Pain in the shoulder

Our shoulders are the most mobile parts of our body, subject to repetitive strain forces that cause injuries. As such, athletes and sports novices will find this to be one of the most common areas of injury. Motion at the shoulder occurs at the main shoulder joint, and at the shoulder blade (scapula) which moves over the chest wall.

Shoulder pains are fairly common ailments that typically last for short periods with simple treatments - but not always. Dr Muthukaruppan Yegappan, orthopaedic surgeon at Parkway East Hospital explains the causes of shoulder pain and the various treatment options for pain relief and rehabilitation.

Where is the pain coming from?
There are various conditions which cause pain in the shoulder. Some are more obvious, like fractures around the shoulder. These include collarbone (clavicle) and arm bone (humerus) fractures. Shoulder dislocation is another common sports injury. The rotator cuff muscle group, hidden deep within the deltoids and joint capsule, can also be a source of painful condition if injured.

According to Dr Yegappan, the pain can spread down to the mid arm, and can be in the front and back of the shoulder. In most conditions, usage and movement of the joint will cause pain, with overhead motions being more painful than other movements. Night pain is another common symptom and may affect the patient's ability to have a good night's rest. Other related symptoms include stiffness and weakness of the shoulder.

What are the common causes?
The pain is usually caused by inflammation of the capsule or the rotator cuff tendons. Sometimes, the rotator cuff tendon is torn and this can be painful as well. Another cause is inflammation of the joint capsule, which leads to what we call a frozen shoulder. Frozen shoulders can happen out of nowhere, or it can be an aftermath of an injury. Patients with history of stroke or diabetes are more susceptible to frozen shoulders. Arthritis in the shoulder is uncommon among Asians, although minor degrees of arthritis are often found in the acromioclavicular joint at the top of the shoulder.

What can we do to manage it?
One good exercise for all shoulder problems you can try is called pendulum exercise. Simply stand and support yourself on a table with your good hand. Let your other arm hang loosely, and swing it in a circular motion, like a spoon stirring in a teacup. Then do the same in the opposite direction. Remember to keep your arm relaxed throughout and let gravity do the work.

A lot of patients have shoulder pains that start subtly, affecting not only their ability to play sports, but also the simple tasks of daily life. Some of these cases can be treated with simple methods such as anti-inflammatory or pain relief medication. Initial rest and moderation of regular activity is advised, especially with activity that involves overhead movement of the shoulder joint. And of course, seeing a doctor definitely helps.

Publication of article by courtesy of Dr Muthukaruppan Yegappan, an Orthopaedic Surgeon at Parkway East Hospital

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