Shoulder Pain

The shoulder, formed by the upper arm bone, the shoulder blade and the collarbone, is the most mobile and most complex joint in the body. The joint's stability is provided by the soft tissues around it, so soft tissue injuries are common in the shoulder. Shoulder pain is the third most common type of pain after low back and neck pain. It becomes more common with age.

1) SHOULDER IMPINGEMENT SYNDROME

Shoulder impingement is the most common cause of shoulder pain. It is a painful condition caused by the tendons of the muscles that allow us to raise our arm, and the bursa in this area, being pinched beneath bony structures. It is more common in people who use their hands above shoulder level. Pain at the front of the shoulder that wakes the person at night is typical. Stiffness in shoulder movements gradually increases and, over time, affects daily activities such as dressing and undressing. If the necessary treatment is not given and precautions are not taken, it can result in a complete tear of the tendons. In treatment, it is important to rest the arm and avoid using it above head level. Patients benefit greatly from intra-articular corticosteroid injections. Continuing physical therapy modalities and an appropriate exercise program is very important.

2) FROZEN SHOULDER

It is a condition in which shoulder pain is accompanied by progressively restricted shoulder movement.
It is most common between the ages of 40 and 60. It is more common in women. While it occurs in 2–5% of the general population, its frequency rises to as high as 40% in patients with diabetes. Although the cause is unknown, minor trauma is an important factor. The pain starts insidiously; at first it increases with movement, and later it continues at rest as well. Pain that wakes the person from sleep is typical. Stiffness gradually adds to the picture. Movements in which the hand reaches over the head and behind the back become especially difficult.
Frozen shoulder is diagnosed with a detailed history and physical examination.
Imaging and laboratory tests are used to rule out other conditions.
The most important point in treatment is informing the patient. The goals of treatment are to reduce pain and then increase shoulder movement. Oral medications, intra-articular injections and physical therapy agents are used in treatment. Surgical methods are tried in cases where functional disability persists despite six months or more of physical therapy.

3) CALCIFIC TENDINITIS

It causes severe shoulder pain. It is a calcium deposit in the soft tissue formed by crystals settling on the shoulder tendons. It can be diagnosed with a plain X-ray. In addition to a physical therapy and rehabilitation program, injections into the calcific lesion are also beneficial.

4) ROTATOR CUFF TENDINITIS

The rotator cuff consists of four important muscles that move the arm. The limited blood supply where the supraspinatus tendon attaches to the bone, which decreases even further when the arm is held above shoulder level, causes inflammation in the tendon. A dull pain is felt, localized to the front and top of the shoulder. In the early phase of treatment, rest, medication and physical therapy agents are used. Once the pain is under control, a protective exercise program is started.