Shoulder pain is inarguably one of the most common orthopedic problems, impacting as much as 70% of the population at some point in their lives. However, just as no two patients are alike, neither are any two treatments.

Our team at Jefferson Orthopedic Specialists has had over forty years of treatment experience, which means that we're no stranger to helping shoulder pain! If you're suffering from a shoulder injury, this article will help answer any lingering questions regarding treatment. Whether the solution is simple or complex, we're here to help you navigate the process.

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Anatomy Of The Shoulder

The shoulder is a complex structure comprising the shoulder joint, shoulder blade (scapula), upper arm bone (humerus), and various muscles and tendons that enable movement. The shoulder joint itself is a ball-and-socket type, where the upper arm bone fits snugly into the socket of the shoulder blade. This design allows for a wide range of motion, from lifting your arm overhead to rotating it across your body.

The rotator cuff, a group of muscles and tendons surrounding the shoulder joint, is a crucial component. It includes tendons that attach the muscles from the shoulder blade to the upper arm bone, providing stability and mobility to the shoulder joint.

Most Common Causes Of Shoulder Pain

Rotator Cuff Tears and Tendinitis: These are among the most common sources of shoulder pain. Rotator cuff tears occur when the tendons of the rotator cuff separate or tear from the upper arm bone, often due to overuse or sudden injury. Rotator cuff tendinitis (also called rotator cuff tendinitis) involves inflammation of these tendons, causing severe pain and restricting motion.
Frozen Shoulder: Also known as adhesive capsulitis, frozen shoulder is a condition characterized by stiffness and pain in the shoulder joint. It typically develops slowly and in three stages: freezing, frozen, and thawing. Each stage can last several months. Shoulder Joint Bone Spurs: Bone spurs are bony projections that develop along the edges of bones. In the shoulder, they can lead to pain by creating friction within the joint or irritating the rotator cuff tendons. These are often seen in patients with ongoing shoulder issues or arthritis pain.
Referred Pain: Shoulder problems can cause pain to be felt in areas other than the shoulder, such as the chest or left jaw. This type of pain, which is called referred pain, occurs because the nerve supply to the shoulder overlaps with the nerves that supply other parts of the body, leading to pain sensations being felt elsewhere.

Diagnosing Shoulder Pain

The process of diagnosing shoulder pain can be intensive or simple, but in either case, it starts with identifying symptoms. Some of the most common symptoms include:

Intense Shoulder Pain and Significant Pain: Often indicative of conditions like rotator cuff tears or severe inflammation.
Inability to Lift Your Arm: This could signal a torn or severe rotator cuff problem, particularly when linked with intense pain.
Redness and Significant Pain: These symptoms could indicate inflammation or infection within the shoulder joint.
Abnormal Shoulder Movements and Tears: Symptoms such as these may point to chronic issues like rotator cuff tendinitis or injuries from poor shoulder posture.

Specific symptoms like sudden, intense shoulder pain or the inability to move the arm can suggest acute injuries, while persistent discomfort or reduced range of motion may be indicative of chronic conditions like tendinitis or degenerative changes in the shoulder.

Diagnostic Approaches

Aside from symptom identification, the remaining steps involved in the diagnostic process include:

Physical Examination by a Shoulder Specialist: A shoulder pain doctor will perform a thorough physical examination, focusing on the range of motion, the presence of pain with certain movements, and the physical integrity of the shoulder muscles and tendons. They will also assess for any shoulder dislocations, shoulder blade problems, or bicep muscle issues that might contribute to the symptoms.
Use of Imaging Tests: Imaging tests such as X-rays, MRIs, or ultrasounds are crucial in visualizing the internal structure of the shoulder. These tests help in identifying rotator cuff tears, abnormalities in the shoulder socket, and other structural issues like bone spurs or broken bones.
Blood or Imaging Tests to Rule Out Other Conditions: In cases where the cause of shoulder pain is not apparent, blood tests may be conducted to rule out systemic conditions that might mimic shoulder pain, such as a heart attack or rheumatic diseases.

Non-Surgical Shoulder Pain Solutions

Before considering more severe treatment options, specialists will attempt to treat shoulder pain using less invasive solutions. Below are some of the most commonly utilized non-surgical methods.

Physical Therapy

A physical therapist specializes in assessing and treating shoulder problems. They develop personalized treatment plans based on the specific conditions diagnosed through imaging tests or physical examinations. Their goal is to restore function, decrease pain, and prevent further injury.

