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From the Physical Medicine Specialist - WHY DOES MY SHOULDER HURT?

Tuesday, June 17th, 2014, 12:09 am

Why Does My Shoulder Hurt?  And What Can Be Done About It?

 

You wake up in the morning and get out of bed.  You do your big morning yawn and stretch and OW! Why does my shoulder hurt?  Did you sleep wrong on it? Was it last night’s basketball game with the guys?  Are you just getting old?

Many things can cause shoulder pain.  When should you see your healthcare professional for shoulder pain?  If any of the following are present:

  • Inability to carry objects or use the arm
  • Shoulder pain that occurs at night or while resting (as in when you aren’t asking your shoulder joint to do any work)
  • Weakness in the shoulder
  • Shoulder pain that persists beyond a few days
  • Inability to raise the arm
  • Injury that causes deformity of the joint (or change in normal appearance of the shoulder joint and arm), swelling or significant bruising
  • Signs of an infection, including fever, redness, warmth

Anatomy of the Shoulder Joint -  the bones, muscles, ligaments and tendons all work together beautifully to make your shoulder work smoothly.  When one or more of these doesn’t work right, pain and dysfunction result.

The clavicle or collarbone is a long bone that connects the scapula and the sternum.  [Interesting factoid! It is the only long bone in the body that lies horizontally.]  For our purposes talking about shoulder pain, we are only concerned with the connection the clavicle makes to the shoulder.

The humerus is the long bone in the arm that runs from the shoulder to the elbow.

The scapula or shoulder blade connects the humerus and the shoulder blade.

The acromium is the part of the scapula that meets up with the clavicle at the acromioclavicular joint.  This joint is one of the places where problems can occur, either through traumatic injury or repetitive motion.

 

How is a Diagnosis Made?

Your health care professional will identify what is causing your shoulder pain through diagnostic testing such as x-rays, MRIs and a thorough physical examination that likely will include range of motion testing and shoulder strength testing.

Possible diagnoses include:

Shoulder bursitis, rotator cuff tendonitis -  inflammation of a particular area within the shoulder joint (rotator cuff tendons and the bursa or lubricating bodies between tendons and bones) that causes impingement.

Impingement syndrome occurs when there is inflammation of the rotator cuff tendons and the bursa that surrounds these tendons, in the acromioclavicular space (A/C joint).  It can be caused by an initial trauma or injury, or reaction to chronic overuse.  Inflammation leads to thickening or calcification of the subacromial bursa and/or supraspinatus tendon leading to more crowding of the anterior shoulder (A/C joint) causing more pain and restriction of motion.

Shoulder Arthritis - often called wear-and-tear arthritis.  Osteoarthritis is the leading cause of arthritis in the shoulder.

Adhesive Capsulitis (Frozen Shoulder)  - in this condition, the capsule surrounding the shoulder joint contracts and forms scar tissue leading to marked stiffness of the joint and significant pain which causes further inability to want to use the shoulder.

Shoulder Trauma – these conditions are related to sports injuries, car accidents, Workers’ Compensation injures and falls.  They are often initially treated differently than the previously described conditions and sometimes require surgery.

  • Acromioclavicular  separation – a disruption of the acromioclavicular joint
  • Rotator cuff tears – these can occur when the tendons rupture or separate from the bone
  • Shoulder Instability (Loose Joint) – often caused by traumatic injury or developed over time
  • Labral Tear – the labrum is cartilage in the shoulder joint
  • SLAP lesion – a labral tear specifically at the top of the joint – typically seen in overhead and throwing activities (pitchers, tennis players)
  • Shoulder Dislocation - occurs when top of the humerus becomes disconnected from the scapula

And Now the Part You’ve Been Waiting For!!!

How Can My Shoulder Pain Be Treated?  How Can You Make My Pain Go Away?

Physical Therapy

Stretching and strengthening of the muscles around the shoulder joint may help decrease the burden on the shoulder. Preventing atrophy of the muscles through exercise is an important part of maintaining functional use of the shoulder.

  • Joint mobilization is a highly skilled painless technique that our physical therapists  provide.  This involves the loosening of the restricted joint and increasing its range of motion.
  • Myofascial release is a soft tissue therapy for the treatment of muscle immobility and pain. The therapy relaxes contracted muscles, improves blood and lymphatic circulation, and stimulates the stretch reflex in muscles.

Our physical therapists are trained to provide pain relief and manual therapy, and also to teach you a home exercise program. Most times a period of physical therapy is initiated for at least 2-4 weeks before any surgical consideration.

Cortisone injections

Injections may help decrease inflammation and reduce pain within a joint. While this will not cure shoulder arthritis or other shoulder conditions, they can quickly diminish the symptoms and help control pain.

NSAIDs

Prescription and non-prescription drugs that treat pain and inflammation. These can be very effective utilized along with physical therapy to help the patient achieve the most relief.

Acupuncture

Has been shown to be extremely helpful in relieving pain.  Our facility offers acupuncture from our trained heath care professionals.

Taping

Kinesio taping is very effective in relieving pain and permitting motion and recovery of shoulder joint pain.  Your physical therapist is skilled in the proper application of tape to achieve maximum relief.

 

The health care professionals at Comprehensive Healthcare Group in Oceanside and Cedarhurst strive to bring you maximal comfort quickly when you are in pain.  Up-to-date training in the latest techniques along with tried-and-true therapies combine to give you pain relief in our state-of-the-art facilities.

 

We will be talking again soon about pain in other joints.  Also watch for our next article on that irritating “pins-and-needles” sensation.  As always,

Yours in Good Health!

 

 

 

 

 

 

 

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Category: Physical Medicine, Rehabilitation


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