The human shoulder joint can perform an extraordinarily wide range of movements, thanks to its ball-and-socket structure and precise interactions among its various soft tissues. Unfortunately, acute injuries, post-injury complications, and chronic pain conditions can cause your shoulder to stop functioning as it should.
If you suffer from severe shoulder pain or debilitating shoulder stiffness, you need to understand why these symptoms occur and what you can do to alleviate your discomfort. Take a look at four common shoulder problems and treatment options you might want to consider.
1. Rotator Cuff Tear
An arrangement of soft tissues collectively known as the rotator cuff holds your shoulder joint in place. These muscles and tendons also permit your arm to move at the shoulder in a variety of directions. The muscles of the rotator cuff include the subscapularis, supraspinatus, infraspinatus, and teres minor.
When any of these muscles or tendons sustains a tear, pain, stiffness, and inflammation may result. This type of injury may occur suddenly, or it may worsen over time with repetitive overuse. This continuous re-injury can make it impossible for the damage to repair itself properly, leaving you with chronic inflammatory pain and arm weakness.
Mild or small rotator cuff tears may respond well to a combination of anti-inflammatory drugs (including steroids) and physical therapy. However, significant tears may require surgical repair for complete recovery of function.
2. Frozen Shoulder
If your shoulder has grown so tight and stiff that you can barely move it, you may suffer from a condition called adhesive capsulitis, also known as frozen shoulder. This problem occurs when the connective tissues surrounding your joint capsule become abnormally thick and lose the synovial fluid that normally lubricates them.
Diabetics, thyroid disease sufferers, and people who have endured a long period of shoulder immobilization (an arm restrained by a sling, for example) may develop frozen shoulder. The initial development of symptoms lasts up to nine months, with symptoms leveling off for up to six more months. Return to normalcy may take two years.
As with rotator cuff tears, anti-inflammatory medications can help some cases of frozen shoulder. Your doctor may recommend fluid injections or manipulation under anesthesia to stretch and loosen the joint capsule. Arm stretches and flexion exercises may also help. If necessary, arthroscopic surgery can release the stiffened tissues.
3. Shoulder Bursitis (Impingement Syndrome)
The shoulder joint includes sacs called bursae that keep the bones and the tendons from rubbing together. However, these problem solvers can create problems of their own. When inflamed, swollen tendons press against a bursa, that bursa can become inflamed as well, a painful situation called bursitis or impingement syndrome.
Impingement syndrome usually causes pain along the outer surface of the shoulder. The pain may grow worse at night or when you raise your arm above your head.
Cortisone injections can prove highly effective in the treatment of impingement syndrome. These steroids reduce the swelling in the tendons and affected bursa. Physical therapy measures may include rest, ice, compression, and elevation (RICE) as well as specific exercises to keep the shoulder from stiffening up.
When conservative techniques fail, arthroscopic surgery can resolve bursitis. In this procedure, a small instrument enters the shoulder joint and removes the inflamed bursa.
4. Osteoarthritis
Nagging shoulder pain may stem from osteoarthritis. In this condition, the cartilage that protects the bone ends within the joint starts to wear out. This deterioration, accompanied by a reduction in lubricating synovial fluid, creates uncomfortable friction and bone spurs.
Shoulder osteoarthritis naturally develops over time, with most sufferers experiencing it after age 50. However, it can also occur due to a previous injury or joint trauma from extreme overuse.
Over-the-counter anti-inflammatory drugs can temporarily ease the pain and stiffness of shoulder osteoarthritis, but you also need to keep the joint as mobile as possible. Your doctor may prescribe a combination of moist heat, ice, and range-of-motion exercises. You may consider joint supplements such as glucosamine and chondroitin.
The doctors at Omaha Orthopedic Clinic and Sports Medicine can evaluate your shoulder problem, recommend treatment options, and administer the care you need to improve your shoulder function and comfort. Contact us today for more information.
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