The shoulder can move in many directions and in many ways. This is an unstable joint, which could easily get hurt. Usually, problems arise with the injuries of the soft tissue or when there is a pathological process. Sometimes, other problems in the body, like liver, heart, cervical spine or gallbladder problems could be manifested as shoulder pain.
Shoulder problems are usually diagnoses by the physical examination, and then tests like MRI, X ray or arthrogram, and sometimes ultrasound.
Possible disorders of the shoulder include: frozen shoulder, dislocation, separation, tendinitis, bursitis, impingement syndrome, torn rotator cuff, (known as adhesive capsulitis) and shoulder fracture.
Frozen shoulder could be caused by an injury or progress of the rheumatic illness, which lead to adhesion growth between the surfaces of the joint. These adhesions seriously limit the movement of the shoulder. Treatment consists of NSAIDs, heat application and assisted stretching. Some cases need transcutaneous electrical nerve stimulation (TENS) to ease the pain. Surgical assistance is rarely needed.
Dislocation of the shoulder is quite common condition, when the ball of the humerus pops out. Some people often experience this condition, and then it’s called shoulder instability. Subluxation is a partially dislocated upper arm bone. The condition produces intensive pain, swelling, weakness and bruising. Sometimes, it could complicate further by ligament tearing or nerve damage. Dislocation is diagnosed by examination and X rays. The treatment includes returning of the humerus into the joint socket and immobilizing the joint for couple of weeks. After that, patient needs physical rehabilitation. Sometimes, it is necessary to perform a surgical procedure. It could be done in open or arthroscopic surgery. The recovery period is usually several months.
Shoulder separation is most likely to be caused by falling on the stretched arm or by sudden, intensive punch to the shoulder. Ligaments of the joint got torn and outer end of the clavicle slips out of place. Usual symptoms include: tenderness of the shoulder, pain, and a bump over the AC joint. It is treated just by resting and wearing a sling and after that specialists recommend physical exercises. The complete healing could be expected in 2 to 3 months.
Tendinitis, bursitis, and impingement syndrome often happen combined. Inflammation and swelling of the tendon and bursa cause these conditions. Impingement syndrome is a condition caused by squeezing of the rotator cuff. The therapy starts with anti-inflammatory medications (non-steroidal anti inflammatory drugs or NSAIDs), to ease the pain and inflammation. Specialists use ultrasound to improve blood flow, and the patients are advised to perform stretching and strengthening exercises. Sometimes, it is necessary to use corticosteroids or perform a surgery to repair the damaged tissue.
Torn rotator cuff is caused by aging, or overuse of rotator cuff tendons, such as by heavy lifting. The treatment involves resting, hot or cold applications and painkillers if necessary. It is also likely that the condition will improve with wearing of the sling, electrical stimulation, ultrasound or cortisone injections. Surgery is the last option.
Fracture means that there is crack through the shoulder bone, usually after collision injury. It causes severe pain, redness and bruising. Specialist brings the bone to its normal position and then use a strap and sling to keep the clavicle where it should be. Patients need physical treatment after removing the strap and sling, to toughen the shoulder and bring back its movement.