If you feel pain in your shoulder, the main cause could be an injury to the rotator cuff. This refers to a cluster of tendons and muscles that keep your shoulder joint firm. Your rotator cuff deteriorates with age, of course, but it can be injured and become painful. To know the exact cause of your shoulder pain, go to the best hospital for examination. It is only a doctor who can tell whether you have a rotator cuff injury or another type of shoulder problem. If your pain is localized in the shoulder itself or on the outer side of your upper arm, there is a cause for alarm. As well, visit your pain doctor if:
- You feel a dull ache in the shoulder
- Your pain moves into the upper arm and doesn’t shift beyond your elbow
- You feel most pain at night
- You feel better after taking a rest
- The pain worsens if you lift something
Shoulder pain can be grouped into two types: Arthritis and diseases affecting the shoulder and injury to the shoulder joint. We will discuss each type exhaustively to help you differentiate the two.
1. Arthritis and diseases affecting your shoulder
Types of arthritis: Arthritis is a term used to describe several different types of diseases that affect our joints, muscles and bones. Arthritis of the shoulders may cause pain, stiffness and swelling. Here are different kinds of arthritis that could affect your shoulders.
- Osteoarthritis – This is a chronic disease that makes the joints’ cartilage breakdown. This disintegration makes the bones touch each other and this can be so painful. Additionally, when bones rub against each other, there can be lack of movement in the joint and a lot of stiffness. Eventually, spurs or bony projections might develop around your joints. Osteoarthritis only affects your shoulders if you get seriously injured.
- Juvenile arthritis – As the name suggests, this type of arthritis affects kids who are below 16 years of age. It is capable of causing pain and swelling, and could eventually destroy the child’s shoulders.
- Rheumatoid arthritis – This is a severe inflammatory disease that affects joints. It happens when our body’s immune system begin to attack the thin membrane that surrounds our joints called synovium. Rheumatoid arthritis can cause damage to the joint due to inflammation and trigger a lot of pain, swelling, loss of function, and disability. Being symmetrical, this disease will eventually affect both shoulders.
- Gout – The first sign of this type of arthritis is extreme pain and swelling in the big toe after it has suffered a trauma. Gout affects your ankles, feet, wrists, hands, knees, and elbows. While it barely affects the shoulder, it can still occur. A disease associated with excess uric acid being deposited in body tissues as needle-like monosodium urate crystals, gout is a serious condition.
- Reactive arthritis – This chronic arthritic disease happens after the genital, gastrointestinal and/or urinary systems have been infected. It causes joint inflammation and swelling, and might as well affect your intestines, bladder, kidneys and eyes. Joints that get affected first are feet, knees and ankles. All the same, the reactive arthritis can attack your shoulder joint as well.
- Infectious arthritis or septic arthritis – It occurs when there has been an infection in the joint itself. The infection is usually bacterial and it is spread to the joints via the bloodstream. If left untreated, the disease can damage your joints, and these can be shoulder joints.
Types of diseases causing shoulder pain – There are a few diseases that are known to affect shoulder joints. These include the following:
- Calcium pyrophosphate dehydrate crystal depositin disease – Also called pseudogout, this disease is almost like gout because it happens when crystals begin to form in joints. Crystals that cause psuedogout are from a calcium pyrophosphate dehydrate salt. It targets aged people and younger people with health issues. Further, Pseudogout is extremely pain and causes joint swelling: shoulder, wrist and knee joints.
- Polymyositis – It refers to the irritation of muscles. It is not a single disease but a cluster of disorders that affect large muscles near your upper body, causing symmetric weakness. Polymyositis attacks shoulders, thighs and hips, but shoulder and pelvic girdle muscles are gravely affected. If you have this disease, you will have difficulties lifting your arm.
- Lupus – This is a chronic autoinnume illness. It is triggered by our body’s immune system when it forms antibodies that attack our healthy tissues. This includes our joints and major organs. It also entails muscle inflammation that mainly affects shoulders, pelvis, neck, upper arms and thighs. Lupus affects joints of our hands and feet too.
- Polymyalgia rheumatic – This is a rheumatic disorder that triggers a lot of pain and stiffness in hips, shoulders and neck. While it develops slowly, it may appear abruptly and catch you off-guard. The disease mostly affects older people beyond 50 years of age. Polymyalgia rheumatic goes away without treatment.
- Dermatomyositis – This is an inflammatory disorder that affects kids and adults. It is just like polymyositis in terms of symptoms, but it may cause a patchy skin rash, swelling around your eyes, calcium deposits in your shoulders, hips, thighs, calves and pelvis and so on. This can limit free movements within the joint.
- Lyme disease – It is a communicable disease spread by the deer ticks that are carrying Borrelia burgdorferi bacteria. It trigger a bull-eye-shaped skin rash and flu signs. If Lyme disease is left alone, it can worsen and attack your joints, including shoulder joints, and major organs.
- Osteonecrosis – Although this disease starts in the femur bone(thigh bone), it can also progress to other joints, including your upper arms and shoulders. Also known as avascular, ischemic or aseptic necrosis, osteonecrosis causes shortlived or permanent loss of blood circulation to the bone. This causes the bone to die and collapse. As this disease occurs in a bone close to a joint, it is easy to see why your shoulders can develop it
Besides the above-mentioned diseases and conditions, you should note that shoulder pain can be felt when you are about to have a heart attack or angina. As well, it is common in women who have an ectopic pregnancy and people with liver abscess or gallstones.
