Shoulder Pain — Muscles, Tendons, Ligaments
Physical discomfort of the shoulder, including the joint itself or the muscles, tendons, and ligaments that support the joint.
The most common cause for shoulder pain is rotator cuff tendinitis. This is a condition made up of swollen tendons. Another common cause of shoulder pain is impingement syndrome where the rotator cuff gets caught between the part of the scapula that covers the ball and humeral head (the ball portion of the humerus).
The shoulder has a wide and versatile range of motion. When something goes wrong with your shoulder, it hampers your ability to move freely and can cause a great deal of pain and discomfort.
The shoulder is a ball-and-socket joint made up of three main bones: the humerus (long arm bone), the clavicle (collarbone), and the scapula (aka the shoulder blade).
These bones are cushioned by a layer of cartilage. There are two main joints. The acromioclavicular joint is between the highest part of the scapula and the clavicle.
The shoulder joint is the most mobile joint in the body. It moves the shoulder forward and backward. It also allows the arm to move in a circular motion and to move up and away from the body.
Shoulders get their range of motion from the rotator cuff.
The rotator cuff is made up of four tendons. Tendons are the tissues that connect muscles to bone. It may be painful or difficult to lift your arm over your head if the tendons or bones around the rotator cuff are damaged or swollen.
You can injure your shoulder by performing manual labor, playing sports, or even by repetitive movement. Certain diseases can bring about pain that travels to the shoulder. These include diseases of the cervical spine (neck), as well as liver, heart, or gallbladder disease.
You’re more likely to have problems with your shoulder as you grow older, especially after age 60. This is because the soft tissues surrounding the shoulder tend to degenerate with age.
Osteoarthritis in the Shoulder
When we see OA of the shoulders, it’s usually the result of past trauma to the shoulders. It can also be the result of years of wear and tear, so you might see it in someone who has done manual labor, for example.
Rheumatoid Arthritis in the Shoulder
While RA most commonly affects the smaller joints in the fingers, hands, and feet. Over 50 percent of patients with RA do ultimately develop shoulder involvement.
OA and RA share similar symptoms, such as pain and limited pain of motion. But an inflammatory arthritis such as RA is more likely to be suspected if the shoulder is red or swollen, other joints are affected, and the patient has fatigue or a fever.
Shoulder pain can also occur in other, less common forms of inflammatory arthritis, such as psoriatic arthritis, ankylosing spondylitis, and gout. There are a few other types of arthritis that your doctor will need to consider as well, including:
- Post-traumatic arthritis:This can develop years after an injury to the shoulder. Post-traumatic arthritis can present as osteoarthritis or as a form of inflammatory arthritis such as gout.
- Rotator cuff tear arthropathy: If you experienced a large tear to your rotator cuff in the past, you may have developed this form of degenerative arthritis. A tear can cause two bones in the shoulder — the top of the humerus and the underside of the acromion — to rub against each other, resulting in damage to the bones.
- Avascular necrosis: In avascular necrosis, death of bone tissue occurs due to lack of blood supply. Possible causes include a broken bone, dislocated joint, high-dose steroid use, heavy alcohol consumption, sickle cell disease, and traumatic injury to the shoulder.