Pain in the shoulder joint occurs very often, at any age, the causes of pain are different. Most often, pain in the shoulder joints occurs in older people and athletes as a result of heavy loads on the joint or injury. The cause of pain in the right shoulder joint can be physical inactivity, constant performance of monotonous movements with the right hand, joint diseases, infections, allergic reactions, arthritis, arthrosis and other diseases. At the Yusupov Hospital, in the therapy clinic, a rheumatologist conducts appointments and consultations. The hospital is equipped with innovative diagnostic equipment that allows you to quickly and accurately make a diagnosis.
At the Yusupov Hospital, you can undergo treatment for diseases of the shoulder joints, undergo diagnostic examinations, and in severe cases, surgical treatment is performed. The shoulder joint has a complex structure; the basis of the joint is the clavicle, humerus, scapula with the articular surface and processes (coracoid and humerus). The joint has a large number of connecting elements: coracohumeral ligament, coracoacromial ligament, acromioclavicular ligament, articular capsule. Neurotrophic disorders in the joint capsule, trauma, inflammation in tendons and muscles, limit the movement of the joint, leading to the development of degenerative processes.
Mechanism of occurrence
Mechanism of occurrence
If pain is detected in the shoulder joints of the arms, treatment must be prescribed taking into account the development mechanism.
Treatment
Help before diagnosis
In case of traumatic injury, you need to fix your hand with a splint or bandage, apply a heating pad with cold water or an ice pack wrapped in a towel. If there are no wounds or abrasions, chlorethyl can be applied to the skin. For severe pain, you can take an analgesic. Independent attempts at reduction, massage, and active movements of the limb are strictly contraindicated - this can aggravate the injury and complicate further treatment.
For non-traumatic pathologies, rest and elevated position of the limb are recommended. In case of exacerbation of degenerative diseases (tendinosis, arthrosis), an ointment with an analgesic, anti-inflammatory and warming effect is applied to the shoulder joint. The appearance of redness, increasing swelling, severe pain, and signs of general intoxication are indications for immediate consultation with a specialist.
Conservative therapy
The general measure is a protective regime, tailored to the characteristics of the disease. It may include permanent immobilization with a plaster or scarf bandage, temporary wearing of orthoses, and exclusion of all or some types of load on the arm. Unjustified immobility, as well as unjustified overload, harm the joint, so the activity regimen should be determined by a doctor.
For dislocations, reduction is performed, for displaced fractures, reposition is performed. The most common non-drug methods are exercise therapy, massage, and physiotherapy. When treating a joint, a wide range of physiotherapeutic techniques are used, including:
- UHF;
- laser therapy;
- magnetic therapy;
- medicinal electrophoresis;
- galvanization;
- ultrasound;
- shock wave therapy.
According to indications, drug treatment is prescribed - NSAIDs in tablets and injections, chondroprotectors, local agents (ointments, gels, creams, warming patches). In some cases, intra-articular administration of chondroprotectors and hormonal drugs, blockade of soft tissues with glucocorticoids is carried out. For synovitis, therapeutic punctures are performed.
Surgery
Surgical interventions on the shoulder joint are performed using open and arthroscopic approaches and are divided into the following groups, taking into account the type of pathology:
- fresh injuries: osteosynthesis of fragments, open reduction of dislocations, suture of damage to the rotator cuff, resection of the head of the humerus;
- consequences of injuries: derotational osteotomy or strengthening of the capsule in case of habitual dislocations, suturing of a Bankart lesion;
- degenerative diseases: subacromial decompression, removal of intra-articular bodies, tenodesis of the biceps tendon;
- neoplasms: tumor removal, marginal or segmental bone resection, disarticulation of the shoulder joint.
Restriction of movements due to scarring of soft tissues becomes an indication for redressing, due to changes in the articular ends of bones - for arthroplasty, arthrodesis, joint replacement. For malignant tumors, surgical interventions are supplemented with chemotherapy and radiation therapy.
Why pain occurs, main reasons
The appearance of pain in the shoulder area is not an independent disease, but a clinical manifestation of the influence of a significant number of different provoking factors, which include:
- Aseptic inflammation affecting various structures of the shoulder (nerve fibers, capsule, cartilage tissue of the joint, tendons, muscles).
