Shoulder pain

Shoulder pain is a fairly common complaint for patients of many age groups. The shoulder joint is actively used by everyone, from young to old, since it is perhaps one of the most mobile joints in the body.

It is the shoulder joint that allows you to move your arm, lift it, put it behind your head or back. Joint movements provide motor activity in three planes, but this ability is a provoking factor that reduces the stability of the joint, as well as the risk of destruction of its structures. The rotator cuff, which is more correctly called the rotator cuff, is damaged especially often.

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Causes of Shoulder Pain

The cause of pain in the shoulder can be various diseases, injuries and anatomical pathologies. The cause is most often determined by the movements that provoke pain, which may include the following:

1. If the shoulder joint hurts when raising the arm forward or moving it to the side, then the search for the disease must begin in the supraspinal tendon.
2. If the shoulder hurts when the arm is externally rotated and the elbow is pressed to the body, the infraspinal tendon is most likely damaged.
3. If pain in the shoulder joint occurs with internal rotation of the arm and the elbow pressed to the body, changes occur in the subscapular region.
4. If the front of the shoulder hurts when the forearm is turned inward, this indicates inflammation of the brachial biceps.
5. If pain in the shoulder joint occurs with any movement, and motor activity is significantly reduced, this is a clear sign of inflammation of the entire joint capsule.
6. If pain occurs when lifting light weights, this is a sign of damage to the tendon located along the biceps muscle.

Most often, pain in the shoulder joint is caused by the following diseases:

• Inflammation of the muscle of the inner zone of the shoulder joint - biceps tendinitis. The pain symptom becomes intense with increasing load, movement and palpation. There may also be a rupture of the muscle tendon in this area, in which case, in addition to pain, a characteristic bulge appears at the site of injury.
• Bursitis, characterized by swelling in the joint area. Bursitis is an inflammatory process in the synovial joint bag, accompanied by the accumulation of fluid - exudate. Bursitis is most often combined with inflammation of the tendon - tendinitis.
• Tendinitis is the most common pathology. Inflammation affects almost all tendons, causing severe pain in the shoulder joint. Tendinitis develops due to increased load on the joint, which causes friction and damage to the tendons against the articular bone.
• A shoulder injury is a blow or fall in which the humerus is displaced and comes out of the joint socket. When injured, tendons are often torn, causing severe pain in the shoulder joint.
• A professional injury of athletes is a recurrent or habitual shoulder dislocation. The shoulder loses stability and periodically falls out of the joint, while the periarticular tissues are irritated, causing pain. Habitual dislocation can also be caused by a lack of calcium in the body (osteoporosis).
• The so-called salt deposition, which would be more correctly called calcification of the ligamentous apparatus of the shoulder. This is a systemic disease, most often diagnosed in elderly patients.
• Stretching of the ligamentous apparatus during intense physical or sports activity, which may be accompanied by a rupture of the cartilaginous sponge.
• Diseases of internal organs that manifest symptomatically as pain in the shoulder joint. This may be angina, myocardial infarction, liver disease or pneumonia. With these pathologies, pain often radiates to the shoulder area.
• Oncological diseases, including chest tumors.
• Osteochondrosis of the cervical spine often manifests itself as pain in the shoulder.
• Anatomical malformations, including hemihypoplasia (unilateral muscle atrophy) or joint instability syndrome.
• Plexitis is a lesion of the brachial plexus.
• Arthrosis of the shoulder joint is a degenerative change in the structure of the cartilaginous tissue of the joint.
• Herniated discs in the chest or cervical region.
• Periarthritis or scapulohumeral periarthritis is a disease caused by a mechanical factor, when the shoulder muscles are in constant tension. Periarthritis can be associated with professional activity (construction specialties). Advanced periarthritis or periarthritis can completely block the work of the shoulder joint.
• Capsulitis, which is figuratively called a “frozen” shoulder, since the movement of the joint is almost completely blocked.

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How is the shoulder joint structured?

The shoulder joint is considered to be a ball-and-socket joint and consists of three main bones – the head, the clavicle and the cavitas glenoidalis or glenoid cavity of the scapula. The clavicle is not connected to the shoulder in an anatomical sense, but it plays an important role in the motor function of the shoulder joint. The edge of the glenoid or glenoid cavity is surrounded by a specific tissue – a cartilaginous ridge or labrum, it is this cartilaginous tissue that holds the head in the joint. The joint capsule consists of a system of ligaments, which are divided into the coracoid and articular-humeral, consisting of three sensitive bundles. The entire joint is supported by muscle tissue and tendons, which create stability of the shoulder joint. Each muscle plays its role in the active movements of the shoulder:

• The subscapularis muscle provides internal rotational movement.
• The supraspinatus muscle helps the arm to rise and move the shoulder joint to the side.
• The deltoid muscle controls the forces during abduction.
• The teres minor muscle helps to perform external rotational movements.
• The infraspinatus muscle also contributes to external rotation of the shoulder.

