An excruciating pressure pain comes to your shoulders as you raise your arm from the side. The pain usually occurs when you raise your hand to parallel to the floor. At the end of the symptom, you move your arm completely overhead or down it. The painful strain on your shoulders can occur when you raise your arms and lower your arms.
Shoulder Anatomy: for better shoulder pain understanding
The shoulder is a complex structure. It consists of several bones, tender tissues, ligaments, and muscles – the bones forming the shoulder joint as described in the picture above are the humerus, scapula, collarbone, and acromion (the outer part of the collarbone). The tendons and ligaments form this shoulder joint and the stabilizing muscles (the rotating cuff muscle consisting of four muscles).
The rotator cuff muscles include supraspinatus, infraspinatus, subscapularis, and terrace minor. This muscle stabilizes the shoulder joint when the arm is moving properly. However, due to their responsibility to stabilize the shoulder joint, they often hurt when they do not work properly, and they often cause pain in the front of the shoulder.
Symptoms of shoulder pain
Shoulder pain can cause a variety of symptoms and clinical features, but some common symptoms include :
- Tingling / Biting sensation on shoulder
- Redness and swelling of the shoulder
- Radiating pain running from neck to the shoulder.
- Upper back pain
- A clicking /popping type sound while moving the affected shoulder.
- Muscle weakness.
- It cannot work with the arm above shoulder height
- Painful shoulder while clothing on and off
- Increased incidence of neck pain and neck headaches
- Stress relief when touching affected muscles, tendons, and joints
Causes of Shoulder pain
Severe Shoulder pain can have many causes. Arm pain occurs due to sitting at work all day long. But whatever the cause of your shoulder pain, there is no need to choose surgery as the first solution.
Pain on the arm may be due to the inertia of your muscles, which you can easily fix.
In general, shoulder pain is more common in children. They run around all the time, causing their body muscles and bones are therefore more affected. They suffer from this problem from injury.
On the other hand, shoulders in adults are due to problems like frozen shoulders. Is your shoulder hurting badly? Let’s take a look at the causes associated with shoulder pain.
The causes of shoulder pain are mainly of two types —
- local or local pain, meaning that the cause lies in the joint of the shoulder and its surrounding tissues.
- Referred pain or distant pain is felt in the shoulder after being nerve-wracked.
There are many other causes such as:
1. During childbirth, bones can be broken, including injuries to the shoulder.
2. If there is a strong pull while holding the hands of small children, there may be dislocation with injury on the shoulder. In that case, you can lift the children by the shoulders.
3. Excessive lifting can lead to muscle and ligament injuries.
4. Excessive stress during exercise can lead to muscle or ligament injuries.
5. In cricket, those who bowl at speed can get injured.
Fractures or fractures of the shoulder bone
Injuries can often lead to broken bones or fractures. In that case, severe pain is felt. A clavicle or collarbone injury causes shoulder injuries.
The shoulder bones, especially the arm bones, may rupture or hurt due to Osteoporosis. Osteoporosis makes bones brittle. We must take calcium and vitamin D according to the doctor’s advice.
- Osteoarthritis (pain that affects the joints): In osteoarthritis, Smooth covers at the edges of the shoulder bones called cartilage to become decays; The result is pain. Its name is osteoarthritis.
- Bachelor’s disease (ankylosing spondylitis)
- Inflammation of the shoulder joint
- Soft tissue damage
- Deltoid (deltoid muscle) myalgia (type of pain in front of shoulder and back)
- Bursitis / mucosal inflammation (subacromial)
- Rotator cuff Tendinitis: The rotator cuff encloses the last part of the four muscles or tendons in our shoulders. The biceps tendon is very important among them. These muscles protect the shoulder from the front. If it is injured for any reason, such as lifting something too heavy, repeatedly rubbing the hand on the top of the head, or any direct injury, it causes inflammation and pain. If left untreated, it can cause long-term shoulder pain.
- Frozen shoulder/adhesive capsulitis: Frozen shoulder is a common shoulder problem. It usually affects people from middle age to older. In this case, Shoulder freezing is a condition in which the shoulder movement is completely stopped. Becomes. This condition occurs when there is inflammation in the shoulder or the shoulder capsule lining. The shoulder becomes stiff due to Inflammation, And the result is pain.
