Definition and Overview
Shoulder pain refers to any pain that affects one or both shoulders. This condition is classified based on its location, cause, and severity, among other factors.
The shoulder consists of a ball and socket joint that has the largest range of movement of all joints in the body. It is made up of the humerus or upper arm bone, the scapula or shoulder blade, and the clavicle or collarbone. It also has a lot of muscles, tendons, and ligaments that hold the joints together. On top of the shoulder, there is another joint called the acromioclavicular joint.
Due to its greater mobility, the shoulder is injured easily, which is why pain in the shoulder is a very common complaint.
Causes of Condition
There is a wide range of possible causes of pain affecting the shoulder. Some of them are minor while some are serious. These include:
- Overexertion or strain
- Tendonitis arising from overuse
- Wear and tear caused by aging
- Instability of the joint
- Frozen shoulder
- Pulled muscles
- Nerve injuries such as radiculopathy and brachial plexus neuropathy
- Separation of the shoulder
- Torn rotator cuff
- Upper arm fracture
- Collar bone fracture
The most common cause of shoulder pain complaints arise from injuries, which can be easily obtained through a fall, a blow to the shoulder or upper arm, or twisting, bending, or dislocation of the shoulder. These often occur during work or sports activities and accidents.
Aside from pain, symptoms of this condition may include the following:
- Warmth in the area
- Redness or other change in color
- Limitations in normal range of shoulder or arm motion
In case of injuries, the symptoms of shoulder pain may go away after a couple of weeks. However, if your pain is not brought about by injury, is sudden, has been developing or increasing in intensity, has been bothering you for a while, or is hindering you from performing your normal activities, it is best to see a doctor.
Who to See and Types of Treatments Available
Shoulder pain is classified as an orthopedic problem. Orthopedic medicine is the medical specialty that focuses on the diagnosis and treatment of problems involving the musculoskeletal system. Orthopedic specialists and surgeons concern themselves with injuries and pain involving the bones, joints, muscles, tendons, and ligaments. They are trained to treat the pain, swelling, or other injuries to the bones, joints, ankle and foot, hand and wrist, shoulder, knee, elbow, and spine.
Before prescribing treatment for this condition, the attending doctor will first make a diagnosis using the following tests:
X-rays – X-rays reveal the space between the ball and socket of the shoulder, which can determine whether there is dislocation or instability.
MRI – A magnetic resonance imaging procedure can reveal details pertaining to the nerves, tendons, and ligaments to delve into other possible causes of shoulder pain that do not show up on x-rays.
Myelography or CT scan – A CT scan can achieve what an MRI can and is often used as an alternative or to confirm MRI results.
Electromyography or EMG – This, along with a nerve conduction velocity or NCV test, can be used to diagnose the cause of pain, numbness, and tingling in the shoulder.
Once the specific cause of shoulder pain is determined, treatment begins using the following medications:
- Anti-inflammatory medication – Ibuprofen or naproxen are safe and effective medications used to relieve pain and swelling associated with shoulder pain.
- Muscle relaxants
- Local corticosteroid – Corticosteroid may be locally injected into the joint. This treatment is more commonly used to treat arthritis in the shoulder.
Aside from medications, there are instances where surgical procedures may be required. These often involve cases where nerves are affected.
For most types of shoulder pain, exercise is often part of the treatment plan to restore mobility. However, if the shoulder pain is severe, exercise should be suspended until after a reasonable period of rest or break from the activity that caused the strain or soreness of the shoulder.
During the period of soreness, applying ice packs to the affected area can relieve pain and reduce swelling. Application of cold pack is recommended at least three times a day, with each application lasting for 10 to 20 minutes. If the shoulder is injured, the ice pack should be applied immediately and certain activities that may further encourage swelling should be avoided. These include hot showers or tubs and drinking alcoholic beverages. Heat may be applied only when swelling has subsided.
For first aid, follow the RICE acronym, which stands for:
- Rest the injured shoulder
- Ice it
- Compress with an elastic or bandage
Doctors will recommend a sling during the first 48 hours after shoulder injury. This is to support the shoulder, avoid painful motions, and keep the patient comfortable.
- Mitchell C., Adebajo A. et al. (2005). “Shoulder pain: diagnosis and management in primary care.”
- Kelley M., Shaffer M., Kuhn J. et al. (2013). “Shoulder pain and mobility deficits: Adhesive capsulitis clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American Physical Therapy Association.” Journal of Orthopaedic and Sports Physical Therapy.
- Stevenson H., Trojian T. (2002). “Evaluation of shoulder pain.” The Journal of Family Practice.
- Engebretsen K., Grotie M., et al. “Determinants of the shoulder pain and disability index in patients with subacromial shoulder pain.” Journal of Rehabilitation Medicine.