The shoulder is a complex ball and socket joint that is able to move in many directions. With this great mobility comes a lack of stability. This lack of stability in the shoulder makes it susceptible to injury and pain. Pain is the most common complaint among patients with shoulder problems. Not only are there several structures within and surrounding the shoulder joint which cause pain, but there are various clinical conditions that can be a cause too.
Common causes of shoulder pain include:
1. Poor posture/Neck origin: Poor posture in sitting or standing can cause shoulder pain. If you have a rounded shoulder posture, the shoulder joint is placed in a position where the bursa, muscles, and tendons in the shoulder can be pinched. Pinched nerves in the neck are the number one cause of shoulder pain and weakness. Many times this weakness gets unnoticed by many for years before it turns into terrible pain.
2. Repetitive activity: While reaching overhead, the space between the shoulder tendon and the shoulder blade decreases. The tendons can then get pinched underneath the bony part of the shoulder blade. This pinching, often called impingement syndrome, can be painful.
Chronic shoulder pain often stems from prolonged, repetitive, or awkward movements. This type of pain is sometimes referred to as repetitive strain injury (RSI) or cumulative trauma disorder. This is common among people who work with their arm above the shoulder level, construction workers, teachers, painters, carpenters, and sports injuries. Sports like shooting a racket in badminton, overhead throwing, etc. will lead to repetitive strain on one group of muscles. Which eventually leads to fraying of those muscles and may cause tears with minor trauma and rarely without trauma also.
3. Trauma: Occasionally, trauma can cause shoulder pain. Falling on an outstretched arm or falling on the side of your arm, fall from two-wheelers, sudden jerky movements while trying to avoid falling, all can lead to sudden injury and can break the bones or injure the tendons and/or ligaments of the shoulder. It also can dislocate the shoulder resulting in shoulder pain.
4. Natural aging or degeneration: Common degenerative conditions are degenerative rotator cuff disease, which involves tendinitis and tear, another common condition is arthritis of the shoulder joint which affects the elderly and is one of the most painful conditions.
Arthritis is a degenerative condition that causes inflammation in any of the joints in the body. It most often occurs in the weight-bearing joints of the body, like the hip and knee. Occasionally, arthritis can occur in the shoulder, causing severe pain and loss of motion.
5. Medical illness – People with conditions like Diabetes, Hypothyroidism, Rheumatoid Arthritis, Peripheral Neuropathy will have more affections in shoulder joints. Diabetes commonly affects the shoulder joint in multiple ways, Adhesive capsulitis or frozen shoulder is the most common shoulder ailment in diabetes. Inflammatory conditions like Rheumatoid Arthritis will cause muscle tendon inflammation of the rotator cuff and biceps and also can cause hypertrophy and inflammation of the subacromial bursa both of which are very painful conditions.
Diagnosis and Treatment:
Early examination by a Physiotherapist or chiropractor will help you to diagnose the root cause of your problem early without further deterioration of the pain, weakness, and stiffness of the joint. A complete physical examination of the neck and shoulder will be helpful. Depending on your condition physiotherapist can recommend some exercises, postural correction tips, self-mobilization, modalities like shockwave therapy, LASER therapy, Ultrasound therapy, acupuncture. Massage therapy can help you to loosen the tissue around the shoulder joint and improve flexibility.