What makes up the shoulder joint?
The shoulder is really made up of several joints, muscles and tendons and allows a wide range of motion of the arm. However, because of this mobility it may lead to increasing problems with the soft tissues surrounding the shoulder resulting in pain. Pain may be present only when the shoulder is moved or brought above your head, or may be present all the time. If the pain persists, it may require medical diagnosis and treatment.
Dr. Stetson is an expert in diagnosing and treating complex shoulder problems. From the professional athlete to the weekend warrior, and to the injured worker, our team of physicians and physical therapists work together to get you back to your activities as soon as possible.
What causes shoulder pain?
Most shoulder problems involve not the bones but the muscles, ligaments and tendons which surround the shoulder joint. The majority of shoulder pain is caused by tendinitis or bursitis, instability or an unstable shoulder joint, a direct injury to the shoulder such as a fall, or arthritis.
TENDINITIS: The tendons of the shoulder help connect the muscles to the bone. When they get inflamed this is known as tendinitis. The majority of tendinitis is a result of the wear and tear which takes place over many years and this is known as chronic tendinitis. Acute tendinitis comes on quickly after some sort of overuse such as throwing a baseball for the first time in a while or some other sports or work-related activity.
BURSITIS: When the tendons become inflamed or irritated tendinitis develops. The bursa, which is a fluid-filled sac, lies on top of the tendons and also often becomes inflamed. This is known as bursitis. Just like tendinitis, bursitis may come on quickly or slowly. Pain may develop in the front or side part of the shoulder.
Sometimes it goes away with a little rest, sometimes it doesn’t.
Patients often wait too long to seek treatment. If your shoulder pain isn’t improving, it may be time to make an appointment to see one of our shoulder experts.
ROTATOR CUFF INJURIES: The rotator cuff is actually made of four small muscles which surround the shoulder joint. The splitting and tearing of these muscles and tendons may result from an acute injury such as a fall or from the wear and tear of the years. Patients often complain of pain doing things over their head or pain at night. Rotator cuff injuries are very common and are best treated early before small tears become large tears.
FROZEN SHOULDER: The shoulder may become so painful that patients don’t want to move it at all. The joint may stiffen as a result leading to a condition, “frozen shoulder.” Early, aggressive therapy is essential. Dr. Stetson works closely with our therapists in treating this problem and getting the shoulder moving again without pain.
UNSTABLE SHOULDER/ INSTABILITY: The shoulder joint is like a golf ball on a tee. The socket, or tee, is very shallow which allows the ball, or humeral head, to move around freely. The shoulder joint is dependent on all the ligaments around it for stability or keeping the ball in the socket. Instability or an unstable shoulder can result when an injury occurs, stretching or tearing the ligaments. The shoulder can partially or completely slip out of the socket or dislocate causing severe pain. When it partially slips out, this is known as subluxation and may occur in athletes such as baseball pitchers or volleyball players. Our team of physical therapists are experts in treating young and older athletes with unstable shoulders. With a carefully monitored, physician directed rehabilitation program, we are able to get most athletes back to competition quickly and without surgery. When surgery is necessary, our physicians use the latest arthroscopic techniques which help speed up your recovery.
ARTHRITIS: Shoulder pain can also be caused by arthritis. Although there are many types of Arthritis, it generally involves the wear and tear of the joint. This typically causes swelling, pain and stiffness. It may be caused by some sort of injury or doing repetitive activities at work or at home.
HOW IS MY SHOULDER PROBLEM DIAGNOSED?
Before any treatment can be recommended, it is essential to determine the source of the problem.
The first step is a detailed medical history determining how and when the pain started. Many shoulder conditions are aggravated by specific activities so a detailed questionnaire is a valuable tool in finding the source of your pain.
A careful physical examination noting any swelling, weakness, tenderness is then done observing the range of shoulder motion – how far and in which direction you can move your arm.
X-rays may also be required to closely look at bones and joints of your shoulder. Magnetic resonance imaging, an MRI, is also a valuable tool which allows us to see the muscles, tendons, and ligaments of the shoulder without using radiation.
TREATMENT: Early treatment of shoulder problems is essentially to prevent long term complications.
Dr. Stetson is an expert in the treatment of complex shoulder problems. This involves an aggressive physical therapy program under the watchful eye of your physician in order to relieve the pain and improve the strength in your shoulder.
Anti-inflammatory medications are often prescribed to help relieve the pain. In addition, cortisone injections may also be used to help relieve the pain when regular oral pain medications don’t do the job.
If all else fails, surgery may be required to resolve your shoulder problem. With the advent of shoulder arthroscopy, many shoulder problems can be treated using this advanced technique.
To see more information about the shoulder, including video animations of shoulder anatomy and other shoulder injuries and ways to treat them, please click here.