Shoulders - Common Conditions

The shoulder is the most mobile joint in the human body. The rotator cuff in the shoulder is made up of four tendons. These tendons give the shoulder a wide range of motion.

Any swelling, inflammation, tearing, or bony changes around these tendons causes pain when a person tries to move the arm above the head, behind the back, or straight out in front.

Causes

The tendons pass underneath a rigid bony arch in the shoulder. The most common cause of shoulder pain is when the tendons become trapped under this arch. The compressed tendons become inflamed or damaged, a condition called rotator cuff tendinitis. This can occur from general wear and tear as you get older, an activity that requires constant shoulder use like baseball pitching, or an injury.

Shoulder pain can also be due to:

• Arthritis in the joints about the shoulder (gradual narrowing of the joints and loss of protective cartilage).
• Bursitis (inflammation of a fluid-filled sac, or bursa, that lies between tendon and skin or between tendon and bone). Normally a bursa protects the joint and helps make movement more fluid.
• Fractures of the shoulder bones.
• Frozen shoulder syndrome occurs when you don't move your shoulder because of pain or injury. The muscles or connective structures stiffen up inside the shoulder and make any motion painful and difficult.
• Inflammation of nearby tendons, such as those connected to the bicep muscles of your arms, from overuse or injury.
• Dislocation of your shoulder, which is when the ball-shaped head of your arm comes out of the socket.

How are shoulder problems diagnosed?

Diagnostic tests that may be performed vary depending on the results of your physical examination. Treatment may include the following:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• A corticosteroid injection
• Referral to a physical therapist and instructions on rehabilitation

Surgery is a last resort.