1. Musculoskeletal Causes
Rotator Cuff Disorders:
Tendinitis: Inflammation of the tendons due to overuse or repetitive motion.
Impingement Syndrome: Tendons are pinched during shoulder movement.
Rotator Cuff Tears: Partial or complete tears causing weakness and pain.
Bursitis:
Inflammation of the bursa (fluid-filled sacs), leading to pain and limited motion.
Frozen Shoulder (Adhesive Capsulitis):
A condition marked by stiffness and pain due to thickening and tightening of the joint capsule.
Shoulder Instability:
Includes dislocations and subluxations, often seen in athletes or younger individuals.
Osteoarthritis:
Degeneration of cartilage in the shoulder joint, causing stiffness and grinding sensations.
Fractures:
Trauma leading to fractures of the clavicle, humerus, or scapula.
2. Neurological Causes
Cervical Radiculopathy:
A pinched nerve in the neck can cause referred pain in the shoulder.
Brachial Plexopathy:
Damage or inflammation of the nerve bundle supplying the shoulder and arm.
Thoracic Outlet Syndrome:
Compression of nerves or blood vessels, leading to pain and weakness.
3. Inflammatory and Systemic Causes
Rheumatoid Arthritis:
Autoimmune inflammation affecting the shoulder joint.
Polymyalgia Rheumatica:
A condition causing bilateral shoulder pain and stiffness in older adults.
Septic Arthritis:
Infection in the shoulder joint, causing severe pain and swelling.
4. Referred Pain from Other Organs
Cardiac Issues: Pain from angina or a heart attack may radiate to the left shoulder.
Gallbladder Disease: Inflammation or gallstones may cause right shoulder pain.
Lung Conditions: Disorders such as Pancoast tumors can refer pain to the shoulder.
5. Postural and Overuse Causes
Poor posture, repetitive activities, and heavy lifting can strain shoulder muscles and joints.
Frozen Shoulder: A Closer Look
Frozen shoulder (adhesive capsulitis) is a common cause of shoulder pain and stiffness. It progresses in three stages:
Freezing Stage (Painful Phase):
Gradual onset of pain and reduced range of motion.
Pain worsens at night or with movement.
Lasts 6 weeks to 9 months.
Frozen Stage (Stiff Phase):
Pain subsides, but stiffness predominates.
Daily activities become challenging.
Lasts 4 to 12 months.
Thawing Stage (Recovery Phase):
Gradual return of mobility and function.
Lasts 6 months to 2 years.
Treatment Options for Shoulder Pain
1. Conservative Management
Pain Relief:
NSAIDs (e.g., ibuprofen) for inflammation.
Corticosteroid injections for severe cases.
Physical Therapy:
Stretching and strengthening exercises to improve mobility and function.
Heat therapy to loosen the joint and ice therapy to reduce inflammation.
Hydrodilatation:
A procedure injecting fluid into the shoulder joint to stretch the capsule.
2. Surgical Management
Arthroscopic Capsular Release:
Surgery to release adhesions and improve movement, reserved for severe cases.
3. Home Remedies and Lifestyle Adjustments
Gentle stretching exercises like pendulum swings.
Supporting the arm with pillows during sleep.
Activity modification to avoid exacerbating pain.
When to Seek Medical Attention
Seek immediate medical advice if shoulder pain is accompanied by:
Persistent weakness or numbness.
Signs of infection, such as fever or redness.
Chest pain or shortness of breath, which may indicate a cardiac issue.
Prognosis
Most cases of shoulder pain, including frozen shoulder, improve with time and appropriate management. Recovery can take weeks to years depending on the cause. Early diagnosis and a tailored treatment plan are key to restoring shoulder function and reducing discomfort.
Dr Purity Carr
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