| Painful shoulder conditions that limit movement are | | | | and the range of movement in your shoulder joint. |
| common, and are caused by problems with the | | | | You may need an X-ray, or other scans, such as an |
| shoulder joint and its surrounding structures. Your | | | | ultrasound scan or MRI. Sometimes, an arthroscopy is |
| shoulder is more prone to injuries than other joints | | | | needed. In this test, your doctor can look inside the |
| because of its wide range of movement. | | | | shoulder joint using a small telescopic instrument that |
| About 13.7 million people went to the doctor's office | | | | has a camera on the end. This is not as painful as it |
| in 2003 for a shoulder problem, including 3.7 million | | | | sounds. |
| visits for shoulder and upper arm sprains and strains. | | | | How your shoulder pain will be treated |
| (Source: National Center for Health Statistics; Centers | | | | In addition to relieving pain, treatment is aimed at |
| for Disease Control and Prevention 2003 National | | | | restoring mobility in your shoulder joint. The choice of |
| Ambulatory Medical Care Survey.) | | | | treatment depends on the extent of your shoulder |
| One of the best ways to avoid injury is to keep | | | | problem and the level of pain. |
| physically fit, with a balanced program of aerobic | | | | Pain relievers such as non-steroidal anti-inflammatory |
| exercise, stretching and strengthening exercises for | | | | drugs (NSAIDs) are often used as an initial treatment |
| your whole body. There is a range of exercise | | | | for shoulder pain. Ibuprofen is the best and Aspirin |
| programs available from local fitness centers, to | | | | should be avoided. |
| online services and even downloads for your MP3 or | | | | Another simple way of easing shoulder pain is by |
| iPod players. | | | | applying a cold pack to your shoulder for 10 minutes |
| There are several reasons that cause pain and limit | | | | at a time three or four times a day. Cold packs will |
| movement of your shoulder joint, including: | | | | reduce inflammation, and are most helpful when |
| 1. Rotator cuff disorders | | | | applied for the first few days following a shoulder |
| Inflammation can be caused by general wear and | | | | injury. After that, you can switch to using a heat |
| tear that occurs with age, activities that require | | | | pack; intermittent applications of heat can help relax |
| constant or repetitive shoulder motion (especially | | | | the shoulder muscles. |
| above shoulder level), heavy lifting, trauma, or poor | | | | A heat pad used at night when sleeping will keep the |
| posture. Serious injuries and untreated inflammation | | | | shoulder from stiffing up. |
| of the tendons can cause the rotator cuff to tear. | | | | You should rest your shoulder for a couple of days |
| The pain associated with rotator cuff problems is | | | | after an injury, and if you have dislocated your |
| normally felt at the front or on the outside of your | | | | shoulder, you may need to rest your arm in a sling or |
| shoulder, particularly when you raise your arm or lift | | | | splint for several weeks after the joint has been |
| something above your head. You may also notice the | | | | manipulated back into place. |
| pain more when lying in bed. Severe injuries can | | | | However, with most shoulder problems it isn’t a |
| cause weakness of the shoulder muscles, restricted | | | | good idea to rest for too long. While you should |
| shoulder movement and continuous pain. | | | | avoid strenuous activities and lifting heavy objects, |
| 2. Rotator cuff tears | | | | you should still move your shoulder to help make |
| It is usually the rotator cuff tendons (the thick bands | | | | sure that you regain full use of the joint. By returning |
| of tissue that connect the muscles to the bones) | | | | to your normal activities as soon as possible (within |
| that tear, but sometimes the tear occurs in the | | | | the limits of disability and pain), you can help prevent |
| muscle. Severe injuries can cause several of the | | | | the shoulder joint from stiffening up. |
| tendons and muscles to tear. There are special | | | | Physiotherapy can help treat you shoulder pain. |
| movement tests that your doctor can use to help | | | | Physiotherapy can help improve your shoulder |
| determine which of the muscles or tendons has been | | | | strength and flexibility as well as relieve the pain |
| torn. | | | | associated with most shoulder problems. |
| 3. Frozen shoulder | | | | Physiotherapists use a variety of different therapies, |
| Frozen shoulder, is characterized by progressive pain | | | | including massage, ultrasound therapy, laser therapy |
| and stiffness in the shoulder. The pain is felt deep in | | | | and electrical nerve stimulation (TENS) — a |
| the shoulder joint and may become worse at night | | | | therapy that uses mild electrical currents to treat |
| due to inactivity. | | | | pain. |
| The exact cause of this condition is not known, but it | | | | Taping the shoulder joint can also help stabilize it and |
| sometimes develops following other shoulder injuries. | | | | reduce pain during activities. Your doctor will refer |
| Resting a painful, injured shoulder for too long can | | | | you to a good Physiotherapist is he feels the extent |
| cause the shoulder muscles and connective structures | | | | of your injury warrants Physiotherapy. |
