The Most Common Types of Shoulder Pain, Explained

The shoulder is an efficient combination of joints, muscles and tendons that enable a wide variety of movement and range of motion. However, its utility and versatility make the shoulder prone to a variety of injuries and conditions. In fact, shoulder pain will affect up to 70 percent of the population in their lifetime. It can be disabling and result in a host of unwanted consequences.

Below are some of the most common painful shoulder conditions:

Biceps Tendinitis

The biceps tendon is a structure that connects the biceps muscle to the humerus (upper arm bone) bone near the shoulder joint. Biceps tendinitis, a common cause of shoulder pain, is an irritation or inflammation of the upper part of the tendon.

Causes

Often, biceps tendonitis is due to wear and tear. It can also be connected to other shoulder issues, such as instability, shoulder impingement or a rotator cuff injury. It is particularly associated with damage to the rotator cuff tendon.

Repeated motion in work or sport—particularly those activities that require overhead motion, such as construction work, painting, swimming, tennis and baseball—can also cause biceps tendinitis.

Treatments

  • Rest (from overhead activity)
  • Ice
  • Medication
  • Physical therapy
  • Steroid injections

Surgery-If more conservative measures have been exhausted, surgery may be indicated. This may entail biceps tenodesis, which is detaching the tendon from the shoulder socket and reattaching it to the upper arm bone.

Rotator Cuff Tear

The rotator cuff is involved every time you move your shoulder. It helps to stabilize the shoulder. So, it stands to reason that it is a commonly injured area. Rotator cuff tears can either be partial or incomplete (a tear that is frayed), or complete, which entails a tear that goes completely through the tendon.

Causes

There are two main causes of rotator cuff tears. They can occur from an acute injury (such as a fall or other cause of severe twisting motion of the joint). An acute injury can also be caused by the stress of improperly lifting a heavy object.

However, most rotator cuff tears occur due to progressive degeneration (wear and tear) over time. The incidence of tears increases with aging. It is important to determine the cause of a rotator cuff tear since this impacts what treatment is recommended.

Treatments

  • Rest
  • Modified activity
  • Medications
  • Physical therapy
  • Steroid injections

Surgery: If conservative measures have not offered relief or if the tear is severe, surgery may be indicated. This is particularly the case for athletes or those who engage in repetitive overhead movement, since many tears do not heal on their own.

Shoulder Impingement

Shoulder impingement syndrome, which is also sometimes called “bursitis” or “tendinitis”, occurs with the repetitive compression (“impingement”) of the rotator cuff during movement. A thorough and careful examination is the best approach to a personalized diagnosis.

Causes

Shoulder impingement is also the result of repeated overhead activity involving the shoulder. It can also be caused by a shoulder injury. Finally, in some cases, there is no known cause of the condition.

Treatment

  • Rest (from overhead activity)
  • Ice
  • Medication
  • Physical therapy
  • Steroid injections 

Surgery: If other treatments do not provide results, surgery may be indicated to increase the space around the rotator cuff. The procedure, which can usually be done with minimally invasive arthroscopy, allows free movement without the compression or rubbing on the bone and the resulting pain.

Frozen Shoulder

Frozen shoulder, technically called adhesive capsulitis, is a condition causing stiffness, pain and immobility in the shoulder joint. It is due to a thickening and tightening of the shoulder joint capsule which restricts room for movement.

Causes

While the causes are usually unclear and cannot be identified, some people suffer frozen shoulder following a recent injury or fracture to the area which resulted in a need to immobilize the shoulder. In about 10 to 20 percent of cases, it can be caused by diabetes. Other medical problems may put people at risk for frozen shoulder (hypothyroidism, hyperthyroidism, Parkinson’s and cardiac disease).

Treatments

  • Medications
  • Physical therapy
  • Steroid injections

Surgery is rarely required for frozen shoulder. Although recovery can take a long time (up to a couple of years), in the majority of people it resolves on its own with the use of nonsurgical treatments. In the event of surgery, manipulation under anesthesia and/or arthroscopy are performed to release the scar tissue.

If you’re having shoulder pain, contact us today to find out what’s wrong and how we can help.

What Is Frozen Shoulder?

Adhesive capsulitis, a common cause of what is known to most people as frozen shoulder, is a condition that occurs when the capsule that surrounds the ball joint in the shoulder begins to form scar tissue. This scar tissue causes a drastic decrease in mobility (hence the “frozen” aspect), as well as severe pain. Not every frozen shoulder is Adhesive Capsulitis.

What Causes Frozen Shoulder?

It is often unknown what causes frozen shoulder to take hold, but there are several factors that can play a part in the likelihood of a person being diagnosed.

Those factors include:

  • Age and gender- Frozen shoulder typically affects patients between the ages of 40 to 60 years old. It is much more common in women than men.
  • Endocrine disorders- Patients with diabetes are at a particular risk for developing frozen shoulder, but other endocrine abnormalities can also lead to the development of this condition, such as thyroid problems.
  • Shoulder trauma or surgery complications- Patients with a shoulder injury or shoulder surgery can develop a frozen shoulder joint. The risk is even higher when the injury or surgery is followed by prolonged joint immobilization.This is usually not the same as Adhesive Capsulitis, but may be treated in a similar way.
  • Other systemic conditions- Pre-existing conditions like heart disease and Parkinson’s disease have been known to be a factor for people who suffer from frozen shoulder.

What Are the Treatment Options for Frozen Shoulder?

According to the American Academy of Orthopedic Surgeons (AAOS), 90 percent of patients with frozen shoulder improved range of motion and had a decrease in pain due to light and consistent physical therapy.

Exercises that might be incorporated into a physical therapy treatment plan include:

  • External rotation
  • Stand in a doorway, then bend affected arm 90 degrees in order to reach the doorjamb. Keep hand in place while rotating the body. Hold for 30 seconds. Relax and repeat
  • Forward flexion
  • Lie on back with legs straight. Use unaffected arm to lift affected arm overhead until there’s a gentle stretch. Hold for 15 seconds and slowly lower to start position. Relax and repeat
  • Crossover arm stretch
  • Gently pull one arm across chest just below chin as far as possible without causing pain. Hold for 30 seconds. Relax and repeat

In addition to physical therapy and exercise, a physician might prescribe the following:

  • Non-steroidal anti-inflammatory medicines
  • Drugs like Aspirin® and Ibuprofen® can temporarily reduce pain and swelling
  • Steroid injections
  • Cortisone injections are injected directly into the shoulder joint to work as a powerful anti-inflammatory

If symptoms related to frozen shoulder are not relieved through conservative treatment options, then surgery might be recommended, although this is not very common

There are two different procedures that are most commonly used in treating frozen shoulder:

1. Manipulation under anesthesia

During this procedure, the patient is put to sleep, and the shoulder is moved in ways that can stretch and tear the stiff adhesions. This will allow relief from the tension that the adhesions cause and can increase range of motion.

2. Shoulder arthroscopy

In this procedure, a doctor cuts through tight portions of the shoulder capsule. This is done by inserting pencil-sized instruments through very small incisions around the affected area. This method breaks up scarring tissue and allows for increased range of motion and eventual pain relief after recovery.

Sometimes, the two procedures are performed in tandem in order to achieve the best possible results.

What Is the Window of Recovery After a Procedure?

The best possible results are achieved by patients who thoroughly follow their rehabilitation plan. Recovery times vary depending on the severity of a patient’s frozen shoulder, ranging typically from six weeks to nine months.

If the rehabilitation process is followed thoroughly, outcomes are usually very positive. The range of motion is restored, and pain generally becomes non-existent.