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
Rotator Cuff / Capsule Problems
Acromioclavicular Joint arthritis
Sternoclavicular Joint
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.
