Shoulder pain is one of the most common joint problems of the human body. This can be due to many different reasons. This is because the shoulder contains many muscles, ligaments, tendons, fluid-filled sacs, and bones, working together in a small space. Though it is not always possible to identify the cause of pain we will learn from this article some common causes of shoulder pain.
Pain, stiffness, or weakness in your shoulders can make it difficult for you to perform daily tasks, such as reaching for things on high shelves, driving a car, or combing your hair. If your pain cannot be eliminated, it is time to see a doctor.
The shoulder is very complex in structure and function, because it is a joint in the Glenohumeral joint, making it one of the freest areas of movement in the human body. Contains a shoulder girdle that connects the upper limb to the axial skeleton through the Sternoclavicular joint. The large-scale movement of the shoulder comes at the cost of decreased joint stability and is prone to dislocation and injury.
Common Causes of Shoulder Pain
Anatomy of the Shoulder
The shoulder joint is one of the most complex joints in the human body and is made up of the three bones of the humerus, the clavicle, and the scapula. The shoulder joint is a complex joint of four joints. The sternoclavicular joint (SC), the acromioclavicular joint (AC), the scapulothoracic joint (ST), the glenohumeral joint (GH). Any of these joints can cause pain and clinical problems. The bones of the shoulder joint are supported by muscles, nerves, ligaments, and blood vessels.
The sternoclavicular joint (SC) is the only joint that connects the upper limb to the axial structure and it is a synovial saddle joint. The sternoclavicular joint connects the clavicle to the manubrium of the sternum and gets stabilization from the costoclavicular ligament.
The acromioclavicular joint (AC) is a plane articulation synovialis that connects the acromion of the scapula to the clavicle. Primarily it receives stabilization from the coracoclavicular ligament and secondary stabilization from the superior and inferior acromioclavicular ligaments.
The scapulothoracic joint (ST) is not an actual joint, but rather the joint of the shoulder cap bone (scapula) that slides over the posterior thoracic cage.
The glenohumeral joint (GH) is a highly mobile ball-and-socket synovial joint that’s stabilized by the rotator cuff muscles that attach to the joint capsule, as well as the tendons of the biceps and triceps brachii.
A small number of fluid-filled sacs referred to as bursae surround the capsule and aid in mobility. These are the subscapular, subacromial, subdeltoid, and subcoracoid bursae.
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When the rotator cuff tendon gets trapped under the bony area of the shoulder bone, it can cause shoulder pain which is the most common causes of shoulder pain. Inflammation or damage to the tendon. This condition is called rotator cuff tendinitis or bursitis. Rotator cuff tendinitis is also called impingement.
There have more causes of shoulder pain. Those are-
- Rheumatoid arthritis
- Frozen shoulder
- Dislocated shoulder
- Brachial Plexus injury
- Polymyalgia rheumatica
- Broken collarbone
- Broken arm
- Avascular necrosis
- Tendon rupture
- Torn cartilage
- Cervical radiculopathy
- Heart attack
- Septic arthritis
- Separated shoulder
Rotator cuff tendinitis
Rotator cuff tendinitis is also known as impingement, bursitis, or biceps tendinitis. Rotator cuff tendinitis is an inflammation of the shoulder muscles and is also accompanied by inflammation of the lubricating mechanism called BURSA. In fact, “bursitis” should not be considered a diagnosis factor for rotator cuff tendinitis, but rather a symptom of it.
Rotator cuff injuries are the most common causes of shoulder pain and restricted movement in all ages. This condition is usually caused by or related to repetitive aerial activities (such as throwing, raking, washing cars or windows, and many other types of highly repetitive movements). It can also occur due to injury.
Rheumatoid arthritis (RA) is a chronic disease that affects multiple joints throughout the body. It is symmetrical, which means that it usually affects the same joints on both sides of the body. Whether they are physical or invasive diseases. This destroys the tissue and cartilage in the shoulder and causes the bones to rub together.
This disease causes pain and swelling, which get worse over time. Unfortunately, there is no known method to treat RA of the shoulder. But, there are many treatment options that can help you relieve pain and stay active.
Frozen shoulder is a condition where the shoulder becomes painful and stiff for no particular reason. Shoulder movements become reduced, sometimes completely frozen. Typically it affects one side of the shoulder. It is also known as adhesive capsulitis. (Source: PhysioMed)
The main cause of the frozen shoulder is unknown. But there have some possible and pathological causes of frozen shoulder. And should remember that these causes are not exact. The process may begin with an injury (such as a fracture) or inflammation of the soft tissues, typically due to overuse injuries like bursitis or tendinitis of the structure. Inflammation causes pain that’s worse with movement and limits the shoulder’s range of motion. (Source: PhysioMed)
Osteoarthritis (OA) is the most common type of arthritis, caused primarily by age-related wear and tear and can affect the shoulders, hips, knees, and other joints. OA is also known as “wear and tear” arthritis and is a disease that involves degeneration of the smooth outer layer of bone (cartilage).