- Imposition Syndrome (shoulder muscle contraction)
- Infraspinatus myalgia (pain that goes beyond the shoulder and into the front)
- Collar bone injury
- Dysfunction in joint locker/rib, neck, shoulder, sternum, or collab
- Lung disease
- Chest or chest muscle tension
- Neuropathy (nerve damage may occur locally or further)
- Panic attacks
- Pectoralis minor myalgia (may cause pain in front of the shoulder and anteriorly)
- Rib muscle myalgia/meiosis
- Rib joint locking (may combine with active myalgias causing pain inside the shoulder and shoulder joint)
- Old injury
- Shoulder blade damage due to fracture
- Over Stretching the muscles of the shoulder joint
- Upper trapezius myalgia (may cause pain in the upper shoulder)
When to see the doctor for shoulder pain
If your shoulder pain is particularly bad, chronic, or debilitating, don’t hesitate to talk to your doctor. Your pain may be a sign of a serious illness or injury. For example, arthritis or a tender tear can cause shoulder pain.
If you early consult your doctor, it will be diagnosed and given a treatment plan. So if your shoulder pain doesn’t go away or gets worse in a week or two, make an appointment now.
The warning sign that’s why you must consult with the healthcare specialist includes :
- Shoulder muscles weakness to carry objects or use your arm
- An injury that causes shoulder joint deformity.
- Increasing Shoulder pain, particularly at night
- Pain on shoulder region sustain more than a week
- Severe pain to up your arm beyond neck level
- Swelling or significant redness with warm feeling around the shoulder region
- Signs of any inflammation or infection include fever, skin redness.
- Any unexpected severe pain symptoms are directly associated with your shoulder pain.
Diagnosis of shoulder pain
After hearing the details of shoulder pain from the patient, it is possible to diagnose the cause of shoulder pain through various physical assessments. A doctor may take a detailed history, present chief complaints, past medical history, laboratory and imaging tests.
X-Ray, MRI, CT Scan, Musculoskeletal Ultrasonography, Electromyography (EMG), NCV(Nerve Conduction Velocity) are the possible radiological and imaging investigation procedures to detect shoulder pain. Blood and hormonal tests help to identify the exact reasoning for shoulder pain.
A publicly licensed clinician (usually a physiotherapist or modern chiropractor) can help you find and investigate the cause of your shoulder pain. He will also investigate the following things such as:
- Shoulder movement.
- Effective shoulder movement test.
- Clinical trials to diagnose clamping syndrome.
- Muscular examination to find out which muscle is involved
- There are areas where joint functioning is tested, and they do not move as they should.
Risk population for shoulder pain
Patients who have had a shoulder injury but have not received proper treatment may develop it later.
People who write, for example, teachers, doctors, and those who type on a computer, are more likely to develop supraspinatus tendinitis.
Diabetic patients and heart patients are more prone to frozen shoulder disease.
According to a study, people with diabetes have a 10-20 percent chance of developing the disease, compared to just 2-5 percent of the general population.
In most cases, frozen shoulder is over 40 years of age, but supraspinatus tendinitis can occur at any age.
Treatment of shoulder pain
Treatment of shoulder pain depends on the successful diagnosis of shoulder pain; your consultant will make the treatment plan which includes :
- Anti-Inflammatory drugs
- Physical therapy
- Surgical management
Anti-Inflammatory drugs to reduce shoulder pain
The priority for shoulder pain is over-the-counter drugs like ibuprofen and paracetamol. If the pain doesn’t reduce within 48 hours, some prescribed analgesics like Naproxen, aceclofenac, diclofenac sodium (Prescribed drugs)are the best options to reduce shoulder pain.
In accidental injury where the pain is unbearable, your doctor may prescribe strong analgesics such as morphine through injection or suppository format.
Corticosteroid is a semi-synthetic drug that is sometimes used to treat inflammatory injuries. Like NSAIDs, cortisone targets inflammatory mediators in the body by blocking inflammatory chemical pathways. Cortisone, compared to NSAIDs, has longer activity and a stronger effect, so it is usually given for chronic shoulder pain. However, cortisone treatment is required.
