Best way shoulder pain treatment

Type of shoulder pain and treatment 

Bimillahirahmanirahim,

Shoulder pain is one of the common problem in attacking around shoulder region 

and it will affected your activity and also your emotional ,today i would like to share 

the info about of this unique joint 

What is the shoulder  and anatomy around it ?

The shoulder is a complex joint made up of the humerus (upper

arm bone), scapula (shoulder blade) and clavicle (collarbone),

along with tendons, muscles and ligaments. These help us lift,

carry, throw and reach up or backward. The shoulder is the most

mobile – and least stable – joint in the body, because it is not

anchored firmly to the skeleton by surrounding muscle.

Type of injuries of shoulder 

Here i will show a common injuries is always happen around the shoulder and also the mechanism of the type of injuries ,it will give you the idea when you meet the Dr and

this explanation will help you to understand about your condition.

Rotator Cuff Injuries 

The rotator cuff comprises four muscles and cord-like tendons,

tightly enclosed within the shoulder joint. Rotator cuff injuries are

the most common causes of shoulder pain and activity restriction

at all ages.

·         Rotator cuff tendonitis. The mildest rotator cuff injury is tendonitis

(tendon inflammation). Tendonitis can develop with repetitive overhead

activities such as playing tennis, pitching, raking, shoveling or

painting. Tendonitis can also arise from joint degeneration due to

osteoarthritis. It produces pain like a toothache radiating through

the upper arm that can awaken you from sleep. Reaching overhead

or behind your back is painful.

·         Shoulder bursitis. Bursitis, which often accompanies rotator

cuff tendonitis, involves painful inflammation of one or more bursa

(fluid-filled sacs that surround our joints to provide lubrication

and protection).

·         Impingement syndrome. Swelling and inflammation of tendons and/

or bursa can place undue pressure on tendons as they pass

between the upper arm bone and the shoulder tip, called the

scapular acromion. In its cramped space, blood flow to the swollen

tendon is reduced, and it begins to fray. The resulting pain intensifies

when reaching overhead or backward. Ongoing impingement

may produce a torn rotator cuff.

·         Rotator cuff tears. A torn rotator cuff, sometimes called “pitcher’s

shoulder” or “tennis shoulder,” is the most common cause of shoulder

pain. The rotator cuff tendons can split or tear suddenly with

injury, or slowly by rubbing bone spurs. Untreated tears can weaken

the arm, inhibit its overhead elevation and visibly shrink muscles.

Pain occurs during motion and also at night

Other Common injuries at the shoulder

Labral tears

The labrum, a cartilage cuff around the socket that encircles the

head of the upper arm bone to hold it within its shallow bony

socket, can tear with injury to the shoulder. It also becomes more

brittle with age and thus susceptible to fraying. Aching in the shoulder,

“catches” in the shoulder when moved, and pain with some

activities may signal a torn labrum

Instability and dislocation

When one of the shoulder bones moves or is pushed out of place

due to injury, the shoulder becomes unstable and is at risk for

partial or complete dislocation. Recurrent dislocations cause pain

and unsteadiness when raising the arm or moving it away from the

body, and a feeling that the shoulder is “slipping out of place” when

reaching overhead.

Frozen Shoulder

Between ages 40 and 60, the joint capsule surrounding the shoulder

can shrink, making movement painful and stiff. Reluctance to

use the shoulder brings increasing stiffness, restricted motion and a

persistent, dull aching. This condition is most frequently associated

with diabetes, but in more than half the patients has no known

cause. Pain fades after several months, but the shoulder becomes

“frozen” and may take two to three years to “thaw” without treatment.

Treatment is directed at pain relief until the acute phase

passes, followed by therapy and even surgical intervention to regain

motion if it does not return spontaneously.

Fractures

Shoulder fractures are usually caused by trauma: a fall while

skiing, a collision during football, a car accident. A fracture of the

“ball” at the top of the arm bone or its socket, or of the collarbone,

can disable the shoulder. Bruising, pain and swelling, and pain or

a deformed appearance can indicate a shoulder fracture. Most

fractures are effectively treated by immobilizing the arm in a sling

until the bone fragments “knit together,” which takes about six

weeks. All fractures should be assessed; some require surgery

Arthritis

Osteoarthritis is the wearing down of cartilage that allows bones to

glide smoothly within the joints, and can occur with aging, trauma or

overuse injury. The bones in the shoulder begin to rub against each

other, and growths called bone spurs can develop. Stiffness, swelling,

pain and reduced range of motion can occur, along with a “catching”

sensation in the joint.

Rheumatoid arthritis, a disorder of the immune

system, produces chronic, painful inflammation of the joint’s lining,

and eventual joint deterioration. Severe osteoarthritis or rheumatoid

arthritis in the shoulder may necessitate joint replacement.

