One of the most common complaints I hear involves pain in the shoulder, particularly amongst my most physically active patients. Not only do they have shoulder pain but usually a stiff and sore neck from trying to keep the shoulder from moving (and hurting!) too much.
Participating in sports that involve a lot of arm and shoulder movements, or working at a job that involves a lot of lifting or overhead work, can cause stress and strain and injury to different parts of the shoulder. It’s important then to know what the exact injury is before it can be treated successfully. Today, I’d like to talk to you about some common causes of shoulder pain and what you can do about them.
Common Causes of Shoulder Pain
Arthritis: Arthritis can set into the shoulder joint after an injury or strain occurs. Treatment consists of anti-inflammatory and/or pain medications. When severe, sometimes the joint may need to be artificially replaced.
Bursitis/tendinitis: Usually the most common cause of shoulder pain. These are inflammation of the bursal sacs and/or tendons of the shoulder caused by overuse mainly. Calcium tendinitis can also occur where calcium deposits occur within the tendons, usually of the rotator cuff. These conditions can be treated with anti-inflammatory medications, rest, and gentle exercise to keep the shoulder moving properly and break up calcium deposits.
Frozen shoulder: This condition can occur when an injury to the shoulder has gone too long untreated but it also can occur on its own with no known injury. It occurs almost twice as often in women ages 40-60 than men. Disorders of the endocrine system (diabetes, thyroid problems, etc) and Parkinson disease can also be factors. Inflammation and stiffness sets in to the point where it becomes very difficult to move the shoulder joint. This is also called adhesive capsulitis and is generally treated by physical therapy. It’s important if you injure your shoulder to get treatment for it before this condition sets in as it can be complicated to resolve.
Rotator cuff tear: The cuff-like band of tendon surrounding the shoulder that hold it in place is called the rotator cuff. With heavy sports playing or overhead arm activity, this cuff can tear and separate from the bone. Often times surgery is needed to re-attach the tendons, but other times it can heal with physical therapy, gentle exercise and/or rest.
SLAP lesion: This is a tear of the labrum, soft, fibrous tissue that surrounds the shoulder socket. It occurs most often when you fall onto your outstretched hands. It is often treated with anti-inflammatory medication and physical therapy. Sometimes, surgery is required to stabilize the shoulder if the tears are too extensive.
Shoulder Instability/Dislocation: This condition occurs when the joint becomes loose in the socket. The shoulder may slide out of place in subluxation and can dislocate altogether. It is usually caused by an initial injury where the shoulder tendons have been torn or stretched more than usual. They can heal too loosely and cause the shoulder to be unstable and/or dislocate. This condition is usually seen in athletes, but also in people whose jobs require them to lift heavy objects and/or constant overhead work. Treatment usually consists of physical therapy/rehab for strengthening exercises. Cortisone injections can help and sometimes surgery is necessary to surgically tighten the loose structures.
Symptoms of Shoulder Injury
If you’re unsure if you just have sore shoulder muscles from over-exercising or playing weekend sports, or if you may have a real injury, here are some important symptoms to watch for:
- Cannot carry objects or raise or use your arm
- Shoulder pain at night, or while resting, or pain that lasts several days
- Swelling or deep bruising around the shoulder joint
- Infection signs including warmth, redness, fever
If you have any of the above symptoms, please see your doctor immediately.
Treatments for Shoulder Pain
If you’ve just overdone it with exercise, rough-housing with your kids, too much overhead home repairs or strenuous landscaping work, the following treatments can help your shoulder/s feel better:
- Rest: This usually is the best thing you can do for your shoulder strain to allow the muscles and tendons to quiet down and calm any inflammation.
- Heat: Generally heat can be helpful in overuse injuries. A heating pad or hot wet or dry towel. However, discontinue if the pain gets worse with heat.
- Anti-inflammatories: Over the counter anti-inflammatories may be needed to help with the soreness. However, there are also some natural anti-inflammatories like arnica which is very good at relieving muscle and joint aches. This can either be bought in a cream or in homeopathic pill form at health food stores. Also, white willow bark is an excellent anti-inflammatory as is dark cherry juice. Soaking in Epsom salts in a warm bath can relieve a lot of pain and inflammation as they contain magnesium which helps to relax the muscle and de-inflame it.
- Stretching: Light stretching after a period of rest will help the muscles and tendons from stiffening up. In the future, stretching all your muscles is a good idea before engaging in vigorous physical activity or work.
- Hydrate: Drinking plenty of water will help your sore muscles relax as well. Dehydration causes your muscles to tighten up and ache.
Shoulder pain can be very uncomfortable and activity limiting. Getting into the habit of doing good muscle stretching of all your muscles before strenuous activity can help you avoid tears, strains and pulls. If your shoulder pain/discomfort isn’t helped with the above recommendations and/or seems to worsen, please call your doctor.