The shoulder is a complex of multiple joints that connects our arm to our torso and allows our arm to fulfil its functions. It is a very mobile joint. Muscles and tendons are involved in the stability of the shoulder as well as bones.
Shoulder pain is a very common problem in the clinic. In shoulder pain, the pain may be continuous or the patient may say that he has pain from time to time. He/she may complain of pain only when he/she moves his/her arm. Sometimes it lasts for a few days and sometimes it may require medical diagnosis and treatment.
What Are The Causes Of Pain In The Shoulder Joint?
Shoulder pain may be due to injury or disease in one or more structures of the shoulder.
Strain in the shoulder muscles, diseases of the shoulder capsule, other joint problems around the shoulder, fractures, infections, nerve-related problems can cause shoulder pain.
In addition, pain radiating to the shoulder may be caused by internal organs such as cervical vertebrae, lung diseases, gallbladder diseases, liver diseases, spleen trauma, heart attack.
Swelling and inflammation may occur with excessive use of the shoulder in the bursae, which are small fluid-filled sacs around the shoulder joint. (Subacromial bursitis)
Impingement of the shoulder joint (impingement syndrome), muscle and tendon tears (rotator cuff tear, biceps tendon tear), frozen shoulder (adhesive capsulitis) are among the diseases we frequently encounter.
What Are The Findings That Suggest A Serious Illness In Patients With Shoulder Pain?
Serious illness may be indicated by the following findings, which require immediate investigation: Skin redness, fever, weight loss, history of trauma, significant muscle weakness, low arm test, unexplained severe muscle or sensory loss, and stiffness and swelling around the shoulder.
In new-onset pain without these findings, immediate investigation may lead to unnecessary surgical interventions, as structural abnormalities can be detected on MRI even in patients with no complaints.
Performing advanced tests immediately may lead to the patient undergoing an unnecessary intervention.
In shoulder pain, it is essential to conduct a thorough pain assessment. It is often accompanied by stiffness, weakness, and a feeling of the shoulder coming out of place.
In diseases originating from the shoulder muscles, the patient reports weakness, but passive joint range of motion is unaffected on physical examination. In frozen shoulder patients, pain and stiffness are accompanied by restricted joint movements both actively and passively, which is a clue to the diagnosis.
It is important to inquire about the activities that our patients with shoulder pain frequently perform during the day. In particular, working with the arm above the head puts excessive strain on the shoulder. Shoulder joints are strained in sports such as swimming, basketball, tennis, and volleyball.
What Can A Person With Shoulder Pain Do To Reduce Shoulder Pain?
Do not overload your shoulder when doing activities.
Avoid activities that increase your pain. However, it is not recommended to rest the shoulder completely and not use it at all unless your doctor recommends it.
You need to be aware of what triggers your shoulder pain. When I experienced back pain, I saw that I was putting too much strain on my shoulders to avoid straining my back. I was unknowingly straining my shoulder tendons while supporting myself with my wrists while getting up.
In my clinical observations, many of my patients also had pain in other areas such as the back, knee, and ankle. We unknowingly put too much strain on the shoulder joint in our daily lives.
It is important to correct the wrong loading done while treating pain. Therefore, it is not enough to focus only on the shoulder in the treatment of shoulder pain, the treatment of pain in other joints that accompany it is also necessary.
In my patients who are elderly with knee pain and do not want to have knee replacement, tendon tears develop in the shoulder due to the strain on the shoulder while using a cane, postponing the necessary surgical intervention.
If you have a new onset shoulder pain, you should first continue your life without straining your shoulder joint. For example,
🩸Avoid wearing clothes that you need to put your head through. When dressing, put on the painful arm first and then the painless arm. When taking off, take off the painless arm first and then the painful arm. Even these simple measures can relieve your pain.
🩸When you have to carry weight, take the thing you will lift as close to your arm as possible and carry it as close to your body as possible. This will reduce the load.
🩸Avoid activities that you do above your head. Place frequently used items in lower places as much as possible. If you have to reach something above, use the stairs.
🩸Carry as little weight as possible. The less weight you carry, the better.
🩸Applying cold to the shoulder joint and painful area helps to reduce pain. It can be done 5-6 times a day, for at least ten minutes, and this time can be extended to 30 minutes. It is good to check for excessive redness on the skin from time to time. Skin burns can occur with direct ice application to the skin. It is important to apply cold by wrapping it in a thin towel to avoid contact with the skin to prevent cold burn.
What Are The Treatment Methods That Can Be Applied In Patients With Shoulder Pain?
We create a treatment plan after we have done what is necessary to determine the cause of our patients’ pain. This plan varies depending on the patient and the disease.
The treatments we apply in my clinic are physical therapy applications, exercise, ozone therapy, dry needling, kinesiotherapy, prp therapy, prolotherapy, ESWT therapy, acupuncture, cupping therapy applications.