What most people call the shoulders, is actually several joints (an area where 2 or more bones meet) that combine with muscles for a varied range of motion in the arm, for example, from scratching your back to throwing a perfect pitch ball. When there is a pain in your shoulders, it hampers your ability to move freely and can cause a great deal of discomfort. 

The shoulder joint (a ball-and-socket joint) comprises 3 bones:

  • The humerus - long arm bone

  • The clavicle - collarbone

  • The scapula - shoulder blade

These bones are protected by a layer of cartilage (a connective tissue that is firm but softer and more flexible than bones and is found in many areas of the body, mostly in joints between your bones). 

Shoulders get their range of motion from the rotator cuff. The rotator cuff is a group of muscles and tendons (tissues connecting muscles to bones) that surround the shoulder joint while making sure that the head of your upper long arm bone (humerus) fits completely within the shallow socket of the shoulder. This cuff is made up of four tendons. If the tendons around the rotator cuff are damaged or swollen, it becomes difficult and painful to lift your arm.

You are more likely to get shoulder pain as you grow older as the tissues surrounding the shoulder degenerate.

Causes

Several factors and conditions contribute to shoulder pain, however, the most prevalent cause is rotator cuff tendonitis (inflamed or irritated tendons). 

Sometimes, shoulder pain results from an injury at another location in your body such as the neck or biceps. This is known as referred pain and worsens when you move your shoulder. 

Other causes of shoulder pain include:

  • Arthritis (inflammation of your joints)

  • Torn cartilage or rotator cuff injuries

  • Bone spurs (bony projections that develop along the edges of your bone)

  • Pinched nerve (too much pressure on the nerve from the surrounding tissue)

  • Frozen shoulder (stiffness in your shoulder)

  • Dislocated shoulder (the upper arm bone comes out of the shoulder blade socket)

  • Spinal cord injury

  • Heart attack

Symptoms

  • Deep pain in the shoulder joint

  • Reduced movement and pain while moving your shoulder

  • Weakness in your shoulder and the upper arm

  • A sensation of pins and needles poking in your shoulder

  • Burning pain in the shoulders

Diagnosis

Your doctor may order specific tests to help identify the cause of your pain and any other problems.

  • X-rays create pictures of the inside of your body.

  • Ultrasound is a machine by which internal structures of your body can be visualized and it works by movement of sound through soft tissue and fluids and bouncing back/echoing off denser surfaces, creating an image.

  • MRI (Magnetic Resonance Imaging) is a machine in which a strong magnetic field is used to generate images of the organs in your body.

  • Computed tomography (CT) scan is a machine in which a series of X-ray images are taken from different angles around your body and used to create cross-sectional images (slices) of the bones, blood vessels, and soft tissues inside your body.

  • Electrical studies to evaluate nerve function.

  • Arthrogram is a dye that is injected into the shoulder to see your joint and its surrounding muscles and tendons.

  • Arthroscopy is a surgical procedure where your doctor looks inside the joint with a fiber-optic camera.

Treatment 

The treatment varies according to the problem affecting your shoulder joint. 

  • In minor injuries, sprains, tendonitis (inflammation of a tendon), or most cases of frozen shoulder, the treatment is usually medicines and exercises suggested by your doctor. 

  • Conditions such as repeated shoulder dislocations or complete tendon ruptures may require repair which can be done surgically. This is totally based on the discretion of your doctor. Previously, surgeries were done using the open technique which frequently resulted in stiffness & pain, post-surgery. But now, newer techniques have emerged where your joint is accessed by small keyhole incisions (arthroscopy) through which most of the problems can be tackled. This has revolutionized the understanding and management of shoulder problems.

  • In severe arthritis of the shoulder joint, where the cartilage is totally destroyed and medicines and exercises have failed, replacement of the shoulder joint gives excellent results both in terms of pain relief as well as functions. Now, newer implants have also come which can restore the shoulder function even in elderly patients where all the tendons have been ruptured.

Prevention

  • Do simple muscle exercises daily. This can help stretch and strengthen your muscles and the rotator cuff tendons. 

  • Apply ice packs. If you have had shoulder issues in the past, use an ice pack 15 minutes after exercising, to prevent future injuries.

  • Practice range motion exercises. Simple range motion exercises every day can keep you from getting frozen shoulders.

Shoulder pain can be prevented and treated as well. However, you should consult your doctor in case you experience fever, inability to move your shoulder, bruises, heat, and tenderness around the shoulder joint, or pain that persists beyond a few weeks.


DisclaimerThis article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.