Shoulder Pain and How to Get Rid of It for Good
The shoulder is the most mobile and one of the most unstable joints in the human body.
Do you find yourself waking up with shoulder pain that does not ease even during the day? Shoulder pain that radiates down the arm or appears when you lift your arm can make even the simplest everyday activities a challenge. Although shoulder pain can be very limiting and unpleasant, it can be treated successfully.
Yes, you heard that right – it is possible to regain freedom of movement and lead an active life without limitations, and physical therapy can certainly help you with that.
How does shoulder pain develop?
The shoulder is the joint with the greatest range of motion, whose stability is supported by nine muscles. However, because of its specific structure, which includes a loose joint capsule, it belongs to the unstable joints. The shoulder is, in fact, a very complex system made up not of one, but five joints.
It is precisely for this reason that injuries and restricted movement or loss of shoulder function can occur. Shoulder pain can appear as a result of injury, but also while performing everyday activities, and even during sleep.
Shoulder pain can also be the result of muscle and joint diseases, joint injury, viral infection, the aging process, or degenerative changes. The pain can be acute (rotator cuff tendon injuries, dislocations) or chronic.
Chronic pain appears as a result of long-term strain and repetitive movements, such as sports injuries. An acute pain condition lasts up to 12 weeks, and it is best to begin therapy during that period. A chronic pain condition develops after three months and requires a longer recovery period than an acute condition.
Shoulder pain is most often accompanied by restricted mobility when raising the arm upward, moving the arm away from the body to the side, as well as during internal and external rotation of the shoulder. Sometimes shoulder pain that radiates down the arm can spread all the way to the fingers, along with tingling in the arm.
A painful shoulder does not always appear immediately after an injury, and the pain can often be unnoticeable or mild. However, as time passes, the pain can become increasingly severe and unbearable. That is why it is very important for shoulder damage to be diagnosed and identified in time, for better treatment and to prevent the development of more serious problems.
Shoulder pain - symptoms
Just as there are different causes, there are also different symptoms of shoulder pain, but they usually present as:
- shoulder pain that appears during movement or while performing a certain action (e.g. holding or lifting things)
- restricted shoulder mobility
- pain and difficulty when raising the arm
- a tingling sensation in the shoulder
- a feeling of discomfort and heaviness in the shoulder
What causes shoulder pain?
The causes of shoulder pain are not entirely clear or known, but it is assumed that different parts of the connective tissue react differently to stimuli and damage of an internal and external nature. Most often it involves injuries (trauma), micro-traumas, overload, psychological and emotional tension, and exposure to cold, damp…
Shoulder pain is often connected with pain in the neck or shoulder blade, since these are the closest neighboring segments. Neck pain that spreads along the arm (accompanied by tingling and burning) most often indicates damage in the cervical part of the spine that extends along the nerve fibers toward the arm.
The most common cause of such pain is damage and pressure from a disc on the spinal canal, with the side – right or left arm – depending on where the pain travels. Symptoms include morning stiffness of the neck and shoulder, as well as neurological pain in the form of arm tingling that can also occur during the night.
Pain in the left shoulder
If pain appears in the left shoulder and upper arm, a potential cause of the pain may be a heart attack (myocardial infarction), in which case it is important to seek medical help urgently. Usually, along with pain in the shoulder and neck, shoulder blade, and upper arm, there is also difficulty breathing (dyspnea) accompanied by tightness in the chest.
It can even happen that pain in the left shoulder and upper arm appears without any other complaints, while it is still a matter of a heart attack. For this reason, pain in the left shoulder should be taken seriously and an ECG should be done in all cases.
Particular attention should be paid to people who have one or more risk factors for heart disease, which may include obesity, high blood pressure, diabetes, or smoking.
Shoulder pain and tingling in the right arm
Pain in the right shoulder and arm is one of the common problems faced by people in the modern age.
Shoulder pain can move into the arm and cause tingling of the arm, and it is also possible that a condition affecting the upper arm and causing pain is felt around the shoulder. You are surely wondering, why does shoulder pain and tingling in the right arm occur?
Generally speaking, the most common cause of this type of pain is problems with the rotator cuff. The rotator cuff is a group of four small muscles (supraspinatus, infraspinatus, subscapularis, and teres minor) and a network of tendons that hold and connect the upper arm to the shoulder.
As its very name suggests reinforcement, these muscles and tendons have the role of keeping the head of our upper arm bone in the shoulder. Injuries or excessive strain on the rotator cuff tissue can cause shoulder pain and lead to various conditions.
Whether it is the right or left shoulder, pain in the shoulder and arm can also appear as a result of the following conditions:
- disease of the cervical spine (cervical syndrome)
- nerve damage in the cervical spine (cervicobrachialgia) and pain that spreads to the shoulders
- disease of the thoracic spine (thoracic syndrome)
- diabetes with nerve damage (diabetes mellitus with polyneuropathy)
- anginal heart pain, myocardial infarction
- gallbladder disease
- lung tumor
What are the most common causes of shoulder pain?
Shoulder pain can occur due to damage or injury, but also due to aging and degenerative changes, osteoarthritis, gout, and other diseases. The most common causes of shoulder pain are:
- Injuries: strains, dislocations, fractures (distensions, joint distortions, fractures)
- Bursitis (bursitis)
- Arthrosis (osteoarthritis) or humeroscapular periarthritis
- Arthritis of the joint as part of inflammatory rheumatism, bacterial, reactive
- Calcification of the shoulder
- Tendon inflammation (shoulder tendinitis)
- Frozen shoulder
Shoulder injury and fracture
Shoulder injuries can be caused by mechanical damage or inflammatory processes. Mechanical damage can occur within the shoulder joint itself, in the form of damage to the ring that surrounds the cartilage (the labrum).
Damage may also occur to the shoulder blade, most often in the form of partial separation of the joint surfaces (subluxation) and dislocation of the shoulder (luxation) or of the head of the upper arm bone (caput humeri). This occurs due to trauma, fracture, or damage to the joint capsule, tendons, and muscles of the shoulder.
It usually appears after traffic accidents, falls, blows, and shoulder joint overuse syndrome.
Bursitis (bursitis)
The body has developed its own defense mechanisms against injuries that arise from excessive friction between two tissues, in the form of fluid-filled sacs (bursae).
These “sacs” are filled with fluid that reduces friction during movement. Although bursae have the ability to adjust the amount of fluid, due to chronic friction, inflammation can occur. They then become a source of additional shoulder pain (acute bursitis).
If bursitis of the rotator cuff (subacromial bursitis) occurs, swelling from the injury can lead to friction and pinching of the muscles and tendons through a narrow space.
This pinching can cause discomfort and a sensation of the muscle being squeezed. Bursitis can be painful, but it is treated successfully with pain medication and physical therapy.
Shoulder arthrosis (osteoarthritis)
Arthrosis is a condition that arises due to damage to the cartilage within the shoulder joint itself. This can result in insufficient lubrication and secretion of synovial fluid, which further leads to friction of the bones in the joint.
Shoulder arthrosis often occurs in older people due to the natural aging of tissue, but it can also appear as a result of injuries or excessive strain.
Damaged cartilage, together with degenerative changes in the joint, can cause pain, restricted mobility, and inflammation.
In addition to physical therapy, non-steroidal medications to reduce pain and the inflammatory process are also recommended in treatment.
Arthritis
In addition to osteoarthritis, there are several other types of arthritis that can cause shoulder pain:
Post-traumatic arthritis can develop when a shoulder injury heals, but long-term damage remains.
Rheumatoid arthritis is a chronic autoimmune disease that attacks the joints in the body, including the shoulders.
Rotator cuff tear arthropathy potentially occurs as a result of a tear of the rotator cuff.
Avascular necrosis usually occurs due to a fracture or disease when something blocks the flow of blood to the bone tissue.
Shoulder calcification (calcific tendinitis)
Calcific tendinitis is a painful condition that develops through the accumulation of calcium deposits within the tendons that pass through the shoulder.
Pain and irritation increase as the deposits grow larger. Calcium deposits can usually be seen on X-rays.
Shoulder tendon inflammation (shoulder tendinitis)
One of the most common causes of shoulder pain is inflammation of the shoulder tendons, that is, tendinitis (tendonitis). This type of pain mainly develops due to excessive or improper exercise.
Apart from mechanical injuries that arise from tearing of the rotator cuff tendons (total or partial ruptures), tendon inflammations of a milder or more serious condition can occur.
Due to a tendon rupture, movements become impossible or very painful, with restricted mobility.
Shoulder pain can also arise as a result of inflammatory processes in the tendons, which can occur if a tendon has not fully healed.
Inflammatory processes most often affect the tendons, such as enthesitis (inflammation at the points where tendons attach) and a group of neck muscles (such as the supraspinatus, infraspinatus, and teres minor).
Although inflammation of the shoulder tendons can be limiting, it is treated successfully with pain medication and physical therapy.
Physical therapy can help by accelerating tissue regeneration and the healing of damage.
Various techniques are used, such as electrical currents (IFS, TENS, DD), ultrasound, laser, magnet, and the Tecar device. If tendon inflammation lasts for a long time, frozen shoulder syndrome can develop.
What is frozen shoulder?
Under normal circumstances, the shoulder joint is lubricated by synovial fluid that is secreted during movement.
However, in frozen shoulder, due to the rigidity of the joint and reduced mobility, there is a reduced secretion of synovial fluid.
That is why restricted mobility, spasm (muscle contraction), and stiffness of the ligaments, tendons, and muscles of the shoulder occur, after which an inflammatory process may also develop.
It most often develops gradually, as spontaneous pain with the appearance of a restricted range of motion, although (in 25% of cases) it can begin suddenly and quickly.
It can lead to the development of shoulder arthrosis and a degenerative joint condition. Frozen shoulder is also known as adhesive capsulitis.
Although the cause of frozen shoulder is still not known, a shoulder injury, a condition following joint surgery, thyroid disease, autoimmune diseases, and stress are often considered causes.
What are the symptoms and how is frozen shoulder treated
The disease process goes through four phases; however, whether all phases will develop and how long they will last depends on when the treatment process was started.
First, shoulder pain appears that is pronounced even during the night, and every movement intensifies it. The range of motion and function of the shoulder become increasingly restricted over time, up to complete stiffness. In rare cases, it can also affect the other shoulder.
In addition to medication and positioning of the joint (immobilization), physical therapy under the supervision of a professional is of essential importance in treating frozen shoulder.
The physical procedures that are carried out are laser therapy, TENS, electrophoresis, magnetotherapy, etc. Of particular importance is kinesitherapy with the application of active and passive exercises that are performed without provoking pain, with gradual stretching and strengthening of the muscles and the shoulder blade.
What can you do at home to prevent shoulder pain?
- Above all, identify the causes of shoulder pain and reduce them as much as possible. For example, if the pain appears after exercise, seek a trainer’s help, since it is possible that you are not performing some exercises correctly. If you are not physically active, introduce some activity. Do you sit at a computer for a long time? Set up your workspace so that your body is in the correct position, and take a walk during your break.
- Rest the shoulder and avoid straining it. Until the severe pain stops, introduce a period of rest (shoulder immobilization).
- Use cold and warm compresses. Cold compresses can help reduce pain and inflammation, while warm compresses help relax the muscles and reduce cramps.
- Pain medication and cream (such as acetaminophen or ibuprofen) can help reduce shoulder pain.
- Exercise regularly. Exercises can be helpful in reducing shoulder pain and improving arm mobility. Make sure to do them correctly and consult a physiotherapist.
- Massage often has a beneficial effect and helps to improve circulation and reduce pain and inflammation in the shoulder.
Treatment for shoulder pain
Shoulder diagnostics usually begins with a specialist examination by a physiatrist, orthopedist, or physiotherapist.
If necessary, the doctor will request X-rays, magnetic resonance imaging (MRI), or ultrasound, depending on the condition and injury. In order to get rid of shoulder pain permanently, the most important thing is to identify the cause of the pain and to define the therapeutic process accordingly.
After the specialist examination and functional assessment by the therapist have been carried out, physical therapy begins.
Therapy includes analgesic procedures using BTL electrical current devices (TENS, IFS, diadynamic, electrophoresis, muscle stimulation), as well as therapy with Tecar radio waves and magnet. These therapies are often combined with ultrasound and laser.
Sometimes medications are used to reduce pain, and after that, mobility and strengthening exercises are started, which play a key role in recovery.
The goal is to restore the functionality of the shoulder and return the condition to what it was before the injury.
Depending on the cause of the shoulder pain, treatment may include needle puncture of the joint in the case of arthritis, or a local injection of corticosteroids that act against inflammation and reduce pain.
In addition to pain medication and physical therapy, surgical treatment is necessary in certain cases.
Shoulder fracture - recovery
A shoulder fracture can be treated surgically or conservatively, depending on the degree of the fracture and the decision of the orthopedist, who will determine the appropriate approach to treatment.
The speed of recovery and bone healing depends most on the patient’s age and the degree of the fracture.
An appropriate medication and cream can also be helpful. After a period of rest and removal of the immobilization, it is important to start exercises as soon as possible.
Their goal is to restore the mobility of the shoulder, in order to avoid the shortening of the ligaments, muscles, and the joint capsule itself.
Exercises are usually performed with the assistance of a therapist. There are two types of assistance: passive assistance and active-assisted assistance. In the case of passive assistance, the therapist helps the patient perform the movement.
With active-assisted assistance, the patient performs the movement with the therapist’s help. These techniques allow a gradual increase in shoulder mobility and a reduction of limitations.
For rehabilitation to be complete, it is important to continue with kinesitherapy, which includes exercises for treating pain, improving mobility, and strengthening the muscles.
Do you feel shoulder pain that radiates down the arm, or does the pain appear when you raise your arm? Do you feel pain in your left shoulder? Do not worry, you are in the right place.
With appropriate physical therapy, most patients are successfully cured of shoulder pain. At the Dynamic Fizio Physiotherapy Center, you can receive detailed examinations and begin treatment that will quickly bring relief and healing.
Do you want to lead a life in which shoulder pain will no longer be present? Our expert team is at your disposal, and the first examination and consultation are completely free.
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When it comes to assessing the length of recovery, our team will determine and give the necessary guidelines for the fastest and best recovery. Not sure yet? You are just one click away from a free consultation.
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Related services: for shoulder pain we recommend kinesitherapy, electrotherapy, and Tecar therapy. For an appointment, book an examination.