Shoulder Pain

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Why does my shoulder hurt?

If we exclude traumatic causes, the main causes of shoulder pain are inflammation of the shoulder tendons (tendonitis). Less frequent causes are adhesive capsulitis and joint arthrosis in the shoulder region. Usually, the pain that originates in the shoulder is referred by the patient to the outer side of the arm. Pain originating in other places such as the cervical spine can be confused with pain originating in the shoulder. To make the differential diagnosis, the doctor has several clinical tests that allow him during the observation to establish the most likely source of the pain.

Rotator Coif Pathology

The rotator cuff is a set of muscles and tendons that surround the shoulder joint, which is extremely important for its movement. If your shoulder hurts, it is possible that this is an injury at the level of this area called the rotator cuff, which can originate from trauma or aging of the joint. Whatever the cause, there are solutions for you

Shoulder bursitis

Shoulder bursitis results from inflammation of the synovial pouches (or bursae) that exist around this joint and the rotator cuff tendons.

It is one of the most frequent causes of pain in this joint. It can be bilateral, reaching both the left shoulder and the right shoulder. It can be acute or progress to chronic shoulder bursitis.

There are several bursitis that can occur in the shoulder depending on whether one or another synovial pouch is affected .

The most frequent are those that reach the subdeltoidal subacromial bursa, forming what is commonly called subacromial bursitis. Shoulder bursitis presents a clinical picture similar to that of shoulder tendonitis. The most characteristic symptoms are the presence of inflammatory pain, located on the antero-lateral face of the shoulder, eventually radiating to the arm and elbow. Its worsening is especially felt with efforts or during the night, making it impossible for the patient to sleep on the affected shoulder .

The most frequent causes of shoulder bursitis are trauma and repeated efforts, such as those that occur with certain work activities (painters or plasterers, storehouses, etc.) or with the practice of certain sports, such as weight training, swimming or others practiced with the arm above the head (“overhead sports”).

Certain rheumatismal diseases (such as, for example, rheumatoid arthritis, gout, lupus, psoriatic arthritis) also often develop with bursitis (namely subacromial).

Osteoarthritis of the shoulder

Osteoarthritis, often referred to as Arthrosis, is the wear and tear of articular cartilage that lines the contact surface between bones.

The articular cartilage decreases the friction within the joint, allowing wide, continuous and pain-free movements. When damaged, the joint surface becomes irregular and worn, progressively leading to deformation, pain and inability to move.

Adhesive capsulitis or frozen shoulder

Adhesive capsulitis or "frozen shoulder" is a disease of unknown cause that is characterized by pain on movement and at rest, especially at night. Sometimes patients associate its beginning with a traumatic episode. The main characteristic of this entity is, however, the progressive decrease in shoulder mobility with increased difficulties in performing simple tasks such as dressing and personal hygiene. Adhesive capsulitis is more common in female patients between 45 and 45 years of age. 55 years old. Diabetic patients or those with a family history of diabetes and patients with thyroid problems are more likely to develop adhesive capsulitis.

Shoulder dislocation

Shoulder dislocation or "dislocated shoulder" is a lesion in which there is loss of contact and congruence between the two surfaces of the shoulder joint or glenohumeral joint (humeral head and glenoid cavity). See superior images.

Shoulder dislocation can occur on either the left or right shoulder and is classified as anterior (forward), posterior (back), upper (up) or lower (down) dislocation, depending on the direction of travel of the humeral head. We call it subluxation of the shoulder when this loss of contact is not total.

The most frequent causes of dislocations in adults are traumatic and occur especially in athletes, whether due to direct trauma to the shoulder or traction and torsion mechanisms.

Contact sports, such as handball, are the ones that cause most episodes of dislocation, although others, such as weight training or weight lifting, may also contribute to their occurrence.

The signs and symptoms that usually occur with shoulder dislocation are pain, usually very intense and the appearance of deformity with the disappearance of the rounded deltoid contour.

Shoulder dislocation can evolve to permanent healing after being reduced, immobilized and properly rehabilitated.

Objectives of a rehabilitation program:

  • Improving mobility and joint movement

  • Relief from pain and inflammation

  • General physical reconditioning

  • Teaching and counselling of support products (orthotics, splints, etc.)

  • Return to work activities , daily life and sports activities  

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