Shoulder painDefinition Shoulder pain involves any pain in or around the shoulder joint.Considerations The shoulder is the most mobile joint in the human body. The joint includes fourtendons. The purpose of a tendon is to hold muscle to bone. Together, these four "rotator cuff" tendons stabilize the upper arm bone to the shoulder socket and allow a wide range of motion in the shoulder. Any swelling, inflammation, tearing, or bony changes around these tendons causes pain when a person tries to move the arm above the head, behind the back, or straight out in front. Common Causes The tendons pass underneath a rigid bony arch in the shoulder. The most common cause of shoulder pain is when the tendons become trapped under this arch. The compressed tendons become inflamed or damaged, a condition called rotator cuff tendinitis. This can occur from general wear and tear as you get older, an activity that requires constant shoulder use like baseball pitching, or an injury. Shoulder pain can also be due to:
Home Care When you first feel shoulder pain, apply ice for up to 15 minutes, then leave it off for 15 minutes. Repeat this cycle for several hours. Wrap the ice in a cloth, DO NOT apply ice directly to the skin. Then, continue to ice 3 to 4 times a day for 2 to 3 days. Rest the shoulder from strenuous activity for the next few days. When the pain and swelling have subsided, gradually begin to strengthen the shoulder muscles. Perform light weight lifting, using a full range of motion. Consider seeing a physical therapist for help doing this safely. Ibuprofen may help reduce inflammation and pain. Call your health care provider if Call 911 if you feel sudden pressure or crushing pain in your shoulder, especially if it extends from your chest, jaw, or neck, or occurs with shortness of breath, dizziness or sweating. Very sudden shoulder pain can, occasionally, be a sign of a heart attack. If you just had a severe blow or injury and your painful shoulder is swollen, badly bruised, or bleeding, get safely to an emergency room where they will check for a fracture or dislocation. Contact your doctor if :
What to expect at your health care provider's office Your health care provider will perform a physical examination, including a detailed examination of the shoulder, and ask questions such as.
Diagnostic tests that may be performed vary depending on the results of your physical examination. Treatment may include the following:
Surgery is a last resort. Prevention
References Braman JP, Tehrany AM, Flatow EL. Rotator cuff repair. Am J Orthop. 2005; 34(6): 267-270. Paternostro-Sluga T, Zoch C. Conservative treatment and rehabilitation of shoulder problems. Radiologe. 2004; 44(6): 597-603. Illustrations
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