- Joint infection (bacterial arthritis).
- An autoimmune process that is the result of a violation of the functional state of the immune system, in which antibodies are produced to the body’s own tissues, in particular to the connective tissue structures of the musculoskeletal system with the development of an inflammatory reaction in them.
- Degenerative-dystrophic processes with destruction of cartilaginous structures (arthrosis).
- Systematic significant exposure to physical activity.
- Previous injuries to the shoulder area affecting various structures (dislocation, subluxation, sprain of ligaments, capsules, fracture of the bone base, severe bruise).
Referred pain may also appear, which is the result of the development of a pathological process of another localization in the body (pain in the left shoulder with angina, referred pain with pathology of the cervical spine on the right or left).
How does pain manifest when the arm is abducted?
Pain when abducting the arm often becomes an attribute of many serious pathologies of the musculo-ligamentous apparatus of the shoulder joint. Therefore, this symptom, to one degree or another, may be accompanied by:
- defeat from the working hand;
- painful sensations on palpation;
- localization of pain along the anterolateral humeral surface;
- increased pain at night;
Often pain when abducting the arm is characterized as:
- strong;
- aching (pulling character);
- spicy.
Diagnostics
Diagnostics
For the differential diagnosis of reflected pain, electrocardiography (ECG) and methods for visualizing the structures of the cervical spine are used.
How common is pain when abducting the arm?
This symptom is recorded predominantly in men, especially those in the age range of 40 years and older, although it can also be observed at a young age. Those most susceptible to it may be:
- young people after shoulder injury;
- elderly people (due to natural age-related changes in the musculoskeletal and joint system);
- representatives of professions that involve lifting and carrying heavy objects (for example, loaders, builders, blacksmiths);
- people performing monotonous non-standard movements with shoulder tension (for example, when painting a room, etc.);
- professional throwing athletes (for example, volleyball players, discus or javelin throwers, tennis players);
- computer scientists and people who work on laptops for a long time (due to inactivity and the predominance of a forced posture).
Pain in the shoulder joint - treatment
Treatment of a disease accompanied by pain of varying degrees of severity and nature in the shoulder area is necessarily comprehensive. It includes several main areas:
- Etiotropic therapy is a set of measures aimed at eliminating the influence of the main causative factor. It can be conservative or include various surgical techniques.
- Pathogenetic therapy - with the help of drugs, the main pathogenetic mechanisms of the formation of pain syndrome are influenced.
- Symptomatic therapy is treatment aimed at reducing the severity of clinical manifestations of the pathological process that worsen the patient’s quality of life.
General directions of therapeutic activities usually complement each other and can be intertwined. Often, one pharmacological group of drugs is used for symptomatic and pathogenetic therapy - non-steroidal anti-inflammatory drugs. The choice of a set of therapeutic measures is made by the doctor based on clinical symptoms, as well as the results of additional diagnostic tests.
Pain in the shoulder joint of the right arm - treatment
Pain in the right shoulder is often of traumatic origin. After diagnosing the nature and localization of the violation of anatomical integrity, complex conservative and surgical treatment can be prescribed, aimed at restoring tissues and structures, as well as their functional state.
After preoperative preparation (including the prescription of various medications that improve the general condition of the patient’s body, as well as drugs to prevent postoperative complications, in particular bleeding and secondary bacterial infection), open access surgery or arthroscopic surgery is performed. It is less traumatic.
In the case of inflammatory origin of pain, conservative drug therapy is predominantly used, as well as physiotherapeutic procedures (magnetic therapy, ozokerite, mud baths, electrophoresis with anti-inflammatory medications). They help reduce pain in the right shoulder joint.
Treatment may vary in duration, depending on the severity of the traumatic or pathological injury, as well as the surgical technique performed.
Treatment of pain in the left shoulder joint
Treatment of shoulder myalgia
Today there are many methods of treating this pathology, including both non-drug and medicinal ones. Non-drug treatment methods have shown high effectiveness in this matter: soft manual therapy techniques, acupuncture, physiotherapy, deep tissue massage, etc. In some cases, it is possible to wear orthopedic orthoses.
