Shoulder Pain: Conditions, Causes and Treatments
Shoulder pain can occur for a variety of reasons, ranging from sports injuries to age-related issues with tendons or muscles. Whether it’s a rotator cuff tear, a frozen shoulder or another impairment, shoulder pain is a common complaint. If you’re active in exercise or sports or have a physically demanding job, you’re at greater risk for a shoulder injury. Shoulder pain also becomes more likely as people age.
Find out about some common shoulder issues below as well as how they’re treated.
What Is Frozen Shoulder?
Also known as adhesive capsulitis, frozen shoulder occurs when the connective tissue, or capsule, surrounding the shoulder joint thickens and tightens. This causes pain when moving the arm, thereby restricting the arm’s movement.
Frozen shoulder symptoms typically manifest in three stages.
- Freezing stage: Pain and stiffness slowly set in over a period of six to nine months, and shoulder movement becomes increasingly difficult.
- Frozen stage: While pain may diminish, moving the shoulder is still difficult and may interfere with daily activities. This lasts two to six months.
- Thawing stage: Pain slowly dissipates, and moving the shoulder gradually becomes easier over a period of six months to two years.
How Common Is Frozen Shoulder?
Frozen shoulder typically appears in people between 40 and 60 years old, and it’s more common in women than in men. Up to 20% of people with diabetes mellitus develop frozen shoulder. People with under or overactive thyroids, Parkinson’s disease, cardiac issues and tuberculosis are at risk of experiencing frozen shoulder. Those with conditions or injuries that cause reduced mobility of the shoulder are also more prone to developing frozen shoulder.
Common Treatments for Frozen Shoulder
Controlling pain and preserving the range of motion are the goals of treatment for frozen shoulder. Over-the-counter and prescription pain relievers and anti-inflammatory medications help mitigate discomfort, and range-of-motion exercises may help preserve and extend the arm’s mobility. Injections of steroids or sterile water may help alleviate pain and improve mobility.
Doctors may try manipulating the shoulder, (AKA Manipulation Under Anesthesia) while the person is under general anesthesia, forcing the shoulder to move and loosening the surrounding tissue. In some cases, a surgeon may make small incisions in the stiffened tissue and remove scar tissue from the area. These two procedures may also be used together.
What Is Scapular Dyskinesis?
Scapula dyskinesis occurs when the scapula (shoulder blade) moves abnormally or rests in an abnormal position. It’s often caused by a shoulder injury or repetitive shoulder movements. Weak shoulder muscles or activities involving prolonged overhead motion, such as painting and decorating, can also cause scapular dyskinesis.
Many people with scapular dyskinesis don’t experience symptoms. However, it can cause pain and discomfort, especially when lifting. Some individuals also report shoulder weakness and a popping sound when they move the affected joint. Sometimes, the condition causes one shoulder blade to sit visibly lower than the other.
How Common Is Scapular Dyskinesis?
Scapular dyskinesis is relatively common, especially among athletes engaging in sports involving throwing or bowling with overhead motions. Around 61% of overhead athletes develop the condition, while non-overhead athletes have a 33% chance of getting scapular dyskinesis.
Common Treatments for Scapular Dyskinesis
Scapular dyskinesis is usually treated with physical therapy. During treatment, doctors often recommend stopping the sport or activity that caused the problem and waiting until normal shoulder function returns before resuming it.
Physical therapy for scapular dyskinesis involves strengthening the shoulder muscles to stabilize the affected joint and stretching to help restore normal movement. If scapular dyskinesis is caused by a shoulder injury, such as a rotator cuff tear, doctors often recommend treating the underlying injury before starting physical therapy.
Over-the-counter painkillers can reduce the pain and discomfort associated with scapular dyskinesis. Heat and ice packs can also help treat pain and irritation.
What Is Shoulder Bursitis?
Bursae are pockets of fluid that act as a cushion to prevent friction in your joints. These sacs can sometimes become inflamed, leading to a condition called bursitis.
Shoulder bursitis occurs when the bursa inside the shoulder joint becomes irritated. There’s often no clear reason why a person develops shoulder bursitis, although it is sometimes caused by repeated strain on the joint or trauma. You can also get a condition called bacterial bursitis in the shoulder if the bursa becomes infected.
The most common symptoms of shoulder bursitis are aching and swelling in the affected shoulder. It may also feel warm to the touch. If you have bacterial bursitis in your shoulder, you may run a high fever and feel generally unwell.
How Common Is Shoulder Bursitis?
Shoulder bursitis is relatively common, and it occurs more often in women and people over 30. You’re more likely to develop shoulder bursitis if you participate in sports or work activities involving overhead lifting, such as weightlifting or painting and decorating.
Common Treatments for Shoulder Bursitis
Most chronic bursitis cases can be treated successfully by applying ice packs to the affected joint and resting the shoulder. If this doesn’t work, doctors may recommend injecting steroids into the bursa to reduce the inflammation. Anti-inflammatories can help reduce the pain during recovery.
