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Shoulder Pain In Middle Aged Adults

Fig 1. Shoulder joint

Always rule  out Infective, Malignancy and Inflammatory causes.  The problems described here are due to mechanical or degenerative causes.

Shoulder joint pain may be  due to

  • Overuse /Disuse
  • Aging
  • Accidents

To an extent these may be prevented by knowing the mechanisms by where they occur.

The pain may be:

  • Articular
    • Inside the Joint
  • Periarticular
    • Surrounding the Joint

Location of the pain

Fig 2. Location of pain
  1. Rotator Cuff / Capsule Problems
  2. Acromioclavicular Joint arthritis
  3. Sternoclavicular Joint
  4. Referred pain from neck

A. Rotator Cuff Tendinitis & Tear

  • Rotator cuff is a protective cuff of muscles around the shoulder. A damage to rotaqtor cuff is the most common shoulder problem in middle aged adults.
  • It is almost always due to due to excess or chronic strain secondary to persistent misuse of the cuff.
Fig 3. Rotator ccuff

Rotator Cuff Injuries may be

  • Tendinitis
  • Tendon Tear

B.Subacromial Bursitis

Subacromial bursa is a small sac below the acromioclavicular joint. Its inflammation is called subacromial bursitis. It leads to pain on abducting the shoulder.

Fig 4 Subacromial Bursa

C. Frozen Shoulder

  • Due to chronic inflammation, shoulder joint capsule shrinks in size and tears with movement with further shrinkage as it heals. Initially there is severe boring pain later leading to gradual reduction in shoulder joint abduction.


D. Acromioclavicular Joint Osteoarthritis

Fig 6. Acromioclavicular joint

Due to degeneration of the Acromioclavicular joint. There will be pain at the point of shoulder.

Shoulder Problems – When to Worry

  • When there is continuous pain at a single site
  • When there is a recurring pain during specific movements.
  • When pain is associated with weakness of muscles/decreasing ROM.
  • When there is a persistent boring pain .
  • When there is more severe pain at night/ sleep disturbances due to pain.
  • When pain is associated wwith visible swelling / redness.

**All the figures has been taken from internet.