It is estimated that up to 70% of people suffer from shoulder pain globally, and around 50-40% suffer from recurring pain and discomfort. Approximately 18 – 26% of adults suffer shoulder pain at any point in their lives; this makes shoulder pain one of the most prevalent regional pain syndromes after back pain.
Shoulder pain dominantly affects the working class; it can be due to long travelling hours, the wrong posture, or due to working for long hours, or because of lifting heavy weights at work.
The shoulder is the most mobile part of our whole body. This mobility has a very intriguing fact backing it: our shoulders are barely connected to the rest of the skeleton. The only point where the shoulder bone is connected to the rest of the skeleton is at the collar bone. But also the shoulder functions with the help of these 8 muscles it is connected to. Other than this, these 8 muscles also ensure that the joint stays firm and stable.
With maximum mobility comes an equal amount of instability in the shoulder joint, and this lack of stability makes the joint more vulnerable to injuries. Shoulder pain can be cured only when you know the exact cause; to know the reason, you must know your body well.
A shoulder is capable of a variety of movements, and this is because of the kind of structure our shoulders have. Our shoulder comprises of 3 major bones, one being the scapula or the shoulder blade, the second one being the clavicle bone, and the third one is the upper arm bone or the humerus. The shoulder also has two joints, one joining the shoulder blade and the collar bone, while another joint is the famous ball-and-socket joint, joining the arm and the shoulder. These joints in the shoulder are held by several fibrous tissues, and these tissues have synovium, a thin membrane, which facilitates smoother movement in the joint by lubricating it.
The tendon in the shoulder, rotator cuff is that connects the bones and the muscles. Due to this rotator cuff, you can do several actions like the shoulder roll, handstand, summersault, and other movements. The shoulder moves to the front, back and sides. But any damage to this tendon could cause achy actions and limit any complex movement.
Now that you know the anatomy of your shoulder in layman’s terms, understanding its pains and the cause of the pain can be a little easier. Keep reading to learn more about shoulder pain, its causes, symptoms, and when you should visit a doctor.
What causes shoulder pain?
The shoulder has a complex structure involving a lot of tendons, ligaments, and muscles involved in it, and any damage to one or all of these could lead to triggering pain in the shoulder.
The following are a few of the most common reasons for shoulder pain.
Post-traumatic Pain
Post-traumatic pain means any pain that originates from a past injury or trauma suffered by someone. This trauma can be any injury that you sustained in the past. If you ever got injured in your shoulder, you might experience gradual pain that keeps returning over time. The pain could be accompanied by inflammation and stiffness at times. This is common if you have ever had a fractured arm or collar bone. Any movement after such injuries becomes quite difficult. These can be prevented to some extent by taking the entire course of physiotherapy post-injury.
Arthritis
It is the most common cause of pain in the shoulder. Arthritis can be due to degeneration of cartilage and tendons over time due to age, which makes the joint weak and incapable of diverse movements or even daily activities. In the shoulder, the cartilage might get damaged on the surface, and slowly the damage gets deeper, the smooth movement wears off and with the membrane.
Osteonecrosis
Osteonecrosis is a painful condition that affects one over time in the upper arm bone due to a lack of blood supply. It is also known as Avascular necrosis. It is a condition in which the bone tissue of the humerus is disrupted because of a lack of blood supply. In the early stage, it only affects the humerus, but it reaches up to the shoulder joint with time. Avascular necrosis usually affects those who consume a lot of drugs, alcohol, and steroids or sometimes due to severe injuries like fractures.
This is a prevalent condition suffered by people in which the shoulder loses its movement over time. In this condition, the shoulder movement is restricted as the shoulder capsule inflames and tightens. In this, there are majorly three stages one being the freezing, the frozen, and the thawing stage.
Damaged Bursae
Bursa is a small sacs filled with fluid that is placed between two bones to avoid friction and make the movements fluent and pain-free. The Bursa acts as a cushion between two bones. When there is an excess fluid build-up in the bursa, and it inflames, this condition can be called bursitis. This can happen overtime due to overuse of the joint or sometimes can also be due to some injuries.
Dislocation
It is a condition in which the upper arm bone pops out of the socket of the shoulder blade. Sometimes in the process, the tendons attached to the bones may also get injured. Since the shoulder has the maximum level of mobility, it is more prone to dislocation. It is a painful situation, and immediate medical assistance should be provided. While the shoulder is dislocated, the tiniest of motion can give excruciating pain.
Sprain
A sprain is caused by the straining or tearing of ligaments, which are the thick fibrous tissue that link two bones at your joints. Depending on the seriousness of the sprain, one may notice a bruise, swelling, limited motion, and pain. A shoulder sprain usually happens during sports like basketball and football and falling. It can be treated at home by using the RICE protocol. But it is advised to visit a doctor once.
Other than these causes, certain risk factors should be kept in mind. These factors make certain people more vulnerable to getting shoulder pain. People who have a history of spine injury, liver, engaging in repetitive and fast arm movements, and people over 50.
What are the symptom of shoulder pain?
The symptoms of shoulder pain will differ from person to person, depending on the root cause of the pain. Some people might feel 2 or more signs at once, while others may feel only one.
Pain in the shoulder and back
Your shoulder may be warm or red.
Backache, neck pain, or arm pain
While moving your arm, you may notice somes clicking, popping, or grinding
Muscle twitching and weakening
a restricted range of motion
Muscle spasm
Numbness in the muscles
If you feel any of these symptoms, it is suggested that you see a doctor and get a check-up done.
When to see a doctor?
When the intensity of the pain doesn’t reduce in a week
When you have fallen and have gotten injured, bruised, or have an open wound.
When the above mentioned symptoms are accompanied by weakness, numbness, and dizziness
When the joint feels unstable
When the shoulder pain radiates to your back and arms.
When everyday movements become challenging and painful
How is shoulder pain diagnosed?
A doctor will begin with a physical exam to screen for any structural issues and to rule out anything involving your spine or neck. They will then try to assess your range of motion to see how strong and flexible your shoulder is. This will entail moving your arms in different directions, such as above your head, across your body, or behind you and rotating them.
Other than these, he may run some tests:
An Xray to check on your bones
An MRI scan to check on your shoulder muscles
A CT scan, which is basically Xray but from all different and possible angles
How do you manage shoulder pain at home?
Posture
Many people do not realise that their hunching, slouching, sliding down when seated, and other relatively harmless movements eventually contribute to pinching and shoulder impingement syndrome. These things, over time, lead to inflammation in the shoulder muscles. So maintaining a healthy posture could be the 1st thing one can do to prevent or reduce shoulder pain.
Apply ice on the shoulder for 15 minutes, then remove it for 15 minutes. Do this 3–4 times each day for 2–3 days. Wrap the ice with a piece of fabric. Do not apply ice straight to the skin as this might induce ice burns.
Rest and workout
When the pain starts, rest for a few days to help you relax the affected area. With time start regular physical activity under the guidance of a physical therapist.
Take painkillers
You can take over-the-counter pills and gels to reduce pain. For their anti-inflammatory properties, you can take simple painkillers such as paracetamol and Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and salicylates. Salicylates can thin your blood, so be careful how you use them.
Exercises for healthier shoulder
Below are some beginner-friendly combos of exercises and yoga poses that will help you build shoulder strength over time. Some exercises here may use dumbells, but you can improvise them to your convenience and add water bottles instead.
Dumbbell Lateral Raise
Reverse Fly
Arnold Press
Plank hold
Cat-cow
Inchworm
Plank to down dog
Arm cycles
Thread and needle
Child pose