All muscles work as a whole as one system called the rotator cuff. Any irritation, inflammation or damage to tissues - muscle, cartilage, tendon, can cause pain in the shoulder joint.

Pain in the left shoulder joint

Pain in the left shoulder joint is a signal not only of possible tendinitis (stretched tendon), bursitis (inflammation of the periarticular bag) or salt deposits. Pain in the left shoulder joint may indicate more serious diseases that require immediate medical attention. Such ailments include traumatic lung injury, angina pectoris or myocardial infarction, the symptoms of which are not always specific. In addition, a diagnosed and suffered infarction can be the cause of left-sided shoulder periarthritis. Necrosis of a certain section of the circulatory system located in the left shoulder area disrupts the circulation and blood supply to the shoulder tendon, which gradually begins to swell and become inflamed, thus developing scapulohumeral periarthritis.

Also, factors that provoke pain in the left shoulder joint may be narrowing syndrome or impingement syndrome, calcification of the tendon (calcification), plexitis, radiculopathy, protrusions of the intervertebral discs of the cervical spine, injuries or tumors of the shoulder joint.

Any painful sensation in the left shoulder requires the help of a doctor, accurate diagnosis and adequate treatment.

Pain in the right shoulder joint

Most often, acute pain in the right shoulder joint is a consequence of a pinched intervertebral hernia of the cervical spine. Also, pain in the right shoulder can be caused by bursitis and biceps tendinitis caused by excessive physical activity, salt deposits, injuries, congenital anatomical pathologies, chronic liver diseases, radiculopathy, pneumonia, myositis. In clinical orthopedic practice, the most common cause of chronic, increasing pain in the right shoulder joint is scapulohumeral periarthritis or periarthritis. Pain with periarthritis appears unnoticed, starting with periodic discomfort, gradually increasing and interfering not only with normal work during the day, but also with sleep at night. Pain in the right shoulder joint must be treated in a timely manner, since a developing chronic disease can lead a person to disability.

Types of Shoulder Pain

Severe pain in the shoulder joint

Severe pain in the shoulder joint is most often caused by three main reasons - a shoulder injury, an acute inflammatory process in the joint and tendon itself, and inflammation of the pinched nerve endings in an intervertebral hernia. Severe pain caused by an injury is preceded by internal swelling in the damaged area and appears literally a few minutes after the injury. Pain caused by a pinched hernia usually begins at the moment of excessive physical exertion, especially if it is associated with lifting weights upward (raised arms). In addition, severe pain in the shoulder joint can be a consequence of chronic tendobursitis, which passes into an acute stage. The tendons and muscles surrounding the joint gradually calcify, causing inflammation in the joint capsule, thus forming a pain symptom. Intense pain in the shoulder often completely limits a person's active and passive movements, so severe pain in the shoulder requires professional medical help. Self-medication is possible only in the initial period as first aid; later, in order to avoid disability, you need to contact an orthopedist or surgeon.

Aching pain in the shoulder joint

Aching pain in the shoulder joint is a sign of a chronic inflammatory process either in the joint itself or in the tendons. It may also indicate more threatening diseases, such as myocardial infarction or angina. The nature of the sensations that are described as aching pain in the shoulder joint is often associated with purely physiological overstrain of the shoulder muscles. This happens during intense training, when performing heavy physical monotonous work. Tendinitis or tendobursitis begins with pain in the neck and shoulder. In addition, aching pain in the shoulder joint, increasing with a change in weather, is a characteristic symptom of periarthritis or periarthrosis. At rest, weak, periodic pain most often subsides and becomes more intense only with increased physical activity. The insidiousness of such symptoms is that a person tries to cope with the disease on his own, wasting precious time that should be spent on high-quality treatment of the underlying cause of the pain.

Sharp pain in the shoulder joint

Sharp pain in the shoulder joint is most often provoked by an injury, but it can also be caused by the rapid development of an inflammatory process in the tissues, in the joint capsule or tendons. The cause of such pain can be capsulitis, arthritis in the acute stage, including rheumatoid arthritis or osteoarthritis, as well as tendobursitis, pleurisy (acute inflammation of the pleura and accumulation of exudate). In addition, sharp pain in the shoulder joint is characteristic of protrusion of the discs of the cervical spine, strangulation of a hernia. Like any other acute symptom, sharp pain requires medical attention. You can take a painkiller (ketanov, analgin) on your own, immobilize the shoulder in case of injury. Further treatment is prescribed by an orthopedist, traumatologist or surgeon.