Bacterial shoulder bursitis usually requires prescribed antibiotics to treat the infection. A procedure to remove some of the fluid from the inflamed bursa to reduce pressure may be required so doctors can run tests to determine infection type. In some cases, surgery may be required to drain the bursa or remove it completely.
What Are Labral Tears?
The shoulder labrum is a ring-shaped piece of cartilage that cushions the shoulder joint and holds the head of the humerus bone securely inside the socket. When the labrum is torn away from the joint or becomes frayed or damaged, it’s known as a labral tear.
Labral tears are often caused by traumatic shoulder injuries and are more likely if the shoulder is dislocated. Labral tears where the labrum is only partially damaged are more often due to age-related wear and tear and tend to cause no symptoms.
More severe labral tears generally cause sharp pain when the shoulder joint moves, and there may be prolonged aching in the affected area. Some people with labral tears report a popping or grinding sensation when they move the joint.
How Common Are Labral Tears?
Shoulder labral tears due to wear and tear are relatively common, and a 2016 study found that between 55% and 72% of a cohort of adults aged between 45 and 60 had the condition without experiencing any symptoms. The chances of developing a partial labral tear increase with age.
Labral tears where the labrum is ripped from the bone are less common. Athletes participating in contact sports, such as rugby or ice hockey, are at higher risk of this type of labral tear because they are more likely to experience shoulder trauma.
Common Treatments for Labral Tears
Many labral tears in the shoulder don’t require treatment because they don’t cause any symptoms. If the condition causes persistent pain or interferes with daily activities, doctors may recommend arthroscopic surgery to repair the damaged section of the labrum. If the labrum has come away from the bone, it typically requires surgery to reattach it.
What Is Impingement Syndrome?
Your shoulder and arm are held together by a group of four muscles collectively called the rotator cuff. The tendons in the rotator cuff can rub against a part of the upper shoulder blade called the acromion when you lift your arm. This sometimes causes pain and tenderness as the tendons are pinched, which is known as impingement syndrome.
Impingement syndrome pain is usually more severe when you lift your arm overhead, but you may also experience constant lower-level pain and weakness in the affected area. The pain often radiates down your arm from the shoulder and could make it harder to fall or stay asleep.
Impingement syndrome doesn’t always have an obvious cause. However, some cases are caused by putting your shoulder under repeated strain. This can cause inflammation and swelling in the soft tissues, making them more likely to rub against the shoulder blade.
How Common Is Impingement Syndrome?
Impingement syndrome is the most common cause of shoulder pain. You’re at a higher risk of developing impingement syndrome if you take part in sports or work activities that put your shoulder under repeated stress.
Common Treatments for Shoulder Impingement Syndrome
Shoulder impingement treatment can usually be treated with a combination of physiotherapy and avoidance of activities that strain the shoulder. Applying ice packs regularly to the affected area and taking anti-inflammatory medications can help manage the pain and inflammation.
If non-invasive treatments don’t work, your doctor may recommend a surgery called a subacromial decompression. The procedure involves cutting part of the upper shoulder blade away to stop your rotator cuff from catching against it.
Rotator Cuff Tear
What Is a Rotator Cuff Tear?
The rotator cuff is a set of four muscles that attach your arm to your shoulder. These muscles are joined to the top of the humerus and shoulder blade and allow you to rotate your shoulder joint.
When one of the tendons in the rotator cuff rips, this is known as a rotator cuff tear. This injury can be partial, which occurs when the tendon remains attached but becomes partially torn, or full-thickness, which occurs when the entire tendon detaches from the bone.
Rotator cuff tears are often caused by putting your shoulder under repetitive strain, as can occur in certain sports or manual labor. Reduced blood supply to the tendons caused by aging can also gradually lead to a rotator cuff tear. A rotator cuff tear can also occur suddenly as the result of an injury.
Rotator cuff tears usually cause pain, especially when you move or lie on the injured shoulder or try to lift something heavy. You may also notice arm weakness or a cracking feeling in the joint.
How Common Are Rotator Cuff Tears?
Rotator cuff tears are relatively common and affect approximately 2 million Americans each year. Your risk of tearing your rotator cuff increases as you get older, especially after you reach 40. Activities involving lifting your arms above your head, such as weightlifting and painting ceilings, make a rotator cuff tear more likely.
Common Treatments for Rotator Cuff Tears
Resting your shoulder and taking anti-inflammatory medication can improve the symptoms of rotator cuff tears. Your doctor may recommend physiotherapy to help strengthen your rotator cuff muscles or steroid injections to soothe inflammation.
If conservative treatment is unsuccessful or you have a full-thickness rotator cuff tear, your doctor may recommend surgery to reattach the torn tendon to the bone.
Get Treatment for Your Shoulder Pain
If you’re experiencing pain in your shoulder area, contact us today to find out how we can help. Set an appointment to be evaluated by one of our experienced physicians and work with us to set up a treatment plan to reduce your discomfort and improve the functionality of your shoulder.