As a medical treatment in the acute period, it is possible to take non-steroidal anti-inflammatory drugs, and local capsaicin patches can be used. Taking muscle relaxants, as practice shows, helps to relieve muscle spasms to a small extent, which is not enough to solve the problem.
In case of chronic pain syndrome, joint work of a vertebroneurologist and a psychotherapist/psychiatrist may be required.
If myalgia is a manifestation of pathology of the shoulder joint, be it an injury or a rheumatological disease, the use of gentle manual therapy techniques on the muscles surrounding this joint shows good results in terms of reducing pain.
When the question arises “how to treat shoulder myalgia?”, it is better to contact a specialist who has experience working with this pathology. Attempts at self-medication can harm your health.
Treatment of pain in the left shoulder joint
Treatment of pain in the left shoulder joint
Discomfort in the left shoulder is also quite the result of a previous injury, and therefore sometimes requires surgical intervention. In modern medical clinics, it is performed using arthroscopy (a diagnostic and treatment technique in which a tube with a camera and lighting is inserted through small incisions; under visual control on a monitor, the doctor performs the necessary manipulations with microinstruments).
Conservative treatment of pain in the shoulder joint of the left hand is carried out with the help of non-steroidal anti-inflammatory drugs, chondroprotectors, vitamins, and physiotherapeutic procedures in the case of diagnosed inflammatory or degenerative-dystrophic processes.
Referred pain requires the implementation of therapeutic measures aimed at normalizing heart function in case of angina pectoris or restoring the relationship of the structures of the cervical spine in case of osteochondrosis.
Muscle pain in the shoulder joint - treatment
Muscle pain syndrome often occurs against the background of aseptic inflammation. In this case, anti-inflammatory drugs and physiotherapeutic procedures in the form of dry heat or infrared radiation are prescribed.
Worried shoulder joint, pain when raising the arm - treatment
If, when trying to move the shoulder with the arm raised upward, discomfort and crunching occur, then SLAP syndrome usually occurs, characterized by traumatic or pathological damage to the lips of the glenoid cavity, increasing its depth. Therapeutic measures in this case include surgery using arthroscopy.
If pain and crunching develop in the shoulder joint, treatment may include the prescription of anti-inflammatory drugs and chondroprotectors to reduce the severity of degenerative processes of cartilage tissue.
Severe pain in the shoulder joint - treatment
Treatment of acute shoulder pain usually involves the use of nonsteroidal anti-inflammatory drugs.
Diagnosis of pathology
Naturally, when there is discomfort, the question inevitably arises: what to do if your shoulder hurts? Don't wait for the symptoms to go away on their own. It is imperative to consult a doctor, whose specialization will depend on the cause of the disease and the general condition of the patient.
If the pain appears after a fall or bruise, then contact a traumatologist. Osteochondrosis and neuritis are treated by a neurologist, a surgeon and a rheumatologist eliminate the consequences of arthrosis, arthritis and tendonitis.
When painful sensations are accompanied by a general deterioration in well-being, it is recommended to consult a therapist, oncologist, cardiologist or gastroenterologist. Indeed, sometimes pain is reflected when there is a discrepancy between the localization of discomfort and the location of damaged organs or tissues. It is very important to diagnose in time, because shoulder pain can appear due to myocardial infarction, pneumonia, pleurisy, pancreatitis, cholecystitis, and neoplasms in the chest.
For diagnostic purposes, the doctor may prescribe the following types of examinations:
- X-ray of the shoulder or entire upper limb;
- Ultrasound of the shoulder joint;
- MRI of the joint and/or spine;
- ECG.
In addition, you may need to take a general blood test, as well as biochemistry and sexually transmitted infections. The patient is also prescribed fluorography and fibrogastroduodenoscopy.
Severe pain in the shoulder joint
Severe pain in the shoulder joint
If it occurs against the background of an injury, then measures must be taken to reduce the mobility of the shoulder (immobilization with a splint or applying a tight bandage to the shoulder) and reduce the severity of tissue swelling, which increases pain. This is done by applying local cold in the form of an ice pack or wetting the injury area with cold water.
