Shoulder Pain.


Shoulder pain is not a diagnosis or pathology in itself but a symptom. It may indeed not be caused by shoulder pathology but by pathology elsewhere in the body. However, shoulder pain is the most common reason to seek medical assistance.


Characteristics of Shoulder Pain:

Location:

The pain may be difficult to localize to a specific point. And its location may not directly correspond to the source of the pain. In many cases pain from the Gleno-Humeral (or ball and socket) joint or from the Subacromial Bursa or Impingement is felt on the side of the upper arm in the region of the deltoid muscle and may extend down the arm towards the elbow.

Pain from the Acromio-Clavicular joint may be more focused over the top of the shoulder and the joint itself.

Pain from neck pathology is frequently perceived extending from the neck over the shoulder girdle and may extend down the arm to the fingers.

Type of pain

The type of pain may differ in nature, it may be sharp or dull stabbing or throbbing etc. The onset of the pain may be spontaneous or traumatic. The pain may have exacerbating or relieving features.

Causes of shoulder pain:

Not all causes of shoulder pain are caused by problems in the shoulder. Some causes of shoulder pain include:

Gleno-Humeral joint arthritis
Acromio-Clavicular joint arthritis
Sub acromial bursitis / tendinosis / impingement
Rotator cuff tear
Gleno-Humeral joint instability
Acromio-Clavicular joint instability
Sterno-Clavicular instability
Biceps tendinosis
SLAP lesions
Adhesive capsulitis / frozen shoulder / intrinsic capsular stiffness
Muscle spasm
Cervical spine arthritis or disc disease.
Chest or abdominal problems.


How is the diagnosis made:

As with all conditions your doctor should take a history and examine you. Further tests may be necessary including Plain radiographs (X-Rays), Magnetic Resonance Imaging (MRI), Ultrasound (USS) and Nerve conduction studies. Injections may be used to further localise and/or treat the pain.

What is the treatment:

The treatment will of course be dependent on the final diagnosis and may include, physiotherapy, injection or sometimes surgery, either arthroscopic (key hole) or open (with a larger scar).

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