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What causes shoulder pain? - Orthopaedic Surgeon, New Delhi, India, Gurgaon
Most shoulder problems will be localized and are relatively short-lived. Less commonly, shoulder problems may be part of a general condition such as rheumatoid arthritis, osteoarthritis or polymyalgia rheumatica.
There are several possible causes of localized shoulder pain:
• inflammation or damage to the muscles and tendons around the shoulder
• inflammation in the sac of soft tissue (bursa) that normally allows the muscles and tendons to slide smoothly over the shoulder bones
• damage to the bones and cartilage, which can be caused by arthritis.
Shoulder pain isn't always caused by a problem in the shoulder joint. Problems in the neck, for example, can cause pain that is actually felt over the shoulder blade or in the upper outer arm (this is known as referred pain). If your shoulder pain is accompanied by a tingling sensation, this is also more likely to be caused by a problem in the neck.
Specific conditions that affect the shoulder include:
• Acute calcific tendinitis – Inflammation caused by a deposit of calcium in a tendon. It's not yet known why calcium builds up in some people. The condition may not cause any symptoms but can sometimes cause intense pain and restricted movement
• Bicipital tendinitis – This causes pain on bringing the arm forward or flexing the elbow and tenderness over the tendon that lies in front of the shoulder joint. Very occasionally the biceps tendon may rupture causing bruising just above the elbow and causing the biceps muscle to bunch
• Brachial neuritis – This causes severe pain over the shoulder area, a sudden reduction in the range of movement, and wasting of the shoulder muscles
• Frozen shoulder – A 'frozen' shoulder (adhesive capsulitis) is where the joint capsule tightens preventing movement. It's not known why this happens though it sometimes follows an injury, a heart attack or stroke, and is much more common in people with diabetes
• Painful arc syndrome – In this condition pain is usually felt as the arm is lifted away from the body. There is usually inflammation in the tendon (supraspinatus tendinitis) and/or the bursa (subacromial bursitis). Often this occurs because there isn't enough space below the acromion for the tendons to pass freely (impingement syndrome)
• Rotator cuff tear – A torn rotator cuff is most common in people over 40. Although the name suggests an injury most people don't remember hurting themselves beforehand. Typically you may find you can't raise your arm properly especially above shoulder height. It isn't always painful, although some people have pain for a few weeks before they notice any difficulty with movement. The muscles between the neck and the shoulder tend to compensate for lack of movement in the rotator cuff muscles which results in hunching of the shoulder.
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