Shoulder pain is pain around the shoulder joint, which may radiate to the upper arm or shoulder blade. The shoulder is made up of the shoulder blade, upper arm, shoulder joint and shoulder muscles and tendons. A patient experiences pain when moving the arm and/or when lying on the painful side. Pain in the shoulder is common.
Cause
The shoulder is a complex joint with many different muscles. The joint enables a rotation of 360 degrees. Therefore, the shoulder is also prone to damage and problems that can cause pain. There are several causes for shoulder pain:
- Tendinitis or tendon rupture in the shoulder. This can happen after overload, due to wear or in case of a sudden event or accident.
- Bursitis in the shoulder. The fluid from the bursa will normally ensure that the joint can move smoothly. In case of a bursitis, the joint will be stiff.
- A so-called ‘frozen shoulder’. Here, a person loses part of the movement capabilities in the shoulder. This can be caused by underlying inflammation.
- Shoulder instability. This allows the shoulder to become almost or completely dislocated. This can occur after dislocation of the shoulder in an accident. If this accident caused damage to the bandage around the shoulder joint, it can more often occur that the shoulder gets dislocated.
- Pinched nerves. If a nerve gets stuck by a wrong movement, it creates a lot of pain. The nerve continues to transfer pain signals to the brains.
Symptoms
The main symptom with shoulder pain is pain. This pain is located around the shoulder joint, but can also radiate to the shoulder blade, neck, elbow or fingers. Due to the pain, a person can often not properly move the arm. This stands out, for example, in dressing or hair combing. Thus, the shoulder pain can hinder everyday activities. One can also suffer from a lot of pain at night. Shoulder pain is often accompanied by headache, back pain, mucle pain and neck pain. These back and neck problems are caused by tension in the muscles.
Diagnosis
When a person has shoulder pain, the general practitioner will examine the shoulder. Photos are rarely needed. That is because they don’t clarify the cause of the symptoms.
Treatment
In case of shoulder pain, painkillers may reduce the pain. If there's less pain, the arm can be moved better and sleep is better. Sometimes, the shoulder problems don’t reduce, despite the medication. An injection into the shoulder may help. The injection contains corticosteroid, which can reduce inflammation and pain in the shoulder for a few weeks. If necessary, the patient can get another injection after a few weeks.
Sometimes, the shoulder symptoms have not diminished after one to two weeks, while using painkillers. Then remedial therapy (Cesar or Mensendieck) may help. It’s important to keep moving in case of shoulder problems. If the shoulder problems come from the neck, then manual therapy may reduce the symptoms. The patient can discuss with the doctor which therapy is considered to be most appropriate in the specific case. Massages and treatments with ultrasound, electrical stimulation and hot radiation don’t accelerate recovery, but sometimes seem to reduce the symptoms.
Prognosis
Shoulder pain usually passes on its own. The worst pain often disappears within two weeks. Then the patient can reasonably use the shoulder again. Especially when symptoms arise suddenly or after overloading by unusual movements, people recover fairly quickly. Shoulder pain that develops gradually or is accompanied by neck pain, usually recovers less quickly.
In more than half of people with shoulder pain, symptoms last longer than six weeks; sometimes even six months to a year. Shoulder problems can also recur.
Considerations
- For recovery, it’s important to keep using the shoulder, even when it hurts. Try to continue daily activities.
- Avoid heavy loads and movements which obviously worsen the pain.
- If even small movements are very painful, it’s good to give the shoulder temporary rest. Then at least try to move the arm a few times a day in multiple directions. Next, reassume daily activities as soon as possible. Don’t wait until the pain has completely disappeared. If one waits too long, the shoulder becomes stiff and it gets increasingly difficult to start using the arm normally again.
- Moving remains important, but do it alternately. When someone makes repetitive movements, for example all day sorting mail or using a computer mouse, this can cause shoulder problems (or prevent recovery). Discuss at work whether the activities can temporarily, or permanently if needed, be adjusted.
- Of treatments with ice, ointments or heat, it isn’t sure whether they really help to cure the condition. But sometimes it can temporarily slightly reduce the symptoms.