Shoulder osteoarthritis is the gradual wear and tear of the articular cartilage that causes pain and stiffness. As the joint surface degenerates, the subchondral bone will remodel, losing its spherical shape and consistency. The joint capsule also thickened, causing further loss of shoulder rotation.
Bursa is a sac-like structure found in the human body where friction can exist, such as between tendons and bones. When the friction is too much, the bursa becomes inflamed, leading to bursitis. The symptoms may vary by type and severity but may include pain, swelling, tenderness, excessive warmth at the location, and fever.
The Causes of bursitis can include injury, overuse, or medical conditions that cause joint inflammation, such as rheumatoid arthritis. Shoulder bursitis is also called “sub-acromial bursitis.” Whether at home or in a doctor’s office, treatment can be done in a variety of ways.
Brachial Plexus injury
The brachial plexus is a set of nerves that originate in the nerve roots of the cervical (neck) and the upper part of the trunk (torso) of the spinal cord (C5-T1), forming a network that connects with the nerves of the arm. . The brachial plexus can be injured in many ways: stress, pressure, or overstretching. Nerves can also be cut or damaged due to cancer or radiation therapy. Sometimes brachial plexus damage occurs when a baby is born.
The most serious brachial plexus injuries are usually caused by car or motorcycle accidents. Severe brachial plexus injury can paralyze the arm, but surgery can help restore function.
The word “poly” means a lot and the word “myalgia” means muscle pain. Polymyalgia rheumatica (PMR) is a syndrome with pain or stiffness, usually in the neck, shoulders, upper arms, and hips, but can occur throughout the body. The pain can be very sudden or it can occur gradually over a period of time. Usually, it begins quickly and is worse in the morning.
Women are more common than men, and Caucasians are more common than other races. It usually develops by the age of 70 and is rare in people under the age of 50. PMR can last from one to five years; however, it varies from person to person.
The clavicle is an elongated bone that runs from the breastbone to each shoulder. Collarbone fractures or clavicle fractures are common injuries. It usually occurs after a fall or a blow to the shoulder. When trying to move the arm, the site of the fracture is often painful. The only way to check for a fracture is to get an X-ray image of the area.
If the broken end of the bone is not significantly displaced, surgery may not be required. Most broken clavicles can be cured without surgery. If the broken end of the bone is displaced significantly, your doctor may recommend surgery.
Avascular necrosis is the death of bone tissue due to insufficient blood supply. Also known as osteonecrosis, it can cause subtle bone fractures and ultimately lead to bone collapse. Broken bones or joint dislocations can cut off blood flow to part of the bone. Long-term use of high-dose steroids and heavy alcohol use can also cause avascular necrosis, which can affect anyone, but this condition is most common in people between the ages of 30 and 50.
The most common symptoms of avascular necrosis are minimal early joint pain, increased joint pain as bone and joint begin to collapse, and limited range of motion due to pain.
Tendinitis is an inflammation of the tendon, a cord of thick, soft tissue that attaches muscle to bone. Tendons help muscles move bones. Tendons often affect the elbows, wrists, fingers, thighs, and other parts of the body.
Pain, swelling, and tenderness outside the joints are the most common symptoms of tendinitis. Tendinitis also called tendonitis.
Tendons are fibrous tissues that attach muscles to human bones. The force exerted on the tendon can be more than 5 times its body weight. In rare cases, the tendon can tear or break. Conditions that make a rupture more likely include the injection of steroids into a tendon, certain diseases like gout or hyperparathyroidism.
Although tendon rupture can be a serious problem, it can lead to severe pain and permanent disability if left untreated. Each type of tendon tear has its own symptoms and signs, and surgery or medical treatment may be performed depending on the severity of the tear and the confidence of the surgeon.
Cervical radiculopathy is a clinical disease caused by compression of the cervical nerve roots. The clinical manifestations of cervical radiculopathy are extensive and can include pain, sensory deficits, motor deficits, weakened reflexes, or any combination of the above. Similarly, there are several pathophysiological processes that can cause cervical nerve root dysfunction.
Nerve numbness, reflex changes, or weak nerve function can radiate from the neck to any part of the shoulders, arms, hands, or fingers. Acupuncture and/or tingling and/or pain (ranging from sore to shock-like or burning pain) can also radiate into the arm and/or hand.
When the blood supply to the heart muscle is blocked, a heart attack occurs. Therefore, people with heart disease may experience chest pain, which can spread to the neck, shoulders, and back.
Septic arthritis is an infection of one (1) or more joints by microorganisms. Normally, the joint is lubricated with a little amount of fluid that’s mentioned as synovia or joint fluid. The traditional joint fluid is sterile and, if removed and cultured within the laboratory, no microbes are going to be detected. With this type of arthritis, microbes are identifiable in an affected joint’s fluid.
Most commonly, septic arthritis affects one joint, but occasionally more joints are involved. The joints affected vary somewhat counting on the microbe causing the infection and therefore the predisposing risk factors of the patient affected. Septic arthritis is additionally called infectious arthritis.