches you proper stretches and exercises to build up the shoulder muscles.  Other options may be a cortisone shot or possibly surgery as a last resort. 

Exercises preventing shoulder pain

Keeping the shoulder muscles tones and in shape is an important part of any exercise program. It is well worth the time and effort put into it preventing future problems.  Regularly performing movements to strength the shoulders will make it that much easier to do everyday tasks and improves posture. 

This website offers good tips on preventing shoulder and rotator cuff injuries.  Another website with good information is the American Academy of Orthopaedic Surgeons offering a set of 13 exercises using small hand weights to keep this area of your body free from pain and injury.