Shoulder Pain: Causes, Treatments & Diagnosis
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Shoulder Pain: Causes, Treatments & Diagnosis

A human shoulder is a combination of several joints that associate with tendons & muscles to allow complete activity through the arms. From picking to throw anything shoulder play an important role in your daily life. But a small shoulder pain affects so much activity of our daily life & sometimes ignoring pain between the shoulder will become a heavy cause in the future. Here in this blog, we explain shoulder pain causes, treatments, and diagnosis.

A shoulder is mainly functioning with three bones, which are:

  • Humerus (Long-arm bone)
  • Clavicle (Collarbone)
  • Scapula (Shoulder blade)

These muscles bones are joint with a layer of cartilage. The main joints of the shoulder acromioclavicular joint present between the part of the scapula & clavicle.

Similarly, the glenohumeral joint is present in the ball-shaped part of the human bone & outer edge of the scapula. In normal terms, we also called this shoulder joint.

This shoulder joint is the most portable joint of the body. It helps to move the shoulder forward, backward, up, and downside.

This article explains the reason for shoulder pain as well as you get more information on treatment & diagnosis of shoulder pain. Also, you get the information on home shoulder pain treatment & when to visit a doctor. 

What Is Shoulder Pain?

The shoulder has a wide and versatile range of motion. When something goes wrong with your shoulder, it hampers your ability to move freely and can cause a great deal of pain and discomfort. The shoulder is a ball-and-socket joint that has three main bones known as humerus, clavicle, and scapula.

These bones are cushioned by a layer of cartilage. There are two main joints. The acromioclavicular joint is between the highest part of the scapula and the clavicle. The glenohumeral joint is made up of the top, a ball-shaped part of the humerus bone, and the outer edge of the scapula. This joint is also known as the shoulder joint.

The shoulder joint is the most mobile joint in the body. It moves the shoulder forward and backward. It also allows the arm to move in a circular motion and to move up and away from the body. Shoulders get their range of motion from the rotator cuff. The rotator cuff is made up of four tendons.

Tendons are the tissues that connect muscles to bone. It may be painful or difficult to lift your arm over your head if the tendons or bones around the rotator cuff are damaged or swollen. You can injure your shoulder by performing manual labor, playing sports, or even by repetitive movement.

Certain diseases can bring about pain that travels to the shoulder. These include diseases of the cervical spine (neck), as well as liver, heart, or gallbladder disease. You are more likely to have problems with your shoulder as you grow older, especially after age 60.

This is because the soft tissues surrounding the shoulder tend to degenerate with age. In many cases, you can treat shoulder pain at home. However, physical therapy, medications, or surgery may also be necessary. Here is what you need to know about shoulder pain, including causes, diagnosis, treatment, and prevention.

The Major Cause of Shoulder Pain

There are several factors & condition will affect your shoulder. Apart from them, Rotator cuff tendinitis is one of the major causes of shoulder pain. Also, impingement syndrome is one of the major reasons for shoulder pain. Where muscles rotator caught (which is part of the scapula) and humeral head in the area of the humerus & this will be a cause of pain in other body parts such as neck or biceps pain. T

his pain is also known as referred pain & this will more panic when you move your shoulder in any direction. Several factors and conditions can contribute to shoulder pain. The most prevalent cause is rotator cuff tendinitis. This is a condition characterized by swollen tendons. Another common cause of shoulder pain is impingement syndrome where the rotator cuff gets caught between the acromion.

That is the part of the scapula that covers the ball, and the humeral head which is the ball portion of the humerus. Sometimes shoulder pain is the result of injury to another location in your body, usually the neck or biceps. This is known as referred pain. Referred pain generally doesn’t get worse when you move your shoulder.

Other Major Cause Responsible For Shoulder Pain

Other causes of shoulder pain include the given below causes:

  • Arthritis
  • Heart attack
  • Torn cartilage
  • Spinal cord injury
  • Torn rotator cough
  • Injury because of heavy use
  • Due to tendons
  • Shoulder dislocation
  • Bone spurs due to the edges of bones
  • Frozen shoulder
  • Nerve pinched in neck or shoulder
  • swollen bursa sacs or tendons
  • broken shoulder or arm bone
  • dislocated shoulder
  • injury due to overuse or repetitive use

These are the list of the basic and very common causes of shoulder pain. Due to any of them, you experience that movement of the shoulder is maybe little or hard panic. So that if you feel any symptoms related to these body parts, you need to take precautions or consult with your doctor or physician.