Acute pain in the shoulder joint

Acute pain in the shoulder joint may be evidence of an exacerbation, the peak stage of the inflammatory process in the muscles and tendons (tendinitis, tendobursitis), a sign of exacerbated arthrosis or arthritis (rheumatoid, infectious, reactive), inflammation of the nerve endings - neuritis of the brachial nerve. Severe pain is characteristic of pinched intervertebral disc herniation. In addition, acute pain in the shoulder joint is often provoked by injuries, including sports ones. These include rupture of the shoulder tendon, bone displacement, shoulder dislocation (recurrent form). In older people, injury can be provoked by age-related degenerative changes in bone tissue, osteoporosis, progressive osteochondrosis of the cervical-brachial region. Acute pain in the shoulder joint on the left is most dangerous, since such a symptom may indicate an attack of angina pectoris or developing myocardial infarction. Acute symptoms require immediate medical attention, and include severe, sharp pain in the shoulder.

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Pain in the shoulder joint

Pain in the shoulder joint is a polysymptom, i.e. a sign of many diseases. These painful sensations in the arm most often indicate an acute stage of scapulohumeral periarthritis.

Pain in the shoulder joint and neck is a symptom of cervical spondylosis, scoliosis, osteochondrosis of the cervical spine, sprains or ligament ruptures, static or physical overexertion

A painful symptom in the joint itself is arthritis or arthrosis.

Pain in the shoulder joint, combined with pain in the sternum, is a clear sign of an inflammatory process in the lungs (pleurisy, pneumonia) or a symptom of chest trauma.

Pain in the muscle tissue surrounding the shoulder joint is a clear sign of myalgia.

If the pain in the shoulder joint is associated with an injury, you should immediately consult a doctor; medical assistance is also needed for pain that lasts more than a day.

Treatment of shoulder pain

After all diagnostic procedures have been completed, including anamnesis, examination, orthopedic tests, X-ray examination, and possibly computed tomography, therapy consists of three stages:

1. Etiotropic measures, the purpose of which is to eliminate the underlying cause of pain in the shoulder joint.
2. Symptomatic treatment, the purpose of which is to provide maximum pain relief and neutralize any discomfort caused by the disease.
3. Restorative measures or rehabilitation aimed at restoring normal activity of the shoulder joint.

Ointment for pain in the shoulder joint

As a first aid, as well as during the rehabilitation period, a specially selected ointment for pain in the shoulder joint can provide invaluable assistance. Gel and ointment can significantly improve blood circulation in the damaged area, relieve shoulder pain, relieve inflammation and swelling, and activate the restoration of atrophied tissues. An external remedy should be selected depending on the nature of the pain and the period of the disease. If the shoulder is injured, an ointment for pain in the shoulder joint should have a cooling effect. A gel containing essential oils of mint or an ointment containing menthol and novocaine will have a good effect. This is the first rule of assistance for any injury, when the damaged area is immobilized and cold is applied. Starting from the second day, the external drug should be either anti-inflammatory or warming. Any ointment for pain in the shoulder joint should have a light consistency, so it will penetrate the tissues more easily and work more effectively. The composition of the products may vary, but the most effective are those containing ibuprofen, diclofenac, and methyl salicylate. Warming ointments that improve tissue blood supply usually contain extracts of irritating components, so the skin should be clean, without wounds or cuts. The most effective ointment for shoulder pain is one that is applied two to three times a day. Recommended products are Diclofenac gel, Indomethacin, Voltaren, and Ketonal.

What to do if you have pain in your shoulder joint?

General recommendations for those who experience shoulder pain are as follows:

• Provide a sufficiently hard bed and a flat horizontal surface.
• Limit shoulder movement (immobilization). The arm should not be immobilized to avoid contracture.
• The first day after the onset of pain, cold is indicated - cold compresses (ice).
• After cold compresses, starting from the second day, you can use warming procedures and rubbing.
• In case of severe pain, you can take a non-steroidal anti-inflammatory drug - ibuprofen, diclofenac. External agents containing these components - ointments, gels - are also indicated.

Shoulder pain requires medical attention because it is a non-specific symptom. To avoid developing a serious illness that can be missed when trying to treat the shoulder on your own, you should see a surgeon, orthopedist, or simply your local doctor.