Shoulder Pain

What most people call the shoulder are really several joints that combine with tendons and muscles to allow a wide range of motion to the arm - from scratching your back to throwing the perfect pitch. Most shoulder problems involve the soft tissues-muscles, ligaments, and tendons-rather than bones. Most of these problems fall into three major categories:

1. Tendonitis/Bursitis
2. Injury/instability
3. Arthritis

Tendonitis
A tendon is a cord that connects muscle to bone or other tissue. Most tendonitis is the result of a wearing process that takes place over a period of years, much like the wearing process on the sole of a shoe.  Generally tendonitis is one of several types:

1. Acute tendonitis following overuse from activities such as excessive ball throwing and other sports or work related activities.
2. Chronic tendonitis resulting from degenerative disease or repetitive wear and tear due to age.
3. The splitting and tearing of tendons that may result from acute injury or degenerative changes in the tendons due to advancing age.

Rotator cuff injuries are among the most common of these disorders. The rotator cuff is the arrangement of muscles and their tendons, which provides shoulder motion and stability.

Bursitis
Sometimes, excessive use of the shoulder leads to inflammation and swelling of a bursa, a condition known as bursitis. Bursas are fluid filled sacs located around the joint that lessen the friction caused by movement of the shoulder. Bursitis often occurs in with rotator cuff tendonitis. Sometimes the many tissues in the shoulder become inflamed and painful, limiting the use of the shoulder. The joint may stiffen as a result, a condition called a "frozen shoulder." Fortunately, with appropriate care, this condition will resolve

Injury/Instability
Sometimes the bones in one of the shoulder joints move (or, in an injury, are forced) out of their normal position. This condition, instability, can result in dislocation of one of the joints in the shoulder. Recurring dislocations, which may be partial or complete, cause pain and unsteadiness when you raise your arm or move it away from your body. When you lift your arm over your head, the shoulder may feel as if it is slipping out of place or an uncomfortable, unusual feeling that some people refer to as having a "dead" arm.

Arthritis
Shoulder pain can also result from arthritis. There are many types of arthritis, but generally it involves wear and tear changes with inflammation of the joint, causing swelling, pain, and stiffness. Arthritis may be related to sports or work injuries.

Often people will avoid shoulder movements to try to lessen the pain from these conditions. This sometimes leads to a tightening or stiffening of the soft tissue parts of the joint, resulting in a painful restriction of motion.

When should you seek treatment?
Many patients ignore temporary minimal shoulder symptoms with few bad effects. In the case of an acute injury, if the pain is intense, you should get treatment as soon as possible. If the pain is less severe, it may be safe to wait a few days to see if time will alleviate the problem.

If symptoms persist, come on in for a thorough examination. Our doctors will determine the source of the problem in the shoulder and recommend the right treatment method for your specific condition.