In this Essential Guide to Shoulder Pain, you will learn about the different conditions that cause shoulder pain and potential options your orthopedic surgeon may recommend.
Table of Contents
What is the Anatomy of the Shoulder?
The shoulder joint is a ball and socket joint between the humerus and the scapula. The structure of the shoulder joint entails the following significant parts:
Articulating Surfaces
The joint is the articulation of the humerus head and the glenoid cavity of the scapula, hence the name glenohumeral joint. The articulating surfaces are covered with hyaline cartilage that facilitates movement.
Joint Capsule and Bursae
The joint capsule encloses the structures of the joints and is typically a fibrous sheath. It extends from the neck of the humerus to the border of the glenoid fossa. Around the joint capsule is the synovial membrane that reduces friction between the articular surfaces. The joint also has several synovial bursae to reduce friction in the joint. A bursa is a sac filled with synovial fluid that acts as a cushion between the tendons and other joint structures. Clinically, the essential bursae are subacromial and subscapular.
Ligaments
The ligaments are crucial for stabilizing the bony structures of the shoulder joint. They include:
- Glenohumeral ligaments, which are the primary source of shoulder stability
- Coracohumeral ligament that supports the superior part of the joint capsule
- The transverse humeral ligament that holds the tendons in the biceps
- The coracoclavicular ligament that maintains the alignment of the clavicle and the scapula
- The coracoacromial ligament overlies the shoulder joint and prevents displacement of the humeral head.
What Are Common Conditions of the Shoulder? Which Is The Most Common?
You may expose your shoulder to various conditions that make it painful, knowingly or unknowingly. These include:
It comes with pain and stiffness in the shoulder joint, also known as adhesive capsulitis. Symptoms of Frozen Shoulder include severe pain and the inability to move the shoulder.
A labral tear happens because of an accident, falling with an outstretched arm, or overuse of the shoulder joint, leading to a tear in the labrum. Most of these injuries heal without the need for surgery.
A Rotator Cuff Injury happens when one of the muscles or tendons surrounding the top of the humerus tears, causing a rotator cuff tear.
Biceps Tendonitis
Biceps Tendonitis is the inflammation of the tendon in the area of the long head of the biceps muscle. The injury occurs when there is a degeneration of the tendon.
Bicep Tendon Rapture is a condition that can cause partial or complete tears. It occurs when you are suddenly injured, causing swelling in the affected area.
A Slap Tear occurs when a piece of cartilage in the inner part of the shoulder joint tears. The condition can be painful and may limit movement, especially overhead positions. Slap tears are common with falls that happen with outstretched arms.
The most common type of shoulder condition is Shoulder Osteoarthritis. It leads to wear and tear of the shoulder joint as you progress in age.
When the humerus or one of the other bones in the shoulder joint slips out of position, Shoulder Dislocation occurs. You may feel and hear a "popping" sensation because of the dislocation.
Distal Clavicle Osteolysis
Also known as DCO, Distal Clavicle Osteolysis, is a pathologic process involving subchondral bone resorption in the distal clavicle. It presents itself as localized pain in the acromioclavicular joint.
AC Separation
Acromioclavicular joint separation, also known as AC Separation, is common among physically active people. In this injury, a separation happens between the collarbone and the shoulder blade (scapula).
What Factors Increase the Risk of Shoulder Conditions?
While anyone is at risk for experiencing shoulder pain, there are specific factors that increase the risk of the above shoulder conditions:
Direct Hit to The Shoulder
A direct blow to the shoulder may lead to sudden or acute injury. The pain is sudden and severe, and swelling and bruising may also happen soon after the impact. If the blood vessels or nerves are injured or pinched in the process, the shoulder and upper arm may feel tingly, numb, cold, or weak. It may also look blue or pale.
Falling On Outstretched Hand
Also known as a FOOSH injury, falling with an outstretched hand is common in sports medicine. The severity of the injury depends on various factors like:
- The impact of the fall
- The type of ground you fall on
- The position of the fall
- Whether you have any existing health conditions or injuries on your hands or wrists
Treatment of these falls depends on the severity of the fall. Some may cause broken bones, sending you to the emergency room. Other FOOSH injuries heal over a few weeks after rest and stretching.
A Sudden Pull While Trying to Lift a Heavy Object
Improper lifting or shoulder overuse can lead to injuries like:
- Tendonitis: Overuse of the shoulder tendons creates friction in the sheaths, irritating the area. Lifting heavy weights can also cause inflammation, irregular movement, and altered tissue alignment. These issues prevent the tendon from moving smoothly and cause pain.
- Bursitis: refers to an injury in the bursae caused by repetitive strain and overuse of the joints from heavy lifting and not treating shoulder injuries.
- Strains and sprains: A strain happens when a fiber in the muscle is torn, while a sprain refers to a torn ligament. Both injuries have degrees of damage from 1 to 3. Grade 3 damage refers to the complete rupture of the tissue. They happen when you suddenly lift heavy items with a swinging motion.
A Sudden and Forceful Overhead Reach
The sudden and forceful overhead reach injury is common in swimmers and happens when the rotator cuff rubs against the acromion. When you lift your arm, the space between the rotator cuff and the acromion becomes narrow, increasing pressure. Consequently, the pressure irritates the rotator cuff, causing impingement syndrome.
The symptoms include:
- Pain that worsens at night
- Minor but constant arm pain
- Shoulder or arm weakness
- Reduced range of motion of shoulder joint
- Swelling around the joint
- Inability to raise the arm
- Pain that moves from the front of the shoulder to the side of the arm.
How Do You Know if Shoulder Pain is Serious?
While the shoulder joint gets more dislocated than other joints in the body, you need to know when your condition is severe enough to seek medical help. Once you determine you have a shoulder injury, check if you:
- Feel as though the shoulder could pop out of the socket.
- Can move the arm normally, or it feels too painful.
- You can still do the things you usually do despite any pain.
While you can treat some shoulder injuries at home with ice and rest, some injuries need professional care.
Here are signs that you need to visit an orthopedic