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Shoulder Pain: Common Causes and Treatments

Shoulder pain can come from a number of sources – some more obvious, like a traumatic injury, and others that may develop more subtly over time from overuse or arthritis. The best treatment depends on the type of injury you have and what bone, muscles or tendons are injured.

If you’re experiencing shoulder pain that doesn’t improve with rest, ice or other at-home treatments, it may be time to work with an orthopedic specialist to determine the cause of your pain and treatment that’s best for you.

Here are two of the most common causes of shoulder pain:

Rotator Cuff Injuries

The rotator cuff is a grouping of tendons and muscles that surrounds the shoulder joint. This tissue tends to be injured in one of two ways:

  1. Wear and tear over time due, in part, to repetitive activities like baseball and tennis or repetitive motions around the house or on the job, such as swinging a hammer or painting. These activities can cause irritation and inflammation which may be diagnosed as tendonitis in the rotator cuff, or as impingement, when the inflammation causes the tendons or bursa to become pinched. People may report an achy pain that disrupts their daily activities as well as their sleep.
  2. A sudden, traumatic situation, such as a sports injury, collision or a FOOSH (fall onto an outstretched hand). These injuries often result in a tear of one or more of this group of muscles, which can vary in severity depending on the level of trauma. Impingement may also occur. Many patients report more severe throbbing pain when their rotator cuff is torn suddenly.

Can a rotator cuff tear heal on its own?

Regardless of the cause or severity, rotator cuff tears typically do not heal on their own, and only surgery can repair the torn tissue. This is important if your goal is to return to a level of activity you enjoyed before the tear. However, surgery is not the answer for everyone.

Depending on age, lifestyle and goals, rest, ice and anti-inflammatory pain relievers may be able to minimize pain, while physical therapy and exercise can achieve a level of strength and range of motion that meets a patient’s needs. Maintaining range of motion is important to allow for day-to-day and self-care activities like showering and dressing.

Osteoarthritis

Osteoarthritis comes with wear and tear on joints over time. It damages the smooth cartilage that covers and protects our bones. As cartilage around the shoulder and clavicle wears away, people typically experience painful bone-on-bone friction. This happens more frequently in the “AC” joint of the clavicle (AC is short for acromioclavicular).

There is no cure for arthritis in any joint, but rest, ice, and nonsteroidal anti-inflammatory drugs such as ibuprofen can help patients manage pain, and again, physical therapy and exercises allow patients to maintain or improve range of motion to maintain some level of activity. Corticosteroid injections also temporarily reduce inflammation and pain.

When does shoulder pain mean surgery?

When a patient’s pain and/or mobility cannot be managed with non-surgical techniques, a patient and orthopedic specialist may determine together that surgery can provide the best outcome. Depending on the nature and severity of the injury, an orthopedic specialist may suggest arthroscopy or arthroplasty:

Arthroscopy is a minimally invasive procedure that is often used for milder cases of arthritis and smaller muscle or tendon tears. A surgeon cleans out the affected joint or repairs a tear by making tiny incisions and using a fiberoptic camera to guide miniature surgical tools. This procedure does not eliminate the arthritis but can reduce pain. It may need to be repeated in the future as further damage occurs.

A partial or total shoulder replacement is known as arthroplasty and replaces damaged tissue with prosthetics. This surgery is considerably more involved and there are several methods that can be used depending on the patient’s specific circumstances. Reverse shoulder replacement, for example, is often recommended when a rotator cuff is completely torn and beyond repair.

Shoulder pain can range from inconvenient to debilitating. If you’ve been coping with shoulder pain, talk with one of our total joint specialists who diagnose and treat all types of shoulder pain. Use our easy scheduling tool to visit us at either of our convenient Colorado Springs locations.

Causes of Shoulder Pain

Your shoulder is a ball-and-socket joint. The ball portion of the joint consists of the rounded head of the upper arm bone (humerus), and the socket portion is made up of a depression (glenoid) in the shoulder blade. The humeral head (ball) fits into the glenoid (socket), creating the joint that allows you to move your shoulder. The joint is surrounded and lined by cartilage, muscles, and tendons that provide support and stability and make it easy for you to move. It’s your shoulder joint that lets you rotate your arm in all directions. Your range of motion depends on the proper articulation of the humeral head upon the glenoid.

In a healthy shoulder joint, the surfaces of these bones where the ball and socket rub together are very smooth, and covered with a tough protective tissue called cartilage. Arthritis causes damage to the bone surfaces and cartilage. These damaged surfaces eventually become painful as they rub together. With that said, there are many different reasons why you could be feeling shoulder pain, including injury, infection, and arthritis.

Shoulder pain can be either acute or chronic, depending on when a diagnosis was made and how long the pain or disability has been felt for. An acute shoulder injury occurs suddenly either through direct impact, by overstretching a muscle, tendon or ligament, overusing a muscle or tendon, or twisting of the shoulder joint. However, if pain becomes chronic, it is important that you see an orthopedic doctor. While chronic pain is considered pain that lasts longer than six months, if the pain doesn’t seem right you should seek help as soon as possible.

Many shoulder problems are caused by the breakdown of soft tissues in the shoulder region. Using the shoulder too much can cause the soft tissue to break down faster as people get older. Doing manual labor and playing sports can also cause shoulder problems, whether from overuse or by sudden injury. The most common shoulder pain problems are:

  •       Dislocation
  •       Separation
  •       Rotator cuff disease
  •       Rotator cuff tear
  •       Frozen shoulder
  •       Fracture
  •       Arthritis

Whatever the reason, continuing to suffer with shoulder pain shouldn’t have to be your only option. To learn more about the shoulder and the most common causes of shoulder pain, call Colorado Center of Orthopaedic Excellence at (719) 623-1050 to request an appointment, or request one online.