Many people have likely experienced a sharp, fleeting pain or twinge of pain in the shoulder when lifting the arm up high, or they have had shoulder pain at least once or twice in their lifetime. There’s nothing unusual about that, as the shoulder joint is one of the most mobile joints in the body. It is used in almost every body movement there is, even while you are sleeping. If someone, for instance, has rotator cuff problems, they will have a hard time sleeping on the side. Shoulder pain can occur due to a variety of causes. It can be caused by problems in the shoulder joint itself, from surrounding joints or surrounding organs. Shoulder pain can even be caused by problems with organs in other parts of the body, such as the neck, inflammation of the liver (hepatitis) or even the heart. Any of these can cause symptoms of pain and discomfort in the shoulder, and this is why physical examinations are important, as they can help to identify the specific cause more clearly and specifically.
Most shoulder joint pain is felt in the front, side and back of the scapula (shoulder blade). The specific location of the pain can help to indicate or determine the cause or type of disorder. For example, if there is a problem in the rotator cuff, there will usually be symptoms of pain on the side of the shoulder, especially when doing any overhead-type activities, such as lifting the arms or playing sports that involve swinging motions with the arms, such as badminton, tennis, golf, etc.
Additionally, the age and activities of the patient can be used to help determine the cause of shoulder pain. For example, shoulder pain in teenagers or young people is usually related to sports, particularly sports involving a lot of shoulder movement, such as volleyball, swimming or basketball. It could also be the result of a profession requiring frequent overhead activity, such as aircraft mechanics, flight attendants, etc. Patients in this group often have conditions of shoulder joint instability or loose shoulder ligaments.
When it comes to shoulder joint pain in older adults, the most common causes are usually conditions of the shoulder tendons. These could be any of a wide variety of conditions, including tendonitis, partial tendon tears and even full thickness rotator cuff tears, which can involve one tendon or multiple tendons. Additionally, the pain may be attributed to joint inflammation (arthritic diseases), such as calcific tendonitis, frozen shoulder and shoulder osteoarthritis.
Treatment of shoulder joint pain depends on the cause and severity of the disease. Treatment falls into two main categories: surgical treatment and non-surgical treatment.
Non-surgical treatment includes oral medication, injected medication and physical therapy. Non-surgical treatment is determined by the severity and the pathology of the disease. This type of treatment also includes the assistance of physiotherapists and orthopedists at our Sports & Orthopedic Center. They will help to determine the best treatment approach, point out activities that should be avoided and provide exercises to help improve and restore the performance of the shoulders and back. In cases where non-surgical treatment fails, surgery is the only alternative.
Because the shoulder joint itself is rather deep, traditional open surgery can actually end up damaging other non-injured muscles surrounding the joint even more than the specific target point for the surgery. Because of this, arthroscopic surgery is often favored, as it is more targeted, involves smaller incisions and causes less pain. Presently, arthroscopic techniques have been developed in order to insert fixation devices, repair and even reconstruct new tendons. Arthroscopic surgery can also include treatment of other nearby joints, such as the acromioclavicular joint (AC joint), or nerves surrounding the joints.
Whether or not treatment should be administered depends on the cause and severity of the disorder. If you are experiencing only mild pain or if the pain only lasts for a short time and then disappears, then you will likely be able to handle it. However, in cases of rotator cuff tears, if these are not treated and taken care of properly, this falls under the category of being “penny wise and pound foolish”. Torn tendons cannot repair themselves, and if the tear is untreated, the condition can worsen or even increase from just one tendon to multiple tendons. This can lead to shoulder osteoarthritis and degeneration of the shoulder joint, for which shoulder replacement surgery often is the only option. This involves the use of special artificial components (prosthesis) and thus is particularly costly as well. Knowing this, making sure to receive treatment from the very beginning is the best and wisest approach.
“Shoulder pain can result from a variety of causes. Because of this, be sure to see a doctor to receive advice and proper examination in order to plan your treatment correctly. Treatment does not always need to involve surgery. If, however, you do need surgery, arthroscopic surgery provides a great deal of benefits, helps reduce pain and inflammation, and provides patients with a faster recovery time as well.”
M.D., Faculty of Medicine, Srinakharinwirot University, 1998