Therapists prescribe exercises designed to strengthen the shoulder muscles, improve flexibility, and enhance the range of motion. These exercises might focus on the rotator cuff tendons and another group of muscles around the shoulder blade and socket, ensuring that movements do not exacerbate existing issues like a torn rotator cuff or lead to abnormal shoulder movement tears.

Medications

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These are commonly prescribed to reduce inflammation and manage pain in your shoulder. NSAIDs can be effective for a wide range of shoulder problems, from rotator cuff problems to more general joint pain.
Corticosteroids: In cases where NSAIDs are insufficient, corticosteroids may be administered either orally or through injections into the shoulder. This treatment is particularly beneficial for severe inflammation and can be part of a comprehensive physical therapy surgery plan.

Lifestyle Adjustments

Maintaining Good Shoulder Posture: Proper posture is crucial to avoid putting undue stress on the shoulder area, especially for those with rotator cuff problems or a history of shoulder dislocations. Good posture helps maintain alignment and prevent issues like frozen shoulders.
Applying Ice and Heat: Applying ice to the shoulder can help reduce acute inflammation and pain, whereas applying heat can relax and loosen tissues and stimulate blood flow to the area. Healthcare providers often recommend this practice to manage symptoms at home.
Modifying Activities: Depending on the specific shoulder problem, certain activities may need to be modified or avoided to prevent exacerbating the pain. This can include changing how you lift objects or adjusting your work and sports routines to avoid movements that strain the shoulder.

Surgical Interventions for Shoulder Pain

Unfortunately, shoulder pain cannot always be resolved through non-surgical means. If the problem proves too severe, orthopaedic surgery will be utilized to correct the problem at its root.

When Surgery Is Needed

Surgery may become necessary for managing shoulder pain in several specific circumstances:

Severe Injury: Major trauma leading to shoulder dislocation, severe rotator cuff tears, or complex fractures.
Ineffective Non-Surgical Treatments: When physical therapy, medications, and lifestyle changes fail to alleviate shoulder pain or improve function significantly.
Chronic Conditions: Severe degenerative conditions like chronic tendinitis or advanced arthritis that impair daily activities and cause persistent pain.

Types of Surgical Procedures

Various surgical options are considered depending on the nature and severity of the shoulder problem:

Arthroscopy: This minimally invasive surgery diagnoses and treats joint problems. For the shoulder, it often involves repairing torn rotator cuff tendons, removing loose cartilage, or excising bone spurs that limit the range of motion. Arthroscopy can significantly reduce shoulder pain and restore function with less recovery time than open surgery.
Shoulder Replacement: In cases of severe arthritis or massive rotator cuff tears where the shoulder joint is extensively damaged, a total shoulder replacement might be necessary. This procedure involves replacing the damaged parts of the shoulder with artificial components, restoring the wide range of motion, and alleviating the pain in your shoulder.

Preventive Measures for Shoulder Pain

Consulting with experts in sports medicine can offer valuable insights into the proper mechanics of shoulder movements during physical activity. This guidance is especially beneficial for athletes or individuals engaged in regular physical exercise, helping them maintain optimal shoulder health and prevent injuries.

Avoiding Actions That Encourage Abnormal Shoulder Movement Tears

Educate on Proper Techniques: Learning and applying the correct techniques for lifting, throwing, or performing overhead activities can reduce the risk of rotator cuff problems and other shoulder injuries.
Regularly Apply Ice and Heat: Using ice packs to manage minor inflammation and heat to relax tight muscles can be effective strategies to prevent chronic conditions from developing. Miller's Orthopaedic Sports Medicine suggests that regular application of ice after strenuous activities helps in reducing inflammation and preventing rotator cuff tears.
Avoid High-Risk Activities: If certain movements or activities consistently cause shoulder pain, it may be advisable to modify or avoid these actions to prevent exacerbating existing conditions or creating new injuries.

Get Shoulder Pain Treatment Today With Jefferson Orthopedic Specialists

If you're battling shoulder pain or suspect issues like rotator cuff tears or other related conditions, don't hesitate to get expert advice. Quick action can greatly improve your recovery, and help dodge persistent issues down the line. Thankfully, Jefferson Orthopedic Specialists are here for you.

At Jefferson Orthopedic Specialists, we do more than just manage shoulder issues—we partner with you on your journey to full physical health. Shoulder problems can really throw a wrench in your daily life, but our team is committed to helping you return to your favorite activities completely pain-free. Let's tackle this together and get you moving freely again!

Don't let shoulder pain hold you back. Contact our highly skilled team of orthopedic and physical therapy specialists at Jefferson Orthopedic Specialists to request a consultation today. Start your journey towards a healthier, more active future with a partner committed to your recovery and well-being.