Although it has strong anti-inflammatory effects, cortisone has some notable side effects. These include loss of immune response, stomach ulcers, and mental disorders with frequent use.
Physical Therapy for shoulder pain
Depending on the specifics of your injury, the shoulder therapy that your physical therapist will provide :
Ice therapy: The RICE (Rest, Ice, Compression Elevation) modal encourages icing injured spots for acute injuries. It helps reduce inflammation and swelling, which, in turn, helps reduce pain.
Heat therapy: Heat therapy is best to apply after 72 hours have passed of the injury. Like ice therapy, it’s also a painkiller and allows muscles to relax.
Manual therapy: Manual therapy means some special exercises and mobilization techniques applied through hands instead of any machine in the physical therapy center.
Manual therapy is highly evident based to reduce your shoulder injury. Specific pressure and thrust have been given to the particular shoulder area to mobilize and increase your shoulder movement restriction.
Stretching: Stretching is a very effective therapy for shoulder pain since it’s designed to gently push your muscles further and further until you regain your range of motion. The physical therapist will likely incorporate varying stretches that may target the shoulder and the neck and spine, depending on the injury.
Strengthening: Strengthening is a type of exercise that a physical therapist will advise to reduce shoulder pain and strengthen your shoulder muscles, ligament, and joint capsule. The strengthening exercise aims to improve your muscle strength to prevent shoulder muscles from being injured again.
Joint mobilization: Physical therapist will perform shoulder joint mobilization to increase the injured shoulder joint range of movement. Stretching the shoulder joint capsule will enhance your shoulder movement more than the previous range. A qualified Physical Therapist can perform this as it requires special technique and professional skills.
Ultrasound: A therapeutic ultrasound is physical therapy to reduce your shoulder pain. Ultrasound therapy is very effective for inflammation of the muscles, tendons, and other soft tissue of the shoulder area.
Electrical stimulation: Muscle stimulation through modifying the frequency of electricity is a suitable way to energize the nerves of the shoulder with its associated areas.
Think of acupuncture. Acupuncture is an ancient art that involves placing fine needles on specific skin and muscle strength points to reduce pain and inflammation. Acupuncture (due to injury or rheumatism) can be effective for shoulder pain, especially when the first symptoms appear.
Acupuncture works by releasing multiple substances, including endorphins and serotonin, which work to reduce pain, based on the principles of traditional Chinese medicine.
Acupuncture has been practiced by many health professionals, including doctors, chiropractors, naturopaths, physiotherapists, and massage therapists – anyone you choose must have an acupuncture course and a certificate.
Acupuncture points that can relieve shoulder pain are not always located near the pain site – there may be far away from the body.
Kinesiology taping: Taping with a special plastic elastic band facilitates shoulder movement. Kinesiology tape is applied on certain shoulder injured areas. It also has the purpose of preventing shoulder injury prevention.
Modern chiropractic for shoulder pain
A modern chiropractor has six years of training and treats muscles, tendons, and joints. Their long and extensive education specializes in assessing and treating problems throughout the musculoskeletal system, including their muscles, tendons, and nerve dysfunction.
Treatment usually consists of custom joint mobilization to normalize joint mobility, muscle treatment against tight muscle knots, and shoulder movements to leave space in the shoulder joint. Medical pressure wave therapy or intramuscular acupuncture is also used on certain shoulders.
Surgery for shoulder pain recovery
When your shoulder pain is not improving for more than six months, you might look forward to consulting with an orthopedic surgeon. The rotator cuff muscles of shoulder repair surgery are very common for shoulder pain recovery. It is major surgery and usually requires six months to recover fully after surgery.
Arthroscopic surgery is one such advanced treatment. By doing the arthroscopic operation, fix the internal problems of the couple without cutting the place of surgery. The patient himself can see monitor what kind of surgery is being performed on his body, and there is also an opportunity to give him the video of the operation.
This type of treatment does not pose a risk of the comma, and the patient can recover in a much shorter time after surgery than other common surgeries. In the case of shoulder arthroscopic surgery, the patient can quickly eat food with his own hands, brush his teeth or comb his hair.
However, any traumatic fractures of shoulder bones needed fixation of bones through metal plate and screw or wiring. After surgery, physical therapy is mandatory to help your shoulder joint and muscles. Apart from accidental fractures, most shoulder pain doesn’t need surgery.