Way To Prevent Shoulder Pain

Including simple shoulder exercise in your daily routine is the best way to take prevention against shoulder pain. Daily arm exercise will help to stretch and strengthen muscles as well as rotator cuff tendons. To know how to do a shoulder exercise, you need to consult with a physical therapist or any occupational therapist.

They will provide you better information related to shoulder or arm exercise in a proper way. Also, if you get any shoulder injury in the past, using ice for 15 minutes after shoulder exercise will prevent any future shoulder injury.

When To Get Medical Help?

If you are feeling extreme condition shoulder pain, without any more delay you need to consult with a physician or doctor. Apart from the pain, some other symptoms such as unable to move your shoulder, heat or any kind of tenderness around the joint, don’t feel any relaxation after home treatment or lasting bruising.

If your shoulder pain is not related to any injury or it occurs suddenly, then you need to consult with your doctor as soon as possible. Because of some time shoulder pain is a symptom of a heart attack as well as including:

  • Any kind of a pain in neck or jaw
  • Chest tightness
  • Excessive sweating
  • Any kind of trouble in breathing
  • dizziness
  • pain in the neck or jaw

You should contact your doctor if you experience fever, inability to move your shoulder, lasting bruising, heat, and tenderness around the joint, or pain that persists beyond a few weeks of home treatment. If your shoulder pain is sudden and not related to an injury, call 911 immediately. It may be a sign of a heart attack. Also, call 911 or go to an emergency room immediately if you injured your shoulder and are bleeding, swollen, or you can see exposed tissue.

Treatment For Shoulder Pain

Basically, shoulder pain treatment is dependent on the cause and severity of the shoulder pain known as severe pain. Based on the shoulder injury there is various treatment such as physical or occupational therapy, surgery or sling or shoulder immobilizer.

The physician or doctor will better prescribe better medicine for instant relief. Most of the time for getting better relief from shoulder pain they suggest nonsteroidal anti-inflammatory medications or corticosteroids. This corticosteroid is one of the powerful anti-inflammatories medicine which is directly taken by mouth or the doctor will inject this medicine in your shoulder.

If you have any previous shoulder injury, you need to consult with your doctor & follow all the instructions very carefully.

Few minor shoulder pain which occurs due to heavy work or other activity will be easily treated at home. The best way to reduce shoulder pain at home, apply ice cube in your shoulder 15 to 20 minutes after shoulder exercise. You need to apply this activity for several days to reduce the pain. Using an ice bag or wrap a few ice cubes inside the cloth is a better way to protect your skin from ice. Because when you apply an ice cube directly on your skin, it will be a major reason for skin burn or frostbite.

Also, you need to rest your shoulder for a few days and try to avoid heavy activity or movement, because they might be a cause of pain. You can also do other shoulder pain relief exercises or activity at home including counter nonsteroidal anti-inflammatory drugs to control or reduce the shoulder pain. Similarly, like reducing the pain, they reduce inflammation and compressing the area by using an elastic bandage which helps to reduce swelling.

What are the treatment options for shoulder pain?

As you know that treatment will depend on the cause and severity of the shoulder pain. Some treatment options include physical or occupational therapy, a sling or shoulder immobilizer, or surgery. Your doctor may also prescribe medication such as nonsteroidal anti-inflammatory medications (NSAIDs) or corticosteroids.

Corticosteroids are powerful anti-inflammatory drugs that can be taken by mouth or your doctor can inject into your shoulder. If you have had shoulder surgery, follow after-care instructions carefully. Some minor shoulder pain can be treated at home. Icing the shoulder for 15 to 20 minutes three or four times a day for several days can help reduce pain.

Use an ice bag or wrap ice in a towel because putting ice directly on your skin can cause frostbite and burn the skin. Resting the shoulder for several days before returning to normal activity and avoiding any movements that might cause pain can be helpful. Limit overhead work or activities.

