What You Should Know About Shoulder Pain

Behind low back pain and headaches, shoulder pain comes up as one of the most common places of pain in the human body.  Dont believe me? Ask around.  Chances are you will be surprised to find out just how many people have bad shoulders.

As one of the most complex joints, the shoulder consists of 16 different soft tissue structures and 3 bones.  All of which affect movement and stability. Shoulder pain affects 10% of the population at some point in their life.  And while 50% of the population of shoulder pain sufferers do not seek any treatment, many cases of shoulder pain are self-limiting and resolve within the first few weeks, fortunately.  Surprisingly, as much as 1 in 4 cases of shoulder pain improve in one month without treatment, but that still leaves 75% of all shoulder related pain cases unresolved.

While each shoulder complaint seems to stem from different causes, they mostly can be placed into 4 categories: overuse, instability, arthritis, and fracture.  Some other categories of shoulder pain, which are far less common, include tumors and infection.

Overuse. The shoulder joint is involved in many day to day activities.  The constant movement and involvement lead to overuse.  The most commonly diagnosed shoulder problems are “bursitis” and “tendonitis.”  These are my most disliked diagnoses that I hear about.  While there are definitely some serious cases of both, I find that they are GROSSLY overused and often mistreated.  The term “itis” refers to inflammation.  Overuse injuries are not inflammatory processes but degenerative!  What this means is that the commonly prescribed treatment of rest, ice, and medication is far from the best treatment as it does absolutely nothing to regenerate the degenerative tissue.  Stretching also does little to solve the problem.  There are a multitude of structures in the shoulder joint, all of which, try to work together to accomplish proper movement of the joint.

Overuse leads to “tight” muscles and increased friction.  Overtime, without proper treatment or recovery, adhesion will form and sometimes tendonosis, which is degeneration of the tendon. We will get more into the proper treatment of this shoulder problem laterl, but for now I wanted to introduce you to common problems.  Often times overuse symptoms refer pain to the front of the shoulder.  Most of the muscles of the shoulder have attachment sites in this area.  Just because it hurts there, does NOT mean that someone should be treating there.  Proper evaluation and diagnosis is vital!

Tendon Tears. Another very common injury of the shoulder are tendon tears.  After reading the last paragraph it is very easy to see why tears are so common.  Most tears are a result of overuse and not seeking treatment.  Small pains gradually become large pains, which eventually lead to tears of structures that have finally weakened enough.  The four rotator muscles; subscapularis, supraspinatus, infraspinatus, and teres minor are the most commonly torn.

Impingement.  Also at the top of the list of shoulder problems is impingement.  As the arm is lifted a bone on the shoulder will “impinge” on the bursa and rotator cuff tendons.  Sometimes this is a cause of arthritis, other times as a result of overuse.  Impingement over time may also lead to tears.  In many cases where impingement is diagnosed the route cause of the issue is adhesion.  Once the adhesion is removed, impingement is no longer an issue.

Instability.  Either by trauma, or overuse (are you seeing a theme here) shoulder instability occurs when the head of the upper arm is forced out of the socket.  Repetitive dislocations may lead to chronic shoulder instability and arthritis – next on our list of shoulder problems.

Arthritis.  Most commonly arthritis develops as osteoarthritis (“wear and tear”) in the shoulder joint.  Arthritis may be related to previous injuries like tears, or infection.  Often times this leads to reduced movement and more chronic pain later on.

As you can see there is a multitude of issues that can cause shoulder pain and problems.  A proper examination and diagnosis, are vital to receiving the proper care that is needed to not only treat but prevent such problems from returning.

We have have great success in the treatment of shoulder pain.  Many times a patient will have been to several different providers.  If you would like information on shoulder pain treatment in Cedar Rapids, and what you can do for it, feel free to call our office at 319-423-0925, or visit our website.