Prevention of shoulder pain/Injury
If your pain allows, try extending your shoulder into your daily routine. Stretching improves your flexibility and can relieve stiffening pain. Do not stretch your shoulder intentionally because of the pain – prolonged inactivity can lead to increased shoulder caps adhesive inflammation (often known as “shoulder stiffness” or “capsulitis”) and stiffening of the shoulder joint. Here are some simple shoulder exercises for you:
Stretching your shoulder
- Leaning slightly to the right, slide your hand along the entire length of your body. When leaning to the right, let your left shoulder come up. You should feel the extension to your right shoulder. Count one to ten and hold this position, return to neutral position and repeat on the other side.
- Stand up straight and extend your arms forward. Hook your fingers together. Lift the arm above your head with the tip of your finger. Pull yourself up and look. Hold this position for 10 seconds.
- Pull your right hand above your head, bend your elbow and place your right hand on your neck. Gently press your right elbow through the left hand, extending your right shoulder and triceps. Hold for 10 seconds.
Tighten your shoulders
If your shoulder pain is caused by excessive impact, you may benefit from strengthening exercises, but only if you do them safely. If your initial pain subsides, try adding light shoulder strengthening exercises to your routine. Stiffer shoulders can withstand the stresses and strains that cause shoulder pain, reducing the chances of the pain coming back.
Gradually resume your normal shoulder activity.
Strenuous physical exercise sometimes reoccurs shoulder injury. Even if the shoulder feels better, it is advisable to start normal activities that slowly cause pain in your shoulder. Try to gradually increase your activity and intensity of work on your shoulder strength until you continue a normal work pressure.
Tips for shoulder pain
- If your shoulder hurts too much, take a hot water bottle, fill it with hot water and place it on the area around your neck and shoulders.
- Do not use the aching shoulder for a while.
- Taking lukewarm water before bed can help you sleep better
- Repeat every night until the pain is almost over.
- Massage it slightly with yellow sesame oil or almond oil.
- Stretch your arm a bit regularly.
The role of different joints is very important for keeping our body fit. The role of the shoulder joint in them is immense because we are always doing our daily activities with their help.
When shoulder pain becomes unbearable, we can be damaged physically, mentally, and financially. So we have to be careful before these places are attacked.
If shoulder joints or muscles are infected for any reason, it is very important to take proper treatment. When our shoulder joints are damaged due to unfair treatment, we may have to regret it for the rest of life. Stay healthy; everyone stays well.
Frequently Asked Question( FAQs)
1. What are the best drugs to reduce shoulder pain?
Analgesic drugs(Pain killers) help alleviate shoulder pain and reduce inflammation. OTC (Over-the-counter) drugs such as paracetamol,aspirin, ibuprofen, and naproxen. Stopping/reducing inflammation is essential in rotator cuff injuries, tendonitis and arthritis, and other shoulder injuries.
2. What are the major causes of shoulder pain?
The main three causes
- Firstly, Cervical spondylosis.
- Secondly, Frozen shoulder.
- Thirdly, traumatic injury or diseases.
3. Which is better to apply( heat or ice) for shoulder pain?
Ice therapy is the first choice to decrease shoulder pain within 72 hours. Heat application is beneficial for sure regarding tight muscles of the shoulder as tight muscles get relaxed while heat is applied. Heat can’t apply to any swollen shoulder injury or acute injury.
4. How to reduce shoulder pain quickly
- Apply an ice pack on the injured area of the shoulder region for ten to fifteen minutes four times daily for three days.
- Make your injured shoulder complete resting condition for three to five days.
- Start your shoulder movement gradually up to pain-free range.
- Take over-the-counter drugs like ibuprofen or paracetamol with caffeine to reduce shoulder pain.
5. What activities cause shoulder pain?
A common athletic game like swimming, tennis, pitching, and weightlifting causes shoulder pain. Besides, household work such as washing, hanging curtains, gardening, and repetitive works are responsible for shoulder aches.
6. Why do I feel shoulder pain when I lift my arm?
Due to a shoulder impingement problem, shoulder pain occurs. When moving arm upward in sideways, tendon of rotator cuff muscle’s tendon pinched around the shoulder joint causes pain.