Diagnosing shoulder pain causes
Your GP will be able to get a fair idea of your shoulder pain causes by performing a simple examination and asking you a few questions. The type of pain, the circumstances in which it occurs, the appearance of the shoulder and the timescale over which it developed, will all give a good indication of what the pain is due to. Sometimes, an X-ray or MRI scan may be needed to back up the initial diagnosis and occasionally investigation via keyhole surgery is required.
Shoulder pain causes: rotator cuff problems
One of the most common shoulder pain causes is a problem with the group of four muscles called the rotator cuff. These muscles (the supraspinatus, infraspinatus, teres minor and subscapularis) stabilise the shoulder at the back of the joint, allowing for a wide variety of different movements.
Rotator cuff injuries cover any strain or damage to this group of muscles and tendons and fall into three main categories:
Acute tear – where the muscles are damaged by a sudden trauma, such as a fall or a strenuous lift. In this case the muscle is literally torn in one incident.
Chronic tear – where the muscles become worn out and torn through repetitive use, such as in sports or jobs involving repeated stretching. In this case, the tear develops over time, gradually increasing in severity.
Tendonitis - where the tendons around the rotator cuff become inflamed as a result of repeated use or the onset of old age. There is no tear involved, but the inflammation and swelling are the main shoulder pain causes
Shoulder pain causes: frozen shoulder
Frozen shoulder, or adhesive capsulitis, is another of the more common shoulder pain causes, especially in women aged 40 to 60. As the name suggests, frozen shoulder is a severe restriction in movement of the shoulder joint. This can develop slowly, taking many months, with a steady decline in flexibility and movement causing a vicious circle of degeneration. Shoulder pain causes the joint to be underused and this lack of movement causes adhesions between the ball joint and the socket. This causes further swelling of the joint and tightening of the surrounding tissue, causing more pain and even less use. While the cause of frozen shoulder is unknown, diabetics are between two and four times at risk of developing it.
Shoulder pain causes: dislocation
The most common of all shoulder pain causes is dislocation. This occurs when the humerus is forced out of the socket by either a strong pull or an extreme rotation, leaving the arm out of position and causing severe pain. However, dislocation can also happen without trauma, as the humerus gradually moves out of place as a result of repetitive exercise, such as swimming or energetic throwing.
In either case, the main treatment is to manipulate the shoulder back into place physically, a process called reduction. The shoulder then needs to be immobilized for up to six weeks to allow for full recovery of damaged muscles, tendons and ligaments.