Shoulder pain is one of the most common reasons for seeking medical help, although its possible causes are as expansive as the range of movement in your rotator cuff (shoulder joint). The nature of the injury and the reason for the pain will determine what sort of treatment is necessary. The first step to healing any shoulder injury is to visit your doctor to find out what is causing the injury and inflammation. He or she will probably recommend rest, relaxation and icing it, at least at first, although the exact treatment will be decided by the nature of the injury.

Causes
The shoulder is a complex joint of that joins three bones: humerus, scapula and clavicle. Shoulder pain may originate in the joint itself, or from any of the many surrounding muscles, ligaments or tendons. It can be caused by tears, calcium deposits, and diseases including cancer and arthritis and others. The most common include:

  • Bursitis | Rotator cuff tendonitis: This is the most common cause of shoulder pain. Bursa are the small fluid-filled pads that that act as cushions among your bones and the tendons and muscles near your joints. Bursitis occurs when these become inflamed.
  • Calcific tendonitis: This is a condition of calcium deposits within a tendon — most commonly within the rotator cuff tendons. This condition may cause frozen shoulder, when the joint becomes immobilized.
  • Frozen shoulder: This is when the shoulder loses motion because of inflammation. Also called ‘adhesive capsuliitis,’ there is no known cause, although risk factors include Calcific tendonitis, shoulder injury, shoulder surgery, diabetes, cervical disk disease of the neck, hyperthyroidism and others.
  • Shoulder dislocation: A dislocation is an injury that occurs when the top of the arm bone becomes disconnected from the scapula. It causes intense pain, and may cause the shoulder to feel mushy, as if the underlying bone is gone, usually the humeral head or the top of the arm bone.
  • Shoulder instability: This is also called a loose shoulder joint. Instability can be caused by a traumatic injury (dislocation), or may be a condition that has developed over time.
  • Biceps tendon rupture: A proximal biceps tendon rupture occurs when the tendon of the biceps muscle ruptures near the joint.
  • Separated shoulder: A separated shoulder is a stretch or tear of one or more of the ligaments supporting the shoulder joint. It often caused by falling on your shoulder; athletes are particularly susceptible.
  • Labral tear: There are several patterns of a torn labrum and the type of treatment depends on the specific injury.
  • Arthritis: Your shoulder can be affected by three different forms: osteoarthritis, rheumatoid or posttraumatic arthritis. Osteoarthritis or “wear-and-tear” arthritis is a degenerative condition that destroys the smooth outer covering (articular cartilage) of bone. Rheumatoid is the systemic inflammatory condition of the joint lining. Posttraumatic is a form of osteoarthritis that develops after an injury, such as a fracture or dislocation of the shoulder. Depending on the type of arthritis and its severity, your doctor will recommend different forms of treatment.
  • Other diseases: Shoulder pain can be caused or exacerbated by a number of diseases and conditions including cancer, heart attack, polymyalgia rheumatic, ectopic pregnancy, Polymyositis, multiple sclerosis and others.

Symptoms
The type of pain – burning, shearing, tingling—will be determined by the condition itself. However, there are number of other symptoms that may accompany shoulder pain.

  • Inability to carry objects or use the arm
  • Inability to raise the arm
  • Swelling or significant bruising around the joint or arm
  • Signs of an infection, including fever, redness, warmth

If you have any of these symptoms as well as shoulder pain, or if you have persistent pain that does not ease, it is best if you seek medical attention.

Diagnostic tests
Your doctor will probably ask for a comprehensive health history and physical examination to figure out the cause of the shoulder pain. He or she may send you for imaging techniques, such as X-rays, MRIs, and CT scans to determine the cause of your shoulder pain. Arthroscopy is when a fiber-optic camera is inserted into the joint to determine if there is any soft tissue damage.

Treatment options
The treatment of shoulder pain will depend on what is causing the problem. If your injury is serious then your doctor may recommend either surgical or non-surgical treatments, such as physical therapy, Nonsteroidal anti-inflammatory pain medications (NSAIDs), cortisone injections, or surgery. Your doctor may recommend self care instead of or to compliment other treatments and procedures. Many self care treatments can greatly help shoulder injuries, or even provide your body with the right conditions to allow it to heal itself: These include:

  • Ice: Place the ice in a plastic bag, wrap the bag with a towel, and then apply to the injured area for 15-20 minutes every hour. Or you can try applying a bag of frozen peas to the injury. Just don’t eat them once they have defrosted!
  • Pain killers: A number of over-the-counter medications, such as ibuprofen (Advil, Motrin, others) or acetaminophen (Tylenol) may help you control the swelling and pain. Make sure you stay within the recommended dose.
  • Elevation: the best way to elevate an injury to reduce swelling is to raise it above your heart. Lie on your side and use a pillow to prop yourself up.
  • Stretching: Stretching the muscles and tendons that surround the joint can help with some causes of shoulder pain. Talk to your doctor or physiotherapist to find the right stretching combination that is most beneficial to healing your injury.
  • Heat: do not apply heat in the first week after the injury as it can aggravate the swelling and worsen the pain.

Often, the first line of treatment is simply to rest the injury, which will probably allow some of the inflammation to ease. Rest is usually part of the treatment for most conditions causing shoulder pain. However, don’t rest for too long without seeing a physician because prolonged immobilization can cause a frozen shoulder.

Prevention
As the causes of shoulder pain are so numerous and varied, the best form of prevention is to listen to your body, and be mindful of any existing health conditions. And when exercising, it’s important that you warm up and cool down correctly to prevent any tears and sprains.

Shoulder pain is really the symptom of a range of possible conditions including bursitis, calcific tendonitis, frozen shoulder, shoulder dislocation, shoulder instability, biceps tendon rupture, labral tear, arthritis, and other diseases and conditions. Its treatment depends on the exact cause, however rest, icing and pain killers are usually the first line of treatment

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