Other causes

Less common causes of shoulder pain include infection

(osteomyelitis), soft-tissue or bone tumors and nerve problems.

A shoulder specialist can help pinpoint the reason. When

shoulder pain is intense, it’s important to seek help promptly.

What is the necessary action you need to take for managing this shoulder problem ?

Evaluating shoulder pain

Your doctor will thoroughly examine your shoulder, take your health

history and order imaging. X-rays detail bone changes from arthritis

and fractures. Magnetic resonance imaging (MRI) reveals soft-tissue

injuries. Computed tomography shows 3-D images of bony abnormalities

and tendon problems. Advanced centers will offer techniques such

as ultra-fast, high-resolution CT to reveal the source of shoulder pain,

and single-sequence MRI to confirm rotator cuff injuries.

Management and shoulder therapy

Conservative care

Rest, ice and heat are essential. Fortunately, most shoulder problems

do not require surgery, and respond to a directed physical therapy

exercise program and anti-inflammatory medication.

Rest

When your shoulder hurts, it’s important to rest it, and refrain from

reaching upward, carrying heavy objects and using heavy shoulder

bags. Pain and inflammation will not subside if repetitive activities

such as vacuuming, raking or car-washing continue to stress the sore

shoulder. Keeping your elbow below shoulder-level is important. To

prevent frozen shoulder after an injury, however, early movement is

important

Ice and heat

Icing the shoulder with cold packs (or bags of frozen peas or corn)

when pain is severe reduces inflammation and swelling, and the

discomfort they cause. Taking hot showers and doing recommended

stretches first thing in the morning also help

Physical therapy

Orthopaedic specialists prescribe physical therapy to help you

recover from shoulder injury. Physical therapists tailor range-of-motion

exercises to increase flexibility in the shoulder. They will also show

you strengthening exercises that help prevent muscle shrinkage, and

good body mechanics to help you avoid shoulder strain. Ultrasound

or massage may be used for bursitis. In frozen shoulder, anesthesiologists

can perform a nerve block to allow for more aggressive physical

therapy.

Anti-inflammatory medications

Non-steroidal anti-inflammatory (NSAID) medication can be purchased

over the counter to relieve shoulder pain. If aspirin, ibuprofen (Advil®),

naproxen (Aleve®) and acetaminophen (Tylenol®) do not provide adequate

relief, prescription-strength NSAIDs can be prescribed.

    

Injections

When other treatments don’t help severe shoulder pain, cortisone (corticosteroid)

injections may temporarily help to “settle down” inflamed

tissues within the cramped joint, reducing pain. However, cortisone is

a potent drug, and potential side effects should be discussed with your

physician.

Surgical options

When shoulder problems do not respond to any conservative care,

your orthopaedic specialist may recommend surgery. Options range

from minimally invasive arthroscopic surgery to total shoulder replacement.

Arthroscopic Surgery

In arthroscopic surgery, only a few small incisions are required,

making recovery quicker and less painful. A viewing camera is inserted

through one incision, and slender telescopic instruments are inserted

through others. This allows surgeons to inspect and repair labral

tears and rotator cuff tears, and remove spurs and bony growths to

allow inflamed, cramped tendons to move more freely. They can also

remove thickened, inflamed bursa and bone to create space around

the rotator cuff and relieve painful impingement (arthroscopic decompression),

and can cut through tight sections of the joint capsule to

release a frozen shoulder.

Arthroscopic surgery can be combined with standard “open” surgery

when a larger incision is required to properly view and repair a more

complex problem, or with forcible stretching of a tight joint capsule

under anesthesia to free up frozen shoulder.

Rotator cuff surgery

Torn rotator cuffs do not heal by themselves and require surgery when

pain persists. Repairing the torn muscle and tendon, and removing

bone spurs restores comfort and function to the shoulder after several

months of healing.

Surgery for shoulder fractures

Severe osteoarthritis or rheumatoid arthritis can cause painful, debilitating

shoulder deformity. In these cases, or when trauma crushes the

“ball” of the shoulder joint, then shoulder replacement surgery can relieve

pain and improve quality of life. Any damaged cartilage or bone in

the shoulder’s ball and socket are removed, and replaced with a metal

“ball” and a plastic “socket.” This artificial shoulder always relieves

pain and usually improves motion, strength and function.

Recovery from surgery

Physical therapy is essential to regaining your range of motion and

strength, which relieves pain. Your therapist and surgeon will prescribe exercises that

will tailor to your needs. Your therapist will ensure

that you perform your exercises correctly, give you advice on body

mechanics so that you avoid straining your shoulder, and check your

progress wallahuaklam...