Strong Connections: Understanding Shoulder Pain, Problems and Treatment
Among the most mobile joints in the human body, healthy shoulders are crucial to our strength, balance and overall comfort in daily activities. In 2006, approximately 7.5 million people visited a doctor for a shoulder problem.* These problems can be caused by everyday activities such as swimming, tennis, cleaning and gardening. They typically involve the muscles, ligaments and tendons, but they can also include fractures. Fortunately, the seasoned orthopedic specialists throughout the Crozer-Keystone Health System can identify, diagnose and treat shoulder issues of all varieties.
Types of Shoulder Problems
Impingement can be the excessive pressure on the shoulder muscles from the top portion of the shoulder blade. Impingement typically occurs during activities that require excessive overhead arm motion, and the friction can result in tendonitis or bursitis. Injuries to the rotator cuff—the tendon and four shoulder muscles that hold the joint together—are very common, accounting for a large percentage of shoulder impingement cases. Impingement symptoms include pain, local swelling, tenderness and stiffness. As the problem progresses without treatment, shoulder strength and range-of-motion may be limited.
Instability is caused when one of the shoulder joints is moved or forced (by injury) out of its normal position, sometimes resulting in dislocation of the shoulder joint. The instability is felt most intensely when an affected individual raises their arm. They may also experience a sensation that the joint is “slipping out of place.”
Trauma to the shoulder can be caused by a fall, impact from a heavy object or a high-speed car accident, and can result in a dislocation, fracture or soft-tissue injury (a tear of the ligament, tendon, muscle or joint capsule). Shoulder dislocation pain is usually felt over the top of the shoulder, and some patients notice a prominent bump on the top of the shoulder. Individuals with shoulder fractures experience severe pain, swelling and bruising and an inability to move the shoulder.
Three major types of arthritis affect the shoulder joints: osteoarthritis (“wear and tear” arthritis that usually occurs in people over 50 years old), rheumatoid arthritis (a systemic inflammatory condition that affects people of any age and can impact multiple joints of the body), and posttraumatic arthritis (a condition that develops after an injury, such as a fracture or rotator cuff tear). The most common symptom of arthritis in the shoulder is pain, which can be aggravated by activity. Other symptoms include limited motion and pain that often changes with weather.
Healing the Shoulder
Many shoulder problems can be addressed without surgery and Crozer-Keystone’s orthopedic specialists have a large arsenal of treatments to minimize pain and heal the injury swiftly and safely.
For most muscle and tendon injuries, shoulder exercises such as wall push-ups, shoulder press-ups and exercise band activities can help strengthen the shoulder and prevent further aggravation. Anti-inflammatory medications or local injections of anesthetic or cortisone may also be prescribed to prevent pain and swelling. Many fractures and dislocations require resetting the joint or “putting it back in its socket.” Arthritis can be treated with rest, physical therapy, ice and heat, anti-inflammatory and other medications.
When non-surgical treatment doesn’t relieve pain, your Crozer-Keystone orthopedic physician may recommend surgery. Surgeries are most often used for fractures that require fixation with plates, screws or rods inside the bone, or for dislocations that led to soft-tissue injury. Surgery is sometimes indicated for repair of torn ligaments or the rotator cuff or to release impingement to create more space for the rotator cuff. Surgical procedures such as joint replacement can also relieve arthritis pain and restore motion to the shoulder.
If you experience any of the above symptoms, call 1-877-CK-MOTION (1-877-256-6846) for a prompt appointment with one of Crozer-Keystone’s orthopedic specialists, or visit here to request an appointment from our secure, online form. Learn more about Crozer-Keystone's orthopedics services.
*American Academy of Orthopaedic Surgeons