What is Shoulder Pain?
There is a joint cover that we call capsule surrounding the shoulder joint. If there is a situation that causes adhesion in the capsule, frozen shoulder disease is encountered.
There are ligaments connecting the joint, which we call ligament , on the capsule. Excessive strain or looseness in these will cause half or full shoulder dislocations in the shoulder joint.
On these ligaments are muscle beams . These tendons are responsible for the movement of the shoulder. There are four important rotator tendons in the shoulder called the rototor cuff. Tearing them can also cause pain.
There is one of the biggest sacs (bursa) of the body called subacromial, which allows the joint to move more easily. This may also cause rheumatic inflammation.
Finally, on top of all this is the deltoid muscle, one of the strongest muscles to shape the shoulder.
Causes such as injury, strain, tearing and trauma in one or more of these structures will cause shoulder pain as well as other complaints.
The area between the humerus, which is the upper arm bone, the scapula, which is the scapula, and the clavicle, which is called the collarbone, is the area where the shoulder joint is located. The shoulder joint is a very mobile joint that can move in four directions.
Although shoulder pain is caused by the shoulder joint, there may also be pain reflected on the shoulder from other regions. The most common example of this is neck hernia.
Shoulder pain can be caused by abnormal reasons that may occur in one or more of all the components described above.
What Causes Shoulder Pain?
The most common causes of shoulder pain are those caused by their own anatomical structure. The most common causes are compression of the shoulder tendons, frozen shoulder, calcific tendinitis caused by calcium accumulation in the tendons, shoulder laxity or shoulder dislocations, and strain of the muscles around the shoulder called myofascial pain. Another important reason is shoulder pain caused by strokes.
Less common causes are usually off the shoulder. Inflammatory rheumatism, upper lung cancers, liver, gall bladder, spleen problems and neck hernias are the most common in this group.
- Shoulder blows, traumas
- Collarbone fracture
- Bursitis, fibrositis, myositis, tendinitis
- Shoulder fractures and dislocations
- Lying on your side and in the wrong position constantly
- Spine injuries
- Activities such as lifting heavy loads, wiping windows
- Impingement syndrome
- Shoulder pain can also be seen in cases such as cardiovascular diseases, chronic lung disease, diabetes, and neck diseases.
- Stroke (half paralysis)
What Are The Symptoms Seen With Shoulder Pain?
Although the complaint is usually pain, they may present with symptoms such as sensitivity in the shoulder, increased warmth, redness, decrease in shoulder movements, epaulette finding in shoulder dislocations, stiffness or mass in the shoulder.
How Should Shoulder Pain Be Diagnosed?
The diagnosis will usually be made by the history to be taken from the patient and especially by a good shoulder examination. Most of the shoulder pain is caused by soft tissue. Since calcifications are seen in older ages, they may not be seen in normal plain films. Tomogrophy is rarely required. The best method to evaluate the shoulder is the MR technique. It shows bone and soft tissues extremely well. EMG may be required in patients with suspected nerve injury.
How Should Shoulder Pain Be Treated?
Shoulder pain, which often occurs after muscle strain and wrong movements, heals spontaneously in a short time. Emergency intervention may be required in shoulder injuries due to trauma.
The causes of shoulder pain are varied. It is observed in a wide range from tumors to traumas. For this reason, first of all, tumors and infections should be considered and should be distinguished in cases of fever, shoulder pain at night, weight loss, shoulder pain that does not change with arm movements and does not respond to painkillers. After other reasons are ruled out, treatment should be planned by focusing on the main cause. Physical therapy is used in most of the pathologies that cause shoulder pain.
Ice application is extremely beneficial in acute pain. The shoulder should be rested as much as possible, used sparingly and anti-inflammatory drugs should be used. Very good results are obtained with ice treatment to be applied for 15 minutes, 3-5 times a day.
A shoulder sling should be used in patients with severe pain that cannot carry their arm or people who have been traumatized. Suspension time should be kept as short as possible.
Treatment approach is different in chronic pain. At this stage, physical therapy methods have an important place. ESWT can be useful in combination with exercise practices to increase range of motion and muscle strength.