Shoulder Pain has been a common problem with middle and elderly age groups. To understand better it is imperative to understand the basic anatomy of the shoulder joint. The joint consists of three bones:
1. The Humerus – Arm bone
2. The Scapula - Shoulder Blade
3. The Clavicle – Collarbone
These form a complex ball and socket kind of a joint which has superb mobility in all directions. Excellent mobility comes at the cost of Instability of the joint. The shoulder has been compared to a golf ball on a tee. The golf ball is surrounded by a soft tissue cover which deepens the joint cavity and provides stability. This is called the labrum and is covered over by the joint capsule. The golf ball has few muscles attached to it which move the arm in all directions. These group of muscles is called the rotator cuff. While the arm is lifted above sideways, there are muscles of the shoulder blade and the rotator cuff which help in this movement. This movement is a conjunction of a Gleno-humeral (Ball & Tee) and a Scapulothoracic (shoulder blade and chest wall) motion in synchrony.
The main pathologies which involve the shoulder and constitute a common clinical spectrum are:
1. Recurrent Shoulder Instability
2. Rotator cuff lesions
3. Scapulothoracic dyskinesia
5. Impingement Syndrome
The main symptoms of shoulder pathology are:
- Restricted mobility
- Painful range of motion
- Abnormal sounds/clicking
- Night pains
- Morning stiffness in shoulder
- Severe pain and inability to move after a throw
- Difficult overhead movements
- Neck pains
- Numbness and paraesthesia
- Pins and needle sensation
- Diffuse pain upper arm
- Associated Tennis/Golfers elbow, Carpel tunnel syndrome
- Pain, Spasm, Stiffness in between both shoulder blades.
It is advisable that you should visit your Orthopaedic surgeon for consultation if you have had any of these. Many times an associated Trapezius fasciitis is diagnosed as a part of Cervical Radiculopathy but the management of the same fails to provide any relief.It is imperative to consult your Orthopaedic for clinical evaluation and precise diagnosis.
The treatment in most cases initially remains conservative with anti-inflammatory and analgesics along with physiotherapy and rehabilitation exercises. Various causes of shoulder pain have been discussed in details in subsequent articles. We shall be happy to help you with more insight if you are also suffering from shoulder pain.