The shoulder joint is formed by a combination of muscles and tendons designed to support the humerus (upper arm bone), shoulder blade (scapula), and collar bone. We have a great deal of range of motion that allows throwing motions and scratching our back. However this great flexibility puts the shoulder at risk to overuse syndromes and injuries.
Shoulder pain may start in the shoulder itself or from the surrounding muscles, tendons, and ligaments. Many patients will present to the clinic with complaints of joint pain in the shoulder not directly related to the neck and elbow. Common causes are arthritis, inflammation of the tendons (tendinitis), inflammation of the bursa (bursitis), or even a tear of a supporting structure such as the rotator cuff or a ligament. An x-ray or MRI may be necessary to further evaluate the source of pain.
Non-surgical treatment options include a peripheral joint injection that places a strong anti-inflammatory into the joint itself to decrease pain and irritation. If you have already had a cortisone injection, we recommend not risking additional damage with repeated injections. Instead, consider regenerative medicine treatments such as platelet rich plasma, stem cell and/or growth factor injection therapy. Physical therapy may also be necessary in combination with the nonsurgical treatment.
Bursitis- Bursae are small, fluid-filled sacs that are located in joints throughout the body, including the shoulder. They act as cushions between bones and the overlying soft tissues, and help reduce friction between the gliding muscles and the bone.
Sometimes, excessive use of the shoulder leads to inflammation and swelling of the bursa between the rotator cuff and part of the shoulder blade known as the acromion. The result is a condition known as subacromial bursitis.
Bursitis often occurs in association with rotator cuff tendinitis. The many tissues in the shoulder can become inflamed and painful. Many daily activities, such as combing your hair or getting dressed, may become difficult.
Rotator Cuff Tendon
Splitting and tearing of tendons may result from acute injury or degenerative changes in the tendons due to advancing age, long-term overuse and wear and tear, or a sudden injury. These tears may be partial or may completely split the tendon into two pieces. In most cases of complete tears, the tendon is pulled away from its attachment to the bone. Rotator cuff and biceps tendon injuries are among the most common of these injuries.
Shoulder pain can also result from arthritis. There are many types of arthritis. The most common type of arthritis in the shoulder is osteoarthritis, also known as "wear and tear" arthritis. Symptoms, such as swelling, pain, and stiffness, typically begin during middle age. Osteoarthritis develops slowly and the pain it causes worsens over time.
Osteoarthritis, may be related to sports or work injuries and chronic wear and tear. Other types of arthritis can be related to rotator cuff tears, infection, or an inflammation of the joint lining.
Often people will avoid shoulder movements in an attempt to lessen arthritis pain. This sometimes leads to a tightening or stiffening of the soft tissue parts of the joint, resulting in a painful restriction of motion.