What is Shoulder Pain?
Pain in the shoulder may suggest an injury, which is more common in athletes participating in sports such as swimming, tennis, pitching, and weightlifting. The injuries are caused due to the over usage or repetitive motion of the arms.
In addition to pain, shoulder injuries also cause stiffness, restricted movements, difficulty in performing routine activities and popping sensation.
What are the Most Common Causes of Shoulder Pain?
Some of the common shoulder injuries that cause pain and restrict the movement of the shoulders include:
Sprains and strains
A sprain is the stretching or tearing of ligaments (tissues that connect adjacent bones in a joint). It is a common injury and usually occurs when you fall or suddenly twist your shoulder. A strain is the stretching or tearing of muscle or tendon (tissues that connect muscle to bone). It is common during sports. Strains are usually caused by twisting or pulling of the tendons.
Dislocations
A shoulder dislocation is an injury that occurs when the end of the bone is forced out of its position. It is often caused by a fall or direct blow to the joint while playing a contact sport.
Tendinitis: It is an inflammation of a tendon, a tissue that connects muscles to bone. It occurs because of injury or overuse.
Bursitis
It is an inflammation of a fluid-filled sac called bursa that protects and cushions your joints. Bursitis can be caused by chronic overuse, injury, arthritis, gout or infection.
Rotator cuff injury
The rotator cuff consists of tendons and muscles that hold the bones of the shoulder joint together. Rotator cuff muscles allow you to move your arm up and down. Rotator cuff injuries often cause a decreased range of motion.
Fractures
A fracture is a break in the bone that commonly occurs because of injuries, such as a fall or a direct blow to the shoulder.
Arthritis
Osteoarthritis is the most common type of shoulder arthritis, characterized by progressive wearing away of the cartilage of the joint.
Treatment for Shoulder Pain
Early treatment is necessary to prevent serious shoulder injuries. The immediate mode of treatment recommended for shoulder injuries is rest, ice, compression and elevation (RICE). Your doctor may also prescribe anti-inflammatory medications to help reduce the swelling and pain.
Your doctor may recommend certain exercises to prevent stiffness and improve range of motion and strength. Passive manipulation and massage therapy to improve blood circulation and healing are also administered. Other techniques such as acupuncture, TENS, and ultrasound therapy may additionally be recommended.
What is Arthritis of the Shoulder?
The term arthritis literally means inflammation of a joint but is generally used to describe any condition in which there is damage to the cartilage. Damage of the cartilage in the shoulder joint causes shoulder arthritis. Inflammation is the body's natural response to injury. The warning signs that inflammation presents are redness, swelling, heat, and pain.
The cartilage is padding that absorbs stress. The proportion of cartilage damage and synovial inflammation varies with the type and stage of arthritis. Usually, the initial pain is due to inflammation. In the later stages, when the cartilage is worn away, most of the pain comes from the mechanical friction of raw bones rubbing on each other.
What are the Types of Shoulder Arthritis?
There are over 100 different types of arthritis. The most common are osteoarthritis and rheumatoid arthritis.
Osteoarthritis
Osteoarthritis is also called a degenerative joint disease; this is the most common type of arthritis, which occurs often in the elderly. This disease affects the cartilage, the tissue that cushions and protects the ends of bones in a joint.
With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge or stick out at the end of a joint and are called bone spurs.
Osteoarthritis causes joint pain and can limit your normal range of motion (the ability to freely move and bend a joint). When severe, the shoulder joint may lose all movement, making your disabled.
Rheumatoid Arthritis
This is an autoimmune disease in which the body's immune system (the body's way of fighting infection) attacks healthy joints, tissues, and organs. Occurring most often in women of child-bearing age (15-44 years), this disease inflames the lining (or synovium) of joints. It can cause pain, stiffness, swelling, and loss of function in the joints. When severe, rheumatoid arthritis can deform or change a joint.
Rheumatoid arthritis mostly affects the joints of the hands and feet and tends to be symmetrical. This means the disease affects the same joints on both sides of the body (both hands or both feet) at the same time and with the same symptoms. No other form of arthritis is symmetrical. About two to three times as many women as men have this disease.
Causes of Shoulder Arthritis
Osteoarthritis is caused by the wearing out of the cartilage covering the bone ends in a joint. This may be due to excessive strain over prolonged periods of time, or due to other joint diseases, injury or deformity. Primary osteoarthritis is commonly associated with aging and general degeneration of the joints.
Secondary osteoarthritis is generally the consequence of another disease or condition, such as repeated trauma or surgery to the affected joint, or abnormal joint structures from birth.
Rheumatoid arthritis is often caused when the genes responsible for the disease is triggered by infection or any environmental factors. With this trigger, the body produces antibodies, the defense mechanism of the body, against the joint and may cause rheumatoid arthritis.
Symptoms of Shoulder Arthritis
There are several forms of arthritis and the symptoms vary according to the form of arthritis. Each form affects the body differently. Arthritic symptoms generally include swelling and pain or tenderness in the joints for more than two weeks, redness or heat in a joint, limitation of motion of a joint and early morning stiffness.
In an arthritic shoulder:
- The cartilage lining is thinner than normal or completely absent. The degree of cartilage damage and inflammation varies with the type and stage of arthritis.
- The capsule of the arthritic shoulder is swollen.
- The joint space is narrowed and irregular in outline; this can be seen in an X-ray image.
- Bone spurs or excessive bone can also build up around the edges of the joint.
Diagnosis of Shoulder Arthritis
Your doctor will diagnose arthritis with a medical history, a physical exam and X-rays of the affected part. Computed tomography (CT) scans and magnetic resonance imaging (MRI) scans are also ordered to diagnose arthritis.
Treatment Options for Shoulder Arthritis
Your doctor may prescribe anti-inflammatory medicine and may recommend occupational therapy or physiotherapy, which includes exercises and heat treatment. In severe cases, surgery may be suggested. The type of surgery depends on the age and severity of the condition. In the elderly with severe arthritis, joint replacement is a good option. A common surgery for the treatment of shoulder arthritis is arthroplasty (replacement of the damaged joint), which may be total shoulder arthroplasty or hemiarthroplasty.
