SHOULDER PAIN – CAUSES AND TREATMENT

The shoulder is basically a ball and socket joint that allows a wide range of movement as it is composed of several key structures such as tendons, cartilage and bone. The shoulder pain occurs because of the following reasons:

• Pain in the movement of the shoulder
• Inability to lift the arm over the level of head.
• Night pain, often related to the pain caused by lying on the affected side
• The weakness of the muscles.

This limited mobility in the shoulder is because of the shoulder stiffness which can be caused because of many reasons such as Arthritis, Frozen shoulder, Rotator cuff tears etc. Shoulder stiffness is a common condition in which there is a scar tissue formed near the joints in the shoulder.

It is also referred to as Adhesive capsulitis. It happens when the tissues within the shoulder joint get thick to restrict movement, which eventually causes pain.

SYMPTOMS:

Some common symptoms of shoulder pain include the beginning of dull ache in your shoulder. Sharp pain under your shoulder blade or stabbing, burning, tingling in your shoulder is a good indicator of shoulder stiffness. Shoulder stiffness also causes pain that goes from your neck to your shoulder blade (or vice versa).

Pain in shoulder or pain in the spinal cord is also attributed to Shoulder Pain. It also causes swelling in the shoulder. Shoulder stiffness is a major reason. The exact cause of shoulder stiffness or a frozen shoulder is still not completely known, however, some of the well-known reasons for shoulder stiffness include:

 

CAUSES:

The major causes of Shoulder Pain are:

SLAP Tear: Superior Labrum Anterior and Posterior. In this, the top (superior) part of the labrum is injured and can occur both in front (anterior) and back (posterior) of this attached point.

Abnormal AC Joint: Acromioclavicular Joint injury occurs in the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle). It can be caused by falling directly on the outside of the shoulder, or by respective overuse.

Frozen shoulder (adhesive capsulitis) is thought to happen when scar tissue forms in the shoulder. This causes the shoulder joint’s capsule to thicken and tighten, leaving less room for movement. The movement may become stiff and painful. The exact cause is not fully understood, and it cannot always be identified. The chances of developing this increases if you’re just recovering from an injury.

However, most people with frozen shoulder have experienced immobility as a result of a recent injury or fracture.

The condition is common in people with diabetes.

Which group of people has a high chance of having a frozen shoulder and hence, the shoulder pain?

It is very well known that shoulder stiffness is mainly because of formation of the scar tissue near the joint or because of an injury. However, with age, chances of shoulder stiffness increase rapidly as the muscles between the joints weaken and the lubricant starts to dry.

• Age: Being over 40 years of age.
• Gender: 70 percent of people with frozen shoulder are women.
• Recent trauma: Surgery or an arm fracture can lead to immobility during recovery, and this may cause the shoulder capsule to stiffen.
• Diabetes: About 10-20%of people with diabetes develop frozen shoulder, and symptoms may be more severe.

The prevention of shoulder pain can be done by exercising regularly or seeing a doctor or an expert immediately in case of an injury so that the problem of shoulder stiffness/ pain does not elevate further.

TREATMENT OF SHOULDER PAIN:

The treatment of shoulder pain is a slow process and the recovery often takes time. There are several ways to relieve and alleviate the pain.

Painkillers, Corticosteroid injections, Shoulder Manipulation, Shoulder arthroscopy are few methods which help the condition. However, we at Aaram Physiotherapy centre believe in non-invasive ways (with the body) to treat the problem of a patient.

At Aaram Physiotherapy Centre, methods like the prescription of hot or cold compression packs which help reduce the level of swelling and pain clubbed with exercises for speedy and natural recovery of shoulder stiffness are recommended. Physical Therapy which involves physical training and exercises with massages to increase the flexibility and mobility of the shoulder is highly recommended.

The doctor will suggest a suitable option depending on the severity of signs and symptoms.

 

EXERCISES FOR REHABILITATION OF SHOULDER PAIN:

Your physiotherapist will recommend some exercises which help relieve and rehabilitate shoulder pain:

• Wand exercise- Flexion: Keep elbow straight throughout each repetition. Slowly push affected arm up.
• Wand exercise – Extension: Keep elbow straight throughout each repetition. Slowly push affected arm back.
• Wand exercise – External Rotation: Place towel roll under the elbow. Keep elbow bent 90°. Slowly push hand toward the floor.
• Wand exercise – Internal Rotation: Hold wand behind you. Slowly raise hands up then slowly return to starting position.
• Wand exercise – Shoulder abduction and adduction: Keep elbow straight. Slowly push affected arm up.

Adduction: Holding on to the end of the wand with the right hand, right elbow slightly flexed, the left hand is on the mid-shaft on the wand and pulls right shoulder across the body (for exercising an involved right shoulder, reverse hands for an involved left shoulder).

• Scapular active range of motion
• Pectoralis Stretch: Stand with good posture and holding a towel behind your back.

1. Lift the towel up behind, holding the ends with both hands
2. Use the towel to gently pull your shoulders into an extension
3. You should feel a stretch in the front of your chest
4. Hold this position for 15-30 seconds, and then relax

• Biceps Stretch
• Upward Couch Yoga Pose
• Locust Yoga Pose
• Revolving Beam Yoga Pose
• Pool Yoga Pose
• Upward Crescent Moon Yoga Pose