Some Causes of Shoulder Pain
Rotator Cuff Tear
There are four muscles which provide stability for the shoulder: supraspinatus, subscapularis, teres minor and infraspinatus. A tear in one of these muscles causes weakness and instability and pain. There may also be a tear in the biceps tendon. It can be difficult to raise one’s arm or perform usual tasks such as brushing your hair or getting dressed. A younger person especially if they are an athlete or do a lot of sport may have the tear repaired. In an older person it may be left to heal itself especially if it is only a partial tear. A full tear which is not repaired may result in weakness and muscle wasting.
Rotator cuff (Supraspinatus) Tendinitis
This can be caused by acute or chronic reasons.
Acute causes can be from overhead throwing or playing tennis or some trauma. It usually affects younger people. Usually complain of an ache followed by intense pain and acute immobility. Pain felt in the top of the arm in the front. It resolves gradually. Local heat, rest and deep transverse friction can help.
Chronic can occur from poor posture leading to misalignment of the shoulder or repetitive actions involving the shoulder and a gradual wearing of the tendon. It can affect the biceps tendon as well as supraspinatus. It affects the older patient. There is often a history of overhead work. Chronic tendinitis can lead to impingement syndrome in which raising the arm between 60 and 120 degrees produces a painful arc due to the damaged tendon pushing against bone.
Osteoarthritis
This may occur following longstanding rotator cuff tears or after trauma. There may be calcification of the tendon present. There will be restriction of movement in all directions. The patient is usually between 50 and 60. There is usually pain and stiffness which can be helped with physical therapy and exercises. Osteoarthritis is common in the acromioclavicular joint in older people and can cause a swelling on the top of the shoulder.
Frozen shoulder
Adhesive capsulitis or frozen shoulder may start like a chronic tendinitis but can spread to affect all the rotator cuff muscles and the joint capsule. It may start following a trauma, however, slight and become painful or there may be no obvious cause. It becomes more severe and can be painful to lie on the affected side. The pain starts to lessen after a few months but then it becomes very stiff. This can last for 6-12 months if untreated. Local heat and exercise therapy can help.
Please seek help if you are experiencing shoulder pain as in some cases it may be sign of something life-threatening such as a heart attack.