Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. The shoulder has a wide and versatile range of motion. When something goes wrong with your shoulder, it hampers your ability to move freely and can cause a great deal of pain and discomfort.

Structure

The human shoulder is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder make up the shoulder joints.

• Glenohumeral joint – where your upper arm bone (the humerus) connects with your shoulder blade (scapula)
• Acromioclavicular joint – where the top of your shoulder blade meets your collarbone (clavicle).

In human anatomy, the shoulder joint comprises the part of the body where the humerus attaches to the scapula. The shoulder is the group of structures in the region of the joint.

The shoulder joint is the main joint of the shoulder. It is a ball and socket joint that allows the arm to rotate in a circular fashion or to hinge out and up away from the body. The joint capsule is a soft tissue envelope that encircles the glenohumeral joint and attaches to the scapula, humerus, and head of the biceps. It is lined by a thin, smooth synovial membrane.

The rotator cuff is a group of four muscles that surround the shoulder joint and contribute to the shoulder’s stability. The cuff adheres to the glenohumeral capsule and attaches to the humeral head.

However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.

If you can’t lift your arm above your head without discomfort, anything from a frozen shoulder to a rotator cuff injury to a dislocated shoulder could be to blame. Our guide to shoulder pain will help you pinpoint why yours hurts–and when you should consider a doctor.

Symptoms

• Weakness of the shoulder/upper arm. Depending on the condition, there may be a sensation of the joint slipping out and back in to the joint socket, or the shoulder can become completely dislodged (dislocated)
• Pain deep in the shoulder joint, in the front or the back of the shoulder and the upper part of the arm. Sometimes the pain in the shoulder can be described as a ‘catching pain’. The location and type of pain is likely to relate to the structure causing the pain
• Reduced movement, and pain when moving your shoulder.
• Sensations of pins and needles (tingling) and burning pain. This is more likely to be associated with nerves from the neck than the shoulder joint itself.
• Lack of movement after a shoulder dislocation. This is usually due to pain. Complete rotator cuff tears and injury to the axillary nerve both cause weakness in moving the arm away from the body. These problems require close clinical examination.

When to see a doctor

Unless you’ve had a serious injury or get a sudden, continuous pain, you can usually treat your shoulder pain without having to see your doctor.

• If, after two weeks of treating yourself, you feel the pain isn’t any better you should see your doctor or a physiotherapist.
• See your doctor immediately if you develop severe pain in both shoulders
• If you have pain in your thighs.
• Feeling feverish or unwell constantly.
• Inability to move your shoulder, lasting bruising, heat and tenderness around the joint, or pain that persists beyond a few weeks of home treatment.
• If your shoulder pain is sudden and not related to an injury. It may be a sign of a heart attack.

Causes

As the shoulder has the most activities, several factors and conditions can contribute to shoulder pain. The most prevalent cause is rotator cuff tendinitis.

Sometimes shoulder pain is the result of injury to another location in your body, usually the neck or biceps. This is known as referred pain. Referred pain generally doesn’t get worse when you move your shoulder.

Other causes of shoulder pain include:

• damage to the muscles and tendons around the shoulder
• damage to the bones and cartilage, which can be caused by arthritis.
• torn cartilage
• torn rotator cuff
• tension in the muscles between the neck and shoulder – this is often linked the way you stand or sit when you’re using a computer or at work
• bone spurs (bony projections that develop along the edges of bones)
• pinched nerve in the neck or shoulder
• broken shoulder or arm bone
• injury due to overuse or repetitive use
• spinal cord injury
• heart attack

Diseases

For shoulder disease diagnose patients age, dominant hand, work activities, sport type is considered important to recognise the exact disease or fracture. Here is the list of common diseases as well as the rare ones.

• Arthritis – the cartilage of the ball and socket (glenohumeral joint) is lost. It may be caused by wear and tear (degenerative joint disease), injury (traumatic arthritis), surgery (secondary degenerative joint disease), inflammation (rheumatoid arthritis) or infection (septic arthritis)
• Acromioclavicular articulation – Acromioclavicular and a small disk of cartilage located in between the acromion and the clavicle. This disk can wear down through injury, extreme joint stress (via bodybuilding) or normal wear.
• Frozen shoulder (adhesive capsulitis) – movement of the shoulder is severely restricted in people with a “frozen shoulder“. This condition, which doctors call adhesive capsulitis, is frequently caused by injury that leads to lack of use due to pain.
• A Slap Tear (Lesion) – This tear occurs when the cartilage of the shoulder (labrum) delaminates from glenoid. This causes an instability of the shoulder, typically in overhead movements.
• Tendinitis– This is inflammation (redness, soreness, and swelling) of a tendon. In tendinitis of the shoulder, the rotator cuff and/or biceps tendon become inflamed, usually as a result of being pinched by surrounding structures.
• Bursitis – An inflamed bursa is called bursitis. Tendinitis and impingement syndrome are often accompanied by inflammation of the bursa sacs that protect the shoulder. Inflammation caused by a disease such as rheumatoid arthritis.
• Rotator cuff – A group of four tendons that blend together as they attach to the upper end of the arm bone (humerus). Normally these tendons transmit the force of muscles originating on the shoulder Blade (scapula) to the arm providing motion and stability.
• Sternoclavicular separation – This may affect shoulder functionality due to problems with sternoclavicular rotation.
• Separated shoulder – A shoulder separation occurs where the collarbone (clavicle) meets the shoulder blade (scapula). When ligaments that hold the AC (acromioclavicular) joint together are partially or completely torn, the outer end of the clavicle may slip out of place,
• Dislocated shoulder – a strong force that pulls the shoulder outward (abduction) or extreme rotation of the joint pops the ball of the humerus out of the shoulder socket. Broken arm ,Broken collarbone are other injuries.
• Avascular necrosis(death of bone tissue due to limited blood flow)
• Impingement – bursa or rotator cuff trapped and compressed during shoulder elevation movements
• Brachial plexus injury – The injury occurs when the nerves are stretched, compressed, or in the most serious cases, ripped apart or torn away from the spinal cord.
• Osteoarthritis (disease causing the breakdown of joints)
• Polymyalgia rheumatica
• Rheumatoid arthritis (inflammatory joint disease)
• Septic arthritis
• Thoracic outlet syndrome
• Torn cartilage

Remember, if you’re ever struggling with a pain for a long, don’t suffer in silence, find the best doctor to your nearest location. And talk to a healthcare professional today!