shoulder is a joint supported by tendons and muscles to provide a wide range of
movement. Owing to the mobility, the shoulder is susceptible to several
conditions that stem from instability or impingement of soft tissues or bony
structures. These lead to pain in the shoulder. Shoulder pain may range in
severity from mild to severe; it may be temporary or long lasting warranting
diagnosing the cause of shoulder pain, the doctor takes a detailed medical
history about the pain, its onset, duration, severity, conditions that
aggravate pain, other diseases that the person has. A physical examination is
then done to assess the shoulder joint clinically. Various imaging modalities
such as X-rays, MRI, CT scans or ultrasound may be employed. Nerve functions
may be assessed using electrical studies (EMG- Electromyogram).
is an X-ray of the shoulder taken after injecting a dye; it helps in better
visualisation of the joint. Those injuries that are not apparent from any other
imaging modalities may be viewed by arthroscopy. This is a surgical procedure
in which the doctor can visualize the joint with a fiber-optic camera.
Arthoscopy can be used to find the cause of pain and also to correct the
rest to the joint often relieves pain and allows inflammation to subside.
Prolonged immobilization may lead to frozen shoulder; hence caution has to be
exercised. Local application of moist heat or ice can relieve mild pain. Pain
killers like ibuprofen, naproxen or paracetamol (acetaminophen) are commonly
prescribed for pain. Muscle relaxant drugs are also employed when required.
Chronic pain may even require antidepressant drugs. Physical therapy and
specific exercises are helpful in certain conditions. Your doctor may also
prescribe injections of cortisone (steroid) to bring down inflammation at
is indicated for a number of conditions that cause shoulder pain. Recurring
dislocation is a common reason for employment of surgical correction.
Arthroscopy may be used in certain cases. Open procedures may be required for
larger reconstructions or shoulder replacement.
Causes of Shoulder Pain
and tendinitis of the rotator cuff
are the commonest causes of shoulder pain. Bursae are small sacs that act as
cushions between bones, tendons, muscles and joints. They contain a fluid
called synovial fluid. Inflammation of a bursa is called bursitis. Tendinitis
is an inflammation or irritation of a tendon that attaches bone to muscle.
Rotator cuff is a group of muscles and tendons that act to stabilize the
shoulder joint. Bursitis or tendinitis may follow repetitive and overuse of a particular
Rotator cuff tear:
of the tendons of the rotator cuff from bone due to injury leads to rotator
cuff tear. This condition may need surgical correction.
Frozen shoulder (Adhesive capsulitis):
this condition, the joint capsule becomes inflamed and stiff. This greatly
restricts motion and causes chronic pain. It usually follows an injury due to
which the patient restricts movement of the arm at the shoulder joint.
of calcium within a tendon, especially within the rotator cuff tendons, leads
to shoulder pain.
Injury or over use may compromise the stability of shoulder joint. The head of
the upper arm bone (humerus) may be forced out of the shoulder socket. This may
be partial (subluxation) or complete. Subluxations or dislocations may occur
repeatedly in persons leading to increased risk of arthritis. The dislocation
can be diagnosed through careful physical examination.
is a painful condition resulting from chronic wear and tear, sports or work
injuries. Arthritis may cause pain severe enough to force people to avoid
(broken bones) commonly involve the collar bone (clavicle), upper arm bone
(humerus), and shoulder blade (scapula). Fractures follow an injury and lead to
pain, swelling, and bruising about the shoulder.
Frequently Asked Questions1. My shoulder clicks, snaps and pops. Is it
disruption in the normal architecture of the shoulder joint, tendons, ligaments
and muscles may be responsible for a snapping or popping shoulder, or a
clicking sound. Chronic stress or trauma may lead to this. The condition is not
significant all the time, especially when there is no associated pain.
Condition like dislocation or labreal tears need correction.
2. What are labreal tears or SLAP (Superior
labral anterior-posterior) lesions?
are injuries to the part of the shoulder called labrum. The glenoid labrum is a
fibrocartilaginous ligament that forms the margin of the glenoid cavity of the
shoulder joint (the socket).
3. What is a ball and socket joint?
arrangement of the shoulder where the ball like part of the upper arm bone
(humerus) works within a socket (the glenoid cavity) is an example for a ball
and socket joint.