Other home treatments include using over-the-counter nonsteroidal anti-inflammatory medications to help reduce pain and inflammation and compressing the area with an elastic bandage to reduce swelling.

Way To Diagnosed Shoulder Pain

The best way to diagnose shoulder pain, consult with the doctor or physician. Also, you need to share all medical history before doing the physical examination. According to the pain or shoulder movement, they suggest imaging tests like X-ray or MRI. These tests based on your shoulder motion, activity, swelling or joint stability.

Your doctor will want to find out the cause of your shoulder pain. They will request your medical history and do a physical examination. They will feel for tenderness and swelling and will also assess your range of motion and joint stability. Imaging tests, such as an X-ray or MRI, can produce detailed pictures of your shoulder to help with the diagnosis.

Your doctor may also ask questions to determine the cause. Questions may include:

  • Is the pain in one shoulder or both?
  • Did this pain begin suddenly? If so, what were you doing?
  • Does the pain move to other areas of your body?
  • Can you pinpoint the area of pain?
  • Does it hurt when you’re not moving?
  • Does it hurt more when you move in certain ways?
  • Is it a sharp pain or a dull ache?
  • Has the area of pain been red, hot, or swollen?
  • Does the pain keep you awake at night?
  • What makes it worse and what makes it better?
  • Have you had to limit your activities because of your shoulder pain?

Points To Share With The Physician During a Shoulder Examination

Few important points you need to discuss with your doctor or physician during the shoulder examination. This will help to find out the main cause of shoulder pain and also beneficial to get the best shoulder pain treatment.

Points You Need To Share

  • Shoulder pain occurs in right-hand or left-hand. Also if you feel both shoulder pains consult with your doctor.
  • Duration of pain. Which means shoulder pain begins suddenly or sometimes.
  • Apart from shoulder pain, do you feel pain in other areas of the body?
  • If possible then pinpoint the exact area of pain.
  • Which time pain occurs mostly? when you move or stable.
  • If pain hurts more when you move to a particular area of the body.
  • Which type of pain sharp or dull ache?
  • Is there any marks or swelling in the area of pain.
  • Do you feel pain 24*7 or any particular time?
  • Which type of home treatment provide you shoulder pain relief.
  • What kind of activity you able to do or what kind of activity you not able to do during the shoulder pain.

Why Do You Need A Thorough Physical Exam?

The term shoulder impingement syndrome is just the starting point to a correct diagnosis and treatment plan. It is a catch-all phrase, It just tells you that a tendon is irritated. What a good physical therapist will do is determine which tendons and muscles are involved.

Some Tests For Shoulder Pain

Shoulder Impingement Test

This test is a very important tool for evaluating your shoulder pain. If you think you may have shoulder impingement syndrome, a doctor may refer you to a physical therapist (PT) who will perform tests to help identify exactly where the impingement is located and the best treatment plan.

Common tests include the Neer, Hawkins-Kennedy, coracoid impingement, and cross-arm impingement tests, along with several others. During these assessments, a PT will ask you to move your arms in different directions to check for pain and mobility problems.

StudiesTrusted Source supports using several different assessments to see what limitations you’re experiencing and what triggers the pain. Physical therapists do not hang their hats on one test. A multitude of tests leads us to a diagnosis.

In Conjunction With Diagnostic Imaging

Many doctors use X-rays, CT scans, MRI scans, and ultrasound testing to clarify and confirm the results of physical examinations. Studies show that imaging tests are highly effective at pinpointing the precise location of an injury. Ultrasound has the advantage of being easy to perform and less expensive than other imaging tests. If there are tears, or lesions, in the rotator cuff, imaging tests can show the degree of the injury and help doctors determine whether a repair is needed to restore your abilities.

What Is Shoulder Impingement?

Shoulder impingement is a painful condition. It happens when the tendons and soft tissues around your shoulder joint become trapped between the top of your upper arm bone (the humerus) and the acromion, a bony projection that extends upward from your scapula (shoulder blade). When the soft tissues are squeezed, they can become irritated or even tear, causing you pain and limiting your ability to move your arm properly.

