Image by Sven Mieke
Man_playing_golf_landscape_1024-unsmushe

Shoulder

Causes of pain & recommended treatments

Image-empty-state_edited_edited.png

Impingement syndrome

What is it? 

The rotator cuff tendons attach to the edge of the shoulder joint (humeral head). These deep muscles are crucial for coordinating movements of the shoulder with the overlying more powerful muscles (deltoid, trapezius, pectoralis, latissimus). The rotator cuff tendons can rub or catch against an overlying bony or fibrous arch, giving rise to subacromial impingement syndrome. Pain is felt in the region of the shoulder when reaching outwards or upwards. If this continues over a long period of time, the rotator cuff tendons can tear. By this stage there will be loss of movement and weakness within the shoulder.

Image-empty-state_edited_edited.png

Rotator cuff tear

What is it? 

Tearing of the rotator cuff tendons can occur as a result of untreated impingement syndrome, where the deep shoulder tendons rub against a fibrous, bony arch over a period of many months or years. Alternatively, the same tendons can tear suddenly as a result of a fall. This often occurs in the over 40’s, when the shoulder dislocates.

Image-empty-state_edited_edited.png

Frozen shoulder

What is it? 

In frozen shoulder, the joint capsule undergoes a biological change with blood vessel ingrowth and fibrous tissue deposition. There are three recognised phases: (1) The painful phase: onset of continuous pain, often worse at night. (2) The freezing phase: shoulder movements are progressively lost. (3) The thawing phase: pain eases and movements of the shoulder slowly return. Each phase can last many months, with considerable overlap. The total process can take over to 24 months to run its natural course.

Image-empty-state_edited_edited.png

Shoulder instability

What is it? 

Some patients are born with loose (hypermobile) shoulders. Most patients with an unstable shoulder have experienced a single or repeated injury (dislocation). The joint capsule may have stretched or torn away from the bony socket (Bankart lesion). After an acute dislocation, the shoulder needs to be put back into place urgently – usually in hospital. In long standing cases, the shoulder may be painful, click, catch and feel unstable.

Image-empty-state_edited_edited.png

Acromioclavicular joint injury

What is it? 

This injury normally occurs as a result of a fall on the point of the shoulder or direct impact to the acromioclavicular joint, for example during a rugby tackle. It usually causes pain, swelling and deformity.

Image-empty-state_edited_edited.png

Osteoarthritis of the shoulder

What is it? 

In a normal joint, the articulating bone ends are covered with a smooth layer of cartilage which allows free and painless movement. In osteoarthritis (degenerative arthritis) the cartilage thins and eventually the bone ends rub against each other. The joint capsule may thicken and there may be additional bone/loose body formation. The result is pain, stiffness, loss of movement and maybe catching or grinding of the joint.

Image-empty-state_edited_edited.png

Rheumatoid arthritis of the shoulder

What is it? 

In rheumatoid arthritis, the synovium which lines joints and tendons becomes swollen and inflamed. In some individuals, the disease progresses with destruction of joint cartilage and tendon rupture. Pain, stiffness, loss of movement and deformity of the joint may follow.