Significant intense pain that is not relieved by conventional means requires the use of narcotic painkillers.
Which doctor should you consult if you have pain when abducting your arm?
At the first manifestation of this symptom, you should immediately contact a good clinic and an orthopedist-traumatologist, who will accurately diagnose the cause of the disease, and, if necessary, prescribe a consultation with related specialists. Only proper diagnosis will help the patient receive adequate treatment and keep the shoulder joint healthy.
Have you or your loved ones started to experience pain when abducting your arm? Don't waste precious time! Qualified medical specialists are always ready to determine the cause of your illness and prescribe the most effective treatment regimen to return your sore shoulder to healthy mobility!
Possible diseases
Various diseases can provoke the appearance of painful manifestations. Let's take a closer look at the symptoms and causes of various diseases of the shoulder joint.
Arthritis
It is one of the most common provoking factors for the appearance of painful sensations. The development of this disease is caused by an inflammatory focus in the joint cavity. When arthritis appears, a person feels severe pain, swelling and swelling of the tissues in the damaged joint, and redness of the skin.
The main causes of this disease are:
- various injuries;
- infectious diseases;
- allergic and autoimmune diseases.
There is an acute and chronic form of the disease, the intensity of the clinical picture depends on this.
Bursitis
This is an inflammatory disease, it is accompanied by the accumulation of fluid in the cavity of the joint capsule. The most common cause of bursitis is trauma. The development of the pathological process is accompanied by intense pain, regardless of whether the person moves the shoulder or not. Supplemented by local or general hyperthermia, severe edema and swelling. During palpation, fluid is felt moving inside the joint.
Capsulitis
The disease is characterized by a chronic inflammatory process in the capsule, which surrounds the joint and serves to stabilize it. With a prolonged inflammatory process, the capsule contracts and the ligaments around it atrophy. Soreness appears at night, symptoms occur in waves. When the active inflammatory process subsides, shoulder movement becomes limited.
Humeroscapular periarthritis
The disease is accompanied by a pronounced inflammatory process, which affects the tissues located around the shoulder joint. During movement, the pain becomes much more intense. It becomes difficult for a person to lift a limb, rotate it, or place it behind the back.
Tendinitis
The disease is characterized by inflammation of the tendons. Develops under the influence of significant physical activity of the limb. Depending on how severe the inflammatory process is, the intensity of the pain will depend.
Osteochondrosis of the cervical-collar area
The pathological process is associated with flattening of the discs that are located between the vertebrae. Nerve endings are pinched. The severity of the pain syndrome is determined by the degree of development of the disease. The pain intensifies when turning and tilting the head. Additionally, the hands become numb and lumbago appears. The pain moves to other parts of the body.
Ligamentous calcification
The disease is accompanied by the accumulation of particles of calcium salts in the ligamentous apparatus. Currently, there is no exact cause for this pathological process. Painful sensations are pronounced, regardless of whether the person moves his arm or not.
Brachial neuritis
The brachial nerves or nerve plexuses in this area are affected as a result of injuries, hypothermia, and infectious processes. Painful sensations spread not only to the shoulder joint, but also to the entire limb. In addition to pain, there is numbness, burning, and a feeling of pins and needles on the arm. If the disease is in an advanced stage, certain groups in the muscular system may become paralyzed.
Diseases of internal organs
Sometimes there is pain that radiates to the shoulder. This is associated with diseases of the internal organs. The most dangerous is myocardial infarction. It is accompanied by the appearance of squeezing pain or a burning sensation in the chest area, between the shoulder blades. The pain may spread to the neck and face.
The development of the pathological process is complemented by the following symptoms:
- weakness;
- increased sweating;
- attacks of dizziness;
- compression in the chest;
- feeling of panic.
This pathology is life-threatening. Sometimes pain in the shoulder joint appears against the background of exacerbation of chronic pancreatitis.
Injuries and damage
Injuries are accompanied by acute pain. Additionally, joint mobility is limited. As the disease progresses, joint deformation develops. Bruises and crunching appear.
It is very important to carry out the correct diagnosis in time, which will help establish the diagnosis, after which the doctor will prescribe the appropriate treatment.