| to stiffen up, so when a shoulder injury occurs make | | | | Physiotherapists can also teach you special |
| an effort to keep it loose without putting to much | | | | rehabilitation exercises to stretch and strengthen the |
| strain on it. | | | | rotator cuff muscles of the shoulder. Exercises that |
| Frozen shoulder can develop spontaneously, | | | | improve your shoulder’s range of movement |
| particularly if you have thyroid problems or diabetes | | | | help reduce the pain and stiffness that occurs after a |
| seem to be at increased risk. Most people with | | | | period of immobility. Range of motion exercises may |
| frozen shoulder tend to improve within 2 years, with | | | | be followed by resistance exercises and weight |
| or without treatment. In the interim, however it can | | | | training to strengthen the muscles. |
| be quite painful. | | | | Steroid injections can be effective but proceed with |
| 4. Dislocated shoulder and shoulder instability | | | | caution. |
| A dislocated shoulder is visibly deformed or out of | | | | Depending on the cause of your shoulder problem, |
| place, and there may be swelling or bruising around | | | | corticosteroid injections may be given to relieve the |
| the joint. Your shoulder movement will be severely | | | | pain in the short term. The corticosteroid, which is |
| restricted. Your Doctor can usually put the shoulder | | | | often mixed with a local anesthetic, reduces |
| bone back into place using gentle maneuvers. | | | | inflammation and allows you to move the shoulder |
| If you suffer a dislocation, keep in mind that the | | | | more comfortably. Make sure you understand what is |
| shoulder joint sometimes becomes unstable and | | | | involved in this kind of treatment to include the long |
| susceptible to repeated dislocations. This causes pain | | | | term effect on your body. The jury is still out on the |
| and unsteadiness when you raise your arm or move | | | | impact of this type of treatment. |
| it away from your body. Your shoulder may feel as if | | | | Surgery may be necessary to treat your shoulder |
| it is slipping out of place when you lift your arm over | | | | problem. |
| your head. | | | | Because most people improve with the above |
| 5. Arthritis | | | | treatments, only about 10 per cent of people with |
| Arthritis causes progressive joint pain, tenderness, | | | | shoulder problems will need to be treated with |
| swelling and stiffness. Both rheumatoid arthritis and | | | | surgery. People with shoulder instability or rotator |
| osteoarthritis will affect the shoulder joint. | | | | cuff problems that are not responding to less |
| Sometimes shoulder pain can be due to problems in | | | | invasive treatments may benefit from an operation, |
| your neck or a mixture of several different problems. | | | | and shoulder joint replacement may be considered |
| A visit to your doctor is almost always necessary | | | | for people with degenerative arthritis. |
| when it comes to a shoulder problem because in rare | | | | There are also some conditions that need to be |
| instances, shoulder pain may be caused by infection, | | | | treated initially with an operation, including some |
| problems with the nerves, or a tumor located | | | | rotator cuff tears and dislocated shoulders that |
| somewhere else in your body. | | | | cannot be reduced (put back in) with simple manual |
| As with any medical issue, a shoulder problem is | | | | maneuvers. Sometimes frozen shoulder is treated |
| generally diagnosed using a three-part process: | | | | with what’s known as manipulation under |
| • Medical History – You tell your doctor about | | | | anesthesia. In this therapy, your shoulder is gently |
| any injury or other condition that might be causing | | | | moved while you are under a general anesthetic to |
| the pain. | | | | help improve its range of motion and of course avoid |
| • Physical Examination – Your doctor | | | | the treatment pain. |
| examines you by feeling for injury and to discover | | | | So make sure you do not self-diagnosis your shoulder |
| the limits of movement, location of pain, and extent | | | | problem, see your doctor. Keep in mind that it |
| of joint instability. | | | | isn’t a good idea to rest it for too long or it will |
| • Tests – Your doctor may order one or | | | | stiffen up. Use Cold and Heat intermittingly to speed |
| more of the tests for you listed below to make a | | | | up the healing process. Avoid strenuous activities and |
| specific diagnosis. | | | | lifting heavy objects, but remember to move your |
| What tests are needed to determine the cause of | | | | shoulder to help make sure that you regain full use of |
| your shoulder pain? | | | | the joint by returning to your normal activities as |
| Your doctor will determine the cause of your pain | | | | soon as possible and you will regain full use of your |
| based on your symptoms and a physical examination. | | | | shoulder in a reasonable period of time. |
| Where the pain is felt, both at rest and when moving | | | | But, if you are still experiencing pain, listen to it, it is a |
| the shoulder, is a clue to the cause of the shoulder | | | | signal trying to tell you something is still wrong with |
| pain. Your doctor will also test your shoulder strength | | | | your shoulder. |