Shoulder pain may present itself as stiffness of the shoulders, pulling pain, or sharp jabbing pain. The severity of the shoulder pain differs amongst patients, some may find that it interferes with mobility and daily activities, while others are unable to raise their arms completely.
What Causes Shoulder Pain?
The shoulder consists of three bones – the humerus, scapula, and collarbone. The head of the humerus is inserted into the scapula, while the scapula is surrounded by a set of muscles and tendons. These tissues are called rotation muscles or rotator cuffs.
Rotary muscles are composed of 4 muscles and tendons. Whenever a muscle or tendon is abnormally stimulated or damaged, the rotation muscle function will be affected, and patients will feel pain.
Broadly speaking, shoulder pain can be due to bony problems, joint problems, or surrounding muscles and tendons issues. Bony pain may include fracture of the humerus, scapula, or collar bone. Shoulder joint typically would include rheumatoid arthritis or wear and tear osteoarthritis of the shoulder as well as dislocation of joint. The last category of muscles and tendon pathology forms a large proportion of painful shoulder conditions eg. Tendinitis, bursitis, muscle or tendon tear.
Types of Shoulder Injuries
Degeneration does not equal arthritis and it can be worn out without any pain. When the shoulder is arthritic, it means that the joint is inflamed and patients will naturally reduce the movement of the shoulder. Over time, the soft tissue of the joints will be further locked and stiffened, and the range of motion of the shoulder will be reduced further.
Shoulder Girdle Syndrome/Personage-Turner Syndrome
It is likely that there is damage or inflammation to the network of nerves that go from the spine through the neck, into each of the armpits, and then down the arms. This network is called the brachial plexus. Damage to those nerves causes muscle weakness.
Parsonage-Turner syndrome is frequently misdiagnosed as cervical radiculopathy or cervical spondylosis. A relatively uncommon condition, current studies have not identified an underlying cause.
Shoulder Impingement Syndrome
Symptoms Of Shoulder Pain
Swelling and Tenderness
A Message About Shoulder Pain
Shoulder pain is a symptom of something that has gone wrong. There are many different reasons for the causes of shoulder pain. If shoulder pain is not treated adequately, it can progress to restriction of movement such as “Frozen Shoulder”. Once it has reached this stage, it is harder to treat. Conservatively, only 20% of patients recover from this “frozen phase” to thawing stage, with others ending up with permanent contracture of the shoulder.
Shoulder pain is not always about bone spur. Sometimes a simple sprain can be the start of persistent shoulder pain, starting on the slippery slope of deconditioning and worsening of shoulder condition, ending in contracture and stricture.
Diagnosing Shoulder Pain
Here at Singapore Paincare, our team of experienced primary care physicians and pain care specialists together with an orthopedic surgeon will evaluate your condition. This includes a physical exam, questions about your symptoms, and an evaluation of your medical history. In cases of referred pain from the cervical spine, additional tests are also carried out such as nerve conduction or electromyography, these tests help to identify characteristic symptoms to eliminate other forms of disease or injuries such as slipped disc of the neck spine causing nerve impingement. In persistent shoulder pain, An X-ray or MRI scan may be needed to investigate the causes of your shoulder pain. The MRI scan is needed to evaluate the soft tissues, tendons, and muscles of the shoulder joint.
What Treatments Are Available for Shoulder Pain?
Depending on the severity of the shoulder injury, medication or surgery may be required to treat the damaged bone, ligament, or muscles.
Non-surgical Treatments for Shoulder Pain
Conservative treatment of shoulder pain would include rest, support, and ice. Often, simple painkillers such as Panadol or Anti-inflammatory medications can reduce the inflammatory pain of simple injuries and sprains. Some of the treatments for shoulder pain may benefit from physiotherapy, which can help to reduce stiffness in the affected areas and help to accelerate the restoration of rotator cuff function.
When pain has persisted beyond 6 weeks, it would need additional medical attention to assist in the healing of the shoulder pain. Generally, some specialised injections would be needed to help with the healing of painful conditions.
Surgical Treatments for Shoulder Pain
Short-term shoulder injuries can be resolved with conservative treatments. However, severe injuries may require surgery, this is usually discussed with our doctors to see if patients are suitable candidates.
If you choose to have surgery, your options may include:
Shoulder Joint Replacement Surgery
How Can I Prevent Shoulder Pain?
The key to preventing shoulder pain is by listening to your body. It is best to seek professional help if the pain doesn’t go away. It’s also important to do a proper warm-up before doing any type of exercise or sport. Having a healthy diet and staying in shape also helps.
Get Your Pain Resolved
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