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Chronic Shoulder Pain


What is it?

The shoulder is a ball-and-socket joint that has wide range of motion. It comprises of three important bones: the humerus (long bone of arm), the clavicle (collarbone), and the scapula (also called as the shoulder blade). Any injury or damage or disease process that affect shoulder joint will reduce ability to move freely and can cause a great deal of pain and discomfort. Degenerative diseases of old age, repetitive movement , manual labor or sports trauma, can cause injury.
Shoulder joint enjoys versatility as the most mobile joint in human body. It can freely and easily move forward and backward and can rotate the arm in a circular motion. It can also move away from the body and close to the body. This is possible because of the rotator cuff, which is formed by four tendons. Any damage or swelling of these tendons or bones around the rotator cuff will limit the motion, cause difficulty in lifting arm up over the head and will be very painful. Disease of the cervical spine, gallbladder, liver, or heart, may cause referred pain in shoulder.

Causes:

The Common causes of shoulder pain include:

  • Simple arthritis, rheumatoid arthritis , osteoarthritis, septic arthritis
  • Inflammation and swelling of the fibrous sacs- protecting shoulder joint- bursitis
  • Cartilage tear
  • Swelling of tendons- tendinitis
  • Fracture of shoulder bone
  • Frozen shoulder
  • Bony spurs (bony projections which appear along edges of bones
  • Shoulder dislocation – the ball of the humerus gets displaced from shoulder socket
  • Referred pain of heart attack

Diagnosis:

  • Careful history of injury, past history of any other disease
  • Physical examination- checking for injury, and evaluating range of mobility and joint stability.
  • Radiological tests- X-ray or MRI,

Treatment:

  • Some minor shoulder pain can be treated at home.

1. Apply ice to the shoulder for 15 to 20 minutes, 6 to 8 hourly a day at least for two to three days may help reduce pain. Do not apply ice directly on the skin as it may lead to frostbite , instead wrap ice in a cloth or use an ice bag
2. Complete rest to the shoulder for one to two weeks before joining normal duty. Restrict any movements which might precipitate pain.
3. Take under supervision nonsteroidal anti-inflammatory medications to help reduce pain and inflammation
4. Restricting movements and compressing the area with an elastic bandage to reduce swelling

  • Other modalities for the shoulder pain are:

1. Physiotherapy
2. Shoulder immobilization by sling o
3. Injection of corticosteroids into the shoulder
4. Surgery :arthroscopic surgery.

Prevention of Shoulder Pain:

  • Simple shoulder exercises to stretch and strengthen muscles and rotator cuff tendons.
  • Use of ice for 15 minutes every time you do exercise to prevent future injuries, if there is previous history of shoulders pain or injury

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