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Eight Common Causes of Shoulder Pain
Shoulder pain includes any pain that arises in or around your shoulder. Shoulder pain may originate in the joint itself, or from any of the many surrounding muscles, ligaments or tendons.
1. Shoulder Bursitis
Shoulder bursitis and rotator cuff tendonitis are different ways of saying there is inflammation of a particular area within the shoulder joint that is causing a common set of symptoms. Impingement syndrome occurs when there is inflammation of the rotator cuff tendons and the bursa that surrounds these tendons. Impingement syndrome is a descriptive term of pinching of the tendons and bursa of the rotator cuff between bones. Often there is an initial injury that sets off the process of inflammation.
2. Rotator Cuff Tear
Rotator cuff tears are a common injury of a complicated joint. In 2008, close to 2 million people in the United States went to their doctors because of a rotator cuff problem. A torn rotator cuff will weaken your shoulder. This means that many daily activities, like combing your hair or getting dressed, may become painful and difficult to do. When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears occur in the supraspinatus muscle and tendon, but other parts of the rotator cuff may also be involved. There are different types of tears.
· Partial Tear. This type of tear damages the soft tissue, but does not completely sever it.
· Full-Thickness Tear. This type of tear is also called a complete tear. It splits the soft tissue into two pieces. In many cases, tendons tear off where they attach to the head of the humerus. With a full-thickness tear, there is basically a hole in the tendon.
A tendon is a cord that connects muscle to bone. Most tendinitis is a result of a wearing down of the tendon that occurs slowly over time, much like the wearing process on the sole of a shoe that eventually splits from overuse. Generally, tendinitis is one of two types:
· Acute. Excessive ball throwing or other overhead activities during work or sport can lead to acute tendinitis.
· Chronic. Degenerative diseases like arthritis or repetitive wear and tear due to age, can lead to chronic tendinitis.
Splitting and tearing of tendons may result from acute injury or degenerative changes in the tendons due to advancing age, long-term overuse and wear and tear, or a sudden injury. These tears may be partial or may completely split the tendon into two pieces.
4. Frozen Shoulder
Frozen shoulder, also called adhesive capsulitis, is a condition that causes restriction of motion and pain in the shoulder joint. Frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue. It often causes pain and stiffness in the shoulder and over time, the shoulder becomes very hard to move. In frozen shoulder, the shoulder capsule thickens and becomes tight. Stiff bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint.
5. Shoulder Instability
Shoulder instability is a problem that occurs when the structures that surround the shoulder joint do not work to keep the ball tightly within its socket. Shoulder dislocations can be partial, with the ball of the upper arm coming just partially out of the socket. This is called a subluxation. A complete dislocation means the ball comes all the way out of the socket. Patients with shoulder instability often complain of an uncomfortable sensation that their shoulder may be about to shift out of place--this is what physicians call "apprehension."
Osteoarthritis is the most common type of shoulder arthritis. Also called wear-and-tear arthritis or degenerative joint disease, osteoarthritis is characterized by progressive wearing away of the cartilage of the joint. Osteoarthritis may be related to sports or work injuries and chronic wear and tear. Other types of arthritis can be related to rotator cuff tears, infection, or an inflammation of the joint lining. Shoulder arthritis typically affects patients over 50 years of age. It is more common in patients who have a history of prior shoulder injury. There is also a genetic predisposition of this condition.
7. Labral Tear
To compensate for the shallow socket, the shoulder joint has a cuff of cartilage called a labrum that forms a cup for the end of the arm bone (humerus) to move within. The labrum circles the shallow shoulder socket (the glenoid) to make the socket deeper. When a patient sustains a shoulder injury, it is possible that the patient has a labral tear. The labrum also becomes more brittle with age, and can fray and tear as part of the aging process. Symptoms of a labral tear depend on where the tear is located, but may include:
An aching sensation in the shoulder joint
Catching of the shoulder with movement
Pain with specific activities
8. SLAP Lesion
A SLAP tear is an injury to a part of the shoulder joint called the labrum. The shoulder joint is a ball and socket joint, similar to the hip; however, the socket of the shoulder joint is extremely shallow, and thus inherently unstable. The SLAP tear occurs at the point where the tendon of the biceps muscle inserts on the labrum. Common reasons for a SLAP tear include:
Fall onto an outstretched hand
Repetitive overhead actions (throwing)
Lifting a heavy object
Typical symptoms of a SLAP tear include a catching sensation and pain with shoulder movements, most often overhead activities such as throwing. Patients usually complain of pain deep within the shoulder or in the back of the shoulder joint.
Alex Visco, M.D. P.C.
25 Fifth Avenue, Suite 1F | New York, NY 10003
Phone 855.695.7742 | Fax 917.254.4873