Shoulder Pain

Pain is a good indicator that there is something wrong at the point of origin. And although pain can be due to a number of reasons, the severity and location is an important factor during diagnosis. For example, joint pain can indicate several issues and, if not treated, can create temporary to permanent mobility issues. In addition, specific diagnostic imaging services can help identify the possible issues causing shoulder pain.

Shoulder pain can be defined as pain in and around the shoulder joint.  According to the Harvard medical school orthopedic associate professor, Dr. Arun Ramappa, “Shoulder problems are very common.” 

This post will look into the causes of shoulder pain, the available diagnostic tests, and how to relieve shoulder pain. 

Causes of Shoulder Pain

Shoulder pain can be a symptom arising from several different issues. Depending on the cause of the shoulder pain, you may need to visit a healthcare professional immediately, or it may be manageable on your own.  

Some of the common causes of shoulder pain are as follows: 

Separation

Separation impacts the joint where the shoulder blade and collarbone meet. It is also known as the acromioclavicular joint. This kind of shoulder pain stems from the tearing of ligaments in the joint due to a fall or strong impact. A hump can be felt on the top of your shoulder blade if the impact is severe enough to push your collar bone out of place—usually, x-ray imaging confirms this kind of injury. 

Dislocation

The joint may pop out of its socket if the shoulder is pushed back forcefully or rotated too much. In case of a dislocation, discomfort, weakness, and reduced movement of the arm and shoulder will be observable. Swelling and bruising may also be there in case it’s not fixed on time. And the accompanying shoulder pain can be moderate to severe. Dislocations are generally easy to fix, but an x-ray scan will be taken to ensure that no hairline fractures or ligament tearing have occurred due to it.

Fracture

The bones in and around the shoulder joint can break due to a bad fall or a strong impact. A fracture can cause the shoulder to droop and reduces the range of motion to zero. Furthermore, a fracture in the shoulder joint or bones connected to it is accompanied by intense shoulder pain. Therefore, x-ray services are needed to confirm the fracture and highlight the extent of the damage in the joint due to the fracture.

Rotator Cuff Tear

The rotator cuff is a collection of muscles and tendons in your shoulder that let you lift your arm above your head and keep it there. A rotator cuff tear can occur due to overuse, a fall at a bad angle, or simple overloading. This kind of injury is commonly seen in people who do strength and weight training. It is caused by overloading the shoulder joint during exercise. 

A rotator cuff tear can also occur due to issues caused by old age, where the tendons and muscles have grown weak with a lack of use. As a result, it makes them more susceptible to tearing and injury. In addition, a crackling sound accompanies this kind of injury during movement, and reduced range of motion and load-bearing ability of the joint are also observed. Furthermore, the shoulder pain associated with this kind of injury is quite intense. 

Cartilage Tear

The cartilage that rims around your shoulder joint is susceptible to injury. It occurs due to repetitive motions and time if proper care is not taken. Additionally, a fall or excessive force can also cause tearing of the cartilage around the shoulder joint. In this kind of injury, you might feel that your joint is locking and grinding during movement. For example, one will feel shoulder pain when trying to raise the arm over the head.  

Impingement

It occurs when the rotator cuff’s tendons get pinched in between the shoulder bones. It results in swelling in the shoulder and is accompanied by a lot of shoulder pain. 

Frozen Shoulder

This condition restricts the amount of movement your joint can make. As a result, adhesions form in the joint and prevent free movement of your shoulder. In addition, your shoulder may “freeze” because you haven’t used it in a while due to discomfort or surgery, causing adhesions to form. And although this condition is not accompanied by intense shoulder pain, the reduction in range of motion can be debilitating.

Osteoarthritis

It is a common form of arthritis and is also known as a degenerative joint disease. As a result, your cartilage may grow weak and experience breakage, which causes pain and swelling. 

Bursitis

If you keep repeating the same actions, your bursa (a fluid-filled sac that cushions your joint) might become inflamed and irritated. However, a fall or similar accident may also be the cause of it. In this kind of injury, any range of motion in the shoulder causes pain. 

Referred Pain

Pain in the shoulder that shows no discernable change with movement in the neck, shoulder, or arm indicates an issue somewhere else. This kind of pain is known as referred pain. For example, referred pain in the shoulders can be caused due to heart or lung problems.  In addition, other conditions such as shingles, Paget’s disease, or thoracic outlet syndrome may also be behind referred pain in the shoulders. 

Rheumatoid Arthritis

Rheumatoid Arthritis is caused when the body’s immune system sees the protective lining of the joints as a foreign invader and starts to attack them, causing damage. It causes stiffness and pain in the shoulders.  

Tendinitis

It happens due to a direct blow or damage due to a fall to your shoulders that causes inflammation of the rotator cuff. 

Heart Attack

A heart attack may also cause pain in the shoulders accompanied. In this kind of situation, you need to get immediate medical help. 

Bone Spurs

Bone spurs, also known as  “osteophytes,” are little bony growths that can occur on top of the existing bone. So, if they start to rub against your rotator cuff, they would prevent your shoulder from moving as it should. Tendonitis or a rotator cuff rupture are possible outcomes.

Diagnostic Tests for Shoulder Pain

In case of shoulder pain, the medical professional will first test the range of motion of your shoulder and its flexibility. After that, they may recommend some diagnostic tests to validate their initial diagnosis or further investigation in case of ambiguity. 

X-rays

X-rays imaging can help identify arthritis, bone spurs, and other bone issues that cause pain in your shoulders. For bone-related issues, x-rays are one of the best available options. In addition, most places these days offer the option of a digital x-ray which is safer and less costly than a traditional x-ray. Organizations like AQMDI NJ Imaging can help you get a digital x-ray in Edison or connect you with an AQMDI imaging center near you. 

MRI Scan

MRI (magnetic resonance imaging) scans to create a more detailed image of the shoulder joint and includes blood vessels and musculature in it. It allows a medical professional to confirm their diagnosis or expand upon their investigation. These are usually done in case the shoulder pain is not caused by a bone-related issue. In some cases, the underlying cause of the shoulder pain is a tumor.

CT Scan

CT Scans are composed of X-rays that are taken from different positions and angles. Then, they are combined to create a more detailed picture. It helps your doctor identify what is happening in your shoulder regarding the bones, tendons, and blood vessels in it.  

Electromyography (EMG)

It is used to evaluate the electrical activity of muscles to observe any nerves problems. This type of test is especially for the electrical activity of your muscles.

Arthroscopy

It’s a surgical process that uses a small fiber-optic camera to take pictures at higher resolutions. These pictures help the doctor to get detailed information about your shoulders. It is done when other imaging tests are inconclusive, and a more detailed look is needed to evaluate the cause of pain in the shoulder.

Specialized Tests

If none of the above tests can find a definitive cause of the shoulder pain, doctors may utilize more specialized tests. A list of those tests is given below; the details are a post of their own. However, it helps to know the options available if generalized tests are not conclusive with their results regarding the possible cause of shoulder pain. 

• Neer’s Test
• Speed’s Test
• Apprehension and Relocation Test
• Sulcus Test
• AC Joint Compression Test
• Hawkins-Kennedy Test
• Drop Arm Test
• Empty Can Test
• Lift-Off Test
• Crank’s Test
• Teres Minor Test

How to Relieve Shoulder Pain?

There are several ways that shoulder pain can be relieved. The method is dependent on the exact cause behind the pain.

Non Surgical Methods

In most cases, shoulder pain improves with time through appropriate non-surgical treatments. Some of the methods that are used are as follows:

• Hot and cold packs can be used for reduction in stiffness temporary relief of shoulder pain. In case of injury, they can prevent or reduce swelling till the rendering of medical help
• Medications can help in case of inflammation of the tendons and muscles around the joint. However, if the pain persists, consult your doctor to ensure the underlying cause of the inflammation is not more severe
• Physiotherapy is often recommended to treat problems such as stiffness and weakness of the shoulder joint. It is usually done for rehabilitation after injury or surgery
• In the case of frozen shoulder, hydrosilation can be suggested

Surgery

In some cases, non-surgical options to relieve shoulder pain may be ineffective, and the medical professional may suggest a surgical procedure to correct the issue. In the case of surgery, physiotherapy plays an important part. Pre-surgery physio helps maintain the strength and range of motion in the shoulder. Post-surgery physio allows for smooth recovery of the range of motion and strength of the shoulder joint. Furthermore, physio is important to ensure that shoulder pain is manageable. 

The following conditions causing shoulder pain may require surgery:

• Frequent dislocations 
• Acute rotator cuff tears. These are tears that have occurred due to an injury to the rotator cuff
• Chronic rotator cuff tears. These occur as a result of regular wear and tear due to age. It is somewhat preventable through a healthy lifestyle that helps maintain cartilage, bone, and muscle health
• Severe damage to the joints due to osteoarthritis and rheumatoid arthritis

Final Thoughts

The post highlights the common cause of shoulder pain, the diagnostic tests that can be done, and the viable relief methods. However, if pain persists longer than a certain number of days, you should book an appointment with a medical professional.  AQ Imaging network offers the best t diagnostic imaging in NJ and is connected to a network that can help you find the right service near you.