Shoulder joint has a very complex anatomy. Since shoulder joint is involved in daily basic activities, pain is in the shoulder joint could lead to limitation of many day-to-day activities. This could also even lead to disruption of sleep cycle. Here are some causes of the shoulder joint pain and the treatment.
Causes
- Osteoarthritis – It could be Glenohumeral Joint or Acromioclavicular joint arthritis. it happens when the cartilage which lines the shoulder joint becomes thinned out or breaks. The cartilage is needed for movements around any joints. When it becomes pathologic, shoulder movements hurt leading to pain and stiffness. Sometimes it progresses to the point where it becomes difficult to sleep at night.
- Rotator cuff pathology – It could be either rotator cuff tear or tendonitis. It can happen with fall, skiing injury, old age, motor vehicle accident. It is inflammation of the rotator cuff which is big muscle and tendon in the shoulder joint. It first starts with night pain. In this pain could be in the shoulder or in the upper arm. It also affects range of motion in later stages.
- Biceps tendonitis – It is due to overuse of biceps tendon with either lifting heavy weights or working in a gym. It is perceived as sharp anterior pain
- Frozen Shoulder or Adhesive capsulitis. It is common in females, patient with uncontrolled diabetes. It causes pain and stiffness. First it restricted backward shoulder movement and taking the arm over the shoulder. It is followed by restriction in all shoulder movements.
- Bursitisa Bursae acts as a cushion pad for a tendon which connects bone to bone and help in reducing the friction between the bones. When bursae become inflamed it is perceived as pain on lying on that shoulder, pain on the top of the shoulder joint, pain while lifting the arm.
- Injury/Trauma – When someone hurts themselves, it leads to acute injury. There could be fracture, muscle injury, tendon tear.
- Referred pain around shoulderà The pain in the shoulder or around it does not always mean shoulder problem. The pain can be referred from either cervical spine, heart, lung, pleura or diaphragm.
Diagnosis
Detailed history à It includes questions like duration of pain, degree of disability, other joints involved, other symptoms like stiffness, reduced range of motion
Physical examination à To examine for swelling, tenderness, restricted range of motion
Investigations à X ray in case of arthritis, injury.
MRI Shoulder is the correct way to diagnose the cause of the pathology.
When to see a doctor for shoulder pain
- When the pain becomes chronic
- When it affects day-to-day activities.
- Severe pain affecting your sleep.
- Severe pain to the point when you need analgesic almost every day.
Treatment
- Medications – Anti-inflammatory medications, muscle relaxants can help.
- Physiotherapy
- PRP therapy This therapy is the emerging treatment for injured tissues, degenerative tendons, and joints. Activated platelets when injected, releases growth factors important for regeneration. Soft tissue healing is also enhanced by increased collagen deposition at the site. This helps a lot for tissues which have poor regeneration capacity. So PRP treatment includes using patient’s own platelets to rebuild the cartilage, tendons.
- Radiofrequency ablation ( RFA)
- Shoulder injection for frozen shoulder, bursitis
- Surgery – Total shoulder replacement for advancement arthritis