2. Shoulder Injuries
As aforesaid, shoulder pain could result after a serious injury has occurred. Being a very unstable joint, a shoulder joint can succumb to any injury. The following are some of the injuries that can affect your shoulders.
- Dislocation – If shoulder is turned too far, the ball of the upper arm bone or humerous can pop out of its socket— glenoid. If your shoulder dislocates often, you have a problem called shoulder instability and should get examined. If the dislocation is partial, it is called a subluxation or partial location.
- Separation – This can occur due to a serious fall, bang to the shoulder or an injury that rips the ligaments that hold together your AC (acromioclavicular) joint. The AC joint can be described as where the collarbone intersects your scapula (shoulder blade). You can imagine the pain you would feel if the outer end of your collarbone were to slips out of its location.
- Ripped rotator cuff – This can be caused by aging, repeated use of the joint or a fall. If your rotator cuff tendons are strained they could hurt. Pain is often felt on top of the deltoid muscle located at the top and the outside of your shoulder. Extending your arm out of your body can hurt and there is likely to be a clicking sound when the shoulder is moved.
- Frozen shoulder – This is also referred to as adhesive capsulitis. It is a situation where movement of a shoulder is totally restricted by the growth of unusual bands of tissue called adhesions and lack of a lubricant called synovial fluid. Adhesions grow amid joint surfaces and can be instigated by a traumatic shoulder injury, arthritis or surgery.
- Fracture – If one of your shoulder bones develops a crack due to a fall or blow, pain can be felt. The most susceptible bones are clavicle or collarbone, the top of your upper arm bone or just beneath the ball. Besides pain, a fracture causes swelling and redness.
- Bursitis – It refers to the inflammation of bursae. These are tiny sacs containing a fluid that lubricates and pads big joints located in your shoulders, knees and hips. Bursitis can be caused by a traumatic injury, rheumatic disease or arthritis. It results to pain and swelling in the sick areas.
- Glenoid labrum tear/Shoulder joint tear – This occurs when the cartilage around the edge of your shoulder socket is injured. Repetitive activities or trauma from an accident triggers this problem. If you have a shoulder joint tear, expect to feel pain, weakness, stiffness, or popping or locking of your shoulder joint.
Besides the above-mentioned injuries, impingement syndrome, kind of tendinitis, can affect your shoulder joints and cause pain.
Symptoms to expect
If you have shoulder pain, the symptoms would depend on what exactly is causing it. For instance, you are likely to have pain, numbness, swelling, bruising, weakness and an arm out of its socket if you have a shoulder dislocation. If your rotator cuff is sick or injured, pain will occur gradually in the upper area of your arm. Pain will worsen when you try to sleep on your shoulder and might continue down your arm. When lifting the arm, extending it out or lowering it, you are likely to feel hurt, and there might be a clicking sound if you move your shoulder. If your shoulder is fractured, there might be redness, bruising, excruciating pain and bones that are out of their usual site. If you have arthritis, stiffness and pain are the first signs to look for.
Shoulder pain is treated with medicines that can reduce inflammation in joints and slow down bone loss. The type of drugs prescribed will be determined by the severity of your condition and the main cause. Generally, your pain management doctor NYC will prescribe some of these drugs.
- NSAIDs – These are called Nonsteroidal anti-inflammatory drugs. There are many options here, and some are useful in regulating arthritic pain and inflammation. NSAIDs can treat all types of arthritis.
- Analgesics – They are necessary for managing arthritis and can be used to reduce pain sustained from an injury or a fracture. These are pain killers only.
- Corticosteroids – these are drugs used to regulate inflammation and it can be directly injected into the shoulder joint or any other.
- Gout drugs – A few of gout drugs are made to minimize uric acid levels in our blood to keep future attacks of joint pain and irritation away. Others are ideal when there is severe pain and inflammation.
- Biologic response modifiers – These are used to treat rheumatoid arthritis and some other types of arthritis and are FDA- certified.
- Osteoporosis drugs – These are designed to decelerate bone loss or to arouse the body to form another bone. As they strengthen bones, osteoporosis medicines might promote your shoulders’ strength. This can make them less prone to fractures.
- DMARDs – Disease modifying anti-rheumatic drugs change the path of an inflammatory disease. They can heal many different kinds of arthritis, including the shoulder one.
How to prevent shoulder pain
- Avoid repetitive activities with your shoulders
- If you are a senior, limit usage of your shoulders
- Stop doing a lot of manual labour
- If you play sports, be careful not to hurt your shoulders. The same case applies to those who work in places where falls are common.
Shoulder pain is treatable. However, you should take a quick action once you feel disturbing pain that won’t stop. As you have learned, shoulder pain can be caused by diseases or injuries. To know what is causing your pain, go to the best doctor today. Ensure that they have ample knowledge about joints, muscles and other soft tissues. Tell your minimally invasive procedure doctor about your lifestyle and how the pain started. As well, tell your specialist about any surgery you have had near the painful area of your shoulder and about other important details.