Painful shoulder conditions that limit movement are common, and
are caused by problems with the shoulder joint and its surrounding structures.
The shoulder is more prone to injuries than other joints because of its wide
range of movement.
Common causes
of shoulder pain
There are several
conditions that cause pain and limit movement of the shoulder joint, including
the following.The rotator cuff is a group of muscles and tendons that help to
move the shoulder and hold the joint in place. Rotator cuff disorders result
from inflammation or damage to the rotator cuff muscles or tendons, or
inflammation of the subacromial bursa (which is a fluid-filled pad that sits
under the highest part of the shoulder). The inflammation can be caused by
general wear and tear that occurs with age, activities that require constant or
repetitive shoulder motion (especially above shoulder level), heavy lifting,
trauma, or poor posture. Serious rotator cuff injury and untreated
inflammation of the tendons can cause the rotator cuff to tear.
Treatment
In addition to relieving pain, treatment is aimed at restoring
mobility in your shoulder joint. The choice of treatment depends on the
shoulder problem.
Pain relievers such as paracetamol and non-steroidal
anti-inflammatory drugs (NSAIDs) are often used as an initial treatment for
shoulder pain. Another simple way of easing shoulder pain is by applying a cold
pack to your shoulder. Cold packs can reduce inflammation, and are most helpful
when applied for the first few days following a shoulder injury. After that,
you can switch to using a heat pack; intermittent applications of heat can help
relax the shoulder muscles.
You should also rest the shoulder for a couple of days after
most injuries, and if you have dislocated your shoulder, you may need to rest
your arm in a sling or splint for several weeks after the joint has been
manipulated back into place. However, with most shoulder problems it isn't a
good idea to rest for too long. While you should avoid strenuous activities and
lifting heavy objects, you should still move your shoulder to help make sure
that you regain full use of the joint. By returning to your normal activities
as soon as possible (within the limits of disability and pain), you can help
prevent the shoulder joint from stiffening up.
·
Physiotherapy: Physiotherapy
can help improve shoulder strength and flexibility as well as relieve the pain
associated with most shoulder problems. Physiotherapists use a variety of
different therapies, including massage, ultrasound therapy, laser therapy and transcutaneous
electrical nerve stimulation (TENS) — a therapy that uses mild electrical
currents to treat pain. Taping the joint can also help stabilise it and reduce
pain during activities.Physiotherapists can also teach special rehabilitation
exercises to stretch and strengthen the rotator cuff muscles of the shoulder.
Exercises that improve your shoulder's range of movement help reduce the
stiffness that occurs after a period of immobility. Range of motion exercises
may be followed by resistance exercises and weight training to strengthen the
muscles.
·
Steroid
injections: Depending on the cause of your shoulder problem, corticosteroid
injections may be given to relieve the pain in the short term. The
corticosteroid, which is often mixed with a local anaesthetic, reduces
inflammation and allows you to move the shoulder more comfortably.
·
Surgery: Because
most people improve with the above treatments, only about 10 per cent of people
with shoulder problems will need to be treated with surgery. People with
shoulder instability or rotator cuff problems that are not responding to less
invasive treatments may benefit from an operation, and shoulder joint
replacement may be considered for people with arthritis.