What are the types of impingement tests, and what happens during each?

Neer test or Neer sign

In the Neer test, the PT stands behind you, pressing down on the top of your shoulder. Then, they rotate your arm inward toward your chest and raise your arm as far as it will go. Some studiesTrusted Source shows that the modified Neer test has a diagnostic accuracy rate of 90.59 percent.

Hawkins-Kennedy test

During the Hawkins-Kennedy test, you’re seated while the PT stands beside you. They flex your elbow to a 90-degree angle and raise it to shoulder level. Their arm acts as a brace underneath your elbow while they press down on your wrist to rotate your shoulder.

Coracoid impingement test

The coracoid impingement test works like this: The PT stands beside you and raises your arm to shoulder level with your elbow bent at a 90-degree angle. Supporting your elbow, they press down gently on your wrist.

Yocum test

In the Yocum test, you place one hand on your opposite shoulder and raise your elbow without raising your shoulder.

Cross-arm test

In the cross-arm test, you raise your arm to shoulder level with your elbow flexed at a 90-degree angle. Then, keeping your arm in the same plane, you move it across your body at chest level. The PT may gently press your arm as you reach the end range of motion.

Jobe’s test

During Jobe’s test, the PT stands to your side and slightly behind you. They raise your arm out to the side. Then, they move the arm to the front of your body and ask you to keep it elevated in that position while they press down on it. All of these tests aim to decrease the amount of space between the soft tissues and bone.

The tests can gradually become more intense as the PT’s examination moves along. We will leave the most painful tests for the end of the assessment so the shoulder is not irritated the whole time. If you do a painful test too early, then the results of all the tests will appear to be positive.

What These Tests Are Looking For?

Pain: A test is considered positive if it elicits the same pain you’ve been experiencing in your shoulder. The Neer test, Vighetti said, will often get a positive result, because it forces the arm into full flexion. You are at the end range of motion with the Neer test. Almost anyone who comes into the clinic with a shoulder issue is going to experience pinching at the upper end of that range.

Location of the pain: During each test, the PT pays close attention to where your pain occurs. This indicates which part of your shoulder complex is likely to be impinged or injured. Pain at the back of the shoulder, for example, could be a sign of internal impingement. Once therapists know which muscles are involved, they can be more specific in their treatments.

Muscle function: Even if you’re not experiencing pain during a test, the muscles involved in shoulder impingement have a slightly different response to pressure testing. We use light, two-finger resistance to test specific motions at the rotator cuff. If someone has an issue with the rotator cuff, even that really light resistance is going to elicit symptoms.

Mobility and joint stability issues: Pain is what brings patients. But there is an underlying problem causing the pain. Sometimes the problem is related to joint mobility. The joint is moving too much or not enough. If the joint is unstable, the cuff is rotating hard to try and provide dynamic stability.

When muscles work this hard, problems can arise not necessarily because the muscles are overused but because they’re being used incorrectly. For that reason, a good PT looks at the activities you do to see if you are moving in a way that is going to lead to injury. Activities like running to identify any dysfunction in the movement.

Doctors and PTs use diagnostic imaging and physical examinations to identify where and to what degree your shoulder may be injured. During the physical exam, a PT will take you through a series of motions to try to replicate the pain you are feeling as you move your arm in different directions.

These tests help the PT find out where you’re injured. The main goals of treatment are to decrease your pain, increase your range of motion, make you stronger and your joints more stable and train your muscles to move in a way that makes future injuries less likely.

Summary

Ignoring shoulder pain is harmful to your life. Because having pain in the shoulder without any injury is symptoms of a major heart attack. By using minor prevention such as regular shoulder exercise at home, you can avoid any serious injury. All the small steps of precaution not only save your shoulder but they provide you a healthy life.

Apart from the shoulder pain home treatment, you need to consult with your doctor if you are not getting much improvement. Regular use of doctors prescribes medicine and exercise will give you better prevention.

An occupied physician or doctor consultation is the best way to treatment of shoulder pain. 

In this article, we provide detail information on shoulder pain: causes, treatments & diagnosis. Hope this article will help you with more information and prevention related to shoulder pain.

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