To treat shoulder pain effectively, orthopedic and sports medicine specialists must first determine the cause of the problem.
Shoulder pain can occur due to a variety of issues within the joint or among any of the surrounding muscles, tendons, ligaments or bones. A number of diseases, chronic conditions and injuries can also create or contribute to shoulder pain.
Bursitis is a condition involving inflammation in the bursae, or small, fluid-filled sacs that cushion the joints and counteract friction. Often, bursitis occurs as a result of repetitive motions or positions that put pressure on a joint, but it may also be caused by trauma or inflammatory arthritis.
Tendinitis is a term for irritation or inflammation of a tendon, usually one of the biceps rotator cuff tendons. Also referred to as pitcher’s shoulder, tendinitis often develops from repetitive overhead throwing or similar repeated motions. Degenerative diseases can also lead to tendinitis.
Acute injury or advanced degeneration in the rotator cuff or biceps tendons can result in splitting and tearing. Tears are often partial, but a complete split of the tendon is possible. With many complete tears, the tendon is no longer attached to the bone.
Shoulder Labral Tear
The labrum, or the rim of cartilage that cushions and stabilizes the joint, can be torn as a result of repetitive motion, particularly in patients over age 40. Shoulder pain from a labral tear can also be caused by acute trauma.
Impingement occurs when the rotator cuff tendons and bursae are compressed or pinched between the shoulder bones. This syndrome may involve a combination of problems, including bursitis, tendinitis and rotator cuff tears. Impingement is typically caused by repeated overhead movements.
Overuse or sudden injury can cause instability, a condition in which the upper arm bone is forced out of the socket. Dislocations may be partial or complete. When the tendons, ligaments and muscles surrounding the joint loosen or tear, repeated dislocations can occur.
Shoulder pain is often due to one of the many types of arthritis — in most cases, osteoarthritis is the culprit. Osteoarthritis is a joint disorder that develops slowly and worsens over time. The condition may be related to a work or sports injury or chronic wear and tear.
A fracture is a broken bone, and the condition can be caused by a fall, motor vehicle accident, contact sports injury or other acute trauma. The collarbone, upper arm bone and shoulder blade are most commonly affected.
Less common causes of shoulder pain include infection, tumors and nerve-related problems. Conditions that affect the chest structures, such as heart disease and gallbladder disease, may also sometimes generate pain in the shoulder.
A shoulder specialist can perform a full range of diagnostic assessments to identify — and then treat — the cause or causes of the problem, and rule out the possibility of more serious health conditions.
For more information, or for expert diagnosis and treatment of shoulder pain, schedule a consultation with a local physical medicine and rehabilitation physician.