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Shoulder pain - that common problem

                                        August 2010  


Shoulder pain – that common problem

shoulderA friend of mine has bad shoulder pain. For a while she thought it was just one of those things that happen as you became older, but the pain became worse and eventually she took herself off to the doctors. She came back amazed at what could go wrong with shoulders, she said she hadn’t realized what a complicated joint the shoulder was.

Luckily for my friend, some anti-inflammatory painkillers and a visit to a physiotherapist, and her problem was soon sorted. But because there are so many causes of shoulder pain, it is important that you obtain a correct diagnosis.

The shoulder, as my friend found out, is hugely complicated. Bones, muscles and ligaments all connect and there is a lot of scope for damage and injury.

The most common problem is a problem with the rotator cuff. The rotator cuff is the name for the group of four tendons and muscles that surround the shoulder joint. Often confused with other names, the “rotator cuff” is the proper word used to describe these muscles and tendons. When people say they have an injury to their rotator cuff, they mean the tendons that connect the rotator cuff muscles to the bone that are injured.

When these tendons become inflamed, from perhaps a strain, overuse or injury, they cannot function properly and you will suffer shoulder pain and often weakness or limited movement as well. A visit to the doctor, and sometimes help from an x-ray or MRI scan, can identify the problem and the best treatment. However, sometimes the rotator cuff can actually tear, or separate from the bone. The main symptom here is pain, commonly over the top of the shoulder and down the arm, sometimes down the outside of the arm all the way to the elbow. If you have torn your rotator cuff, the shoulder can also feel quite weak, and lifting overhead or stretching can become really difficult and painful.

Today rotator cuff tears can often be treated without surgery. Usually anti-inflammatory pain killers and exercise can work, and sometimes cortisone injections are recommended. Sometimes though surgery is the best option to repair the torn tendons and here again there are several surgical options available, usually with excellent outcomes.

While the rotator cuff is responsible for many shoulder problems, with such a complex area there are many other things that can go wrong. Calcific tendonitis is when calcium deposits within a tendon causes restrictions and damage; a frozen shoulder is when for various reasons the shoulder has become stiff – here physical activity including stretching is key to recovery. A dislocation of course is a severe injury, but less traumatic damage can still cause instability within the shoulder that means the joint is loose and doesn’t work quite as it should. You can also get arthritis in a shoulder. This is less common than knee or hip arthritis but equally debilitating and joint replacement surgery is available for this area too.

The more you learn about shoulders, the more you realise you should treat them with respect! If you have shoulder pain that does not go away after a few days or causes movement problems, it is important to see your doctor.

Basic treatments before turning to medication and surgery can include rest to allow any inflammation to subside (although prolonged rest can lead to a frozen shoulder); ice packs and heat pads can be useful in various situations and stretching the muscles and tendons can be vital in getting the shoulder back to normal.

But because the shoulder is so complex and because there are a variety of treatments available, it is imperative that you get professional advice. Then, with a bit of luck, you will be able to shoulder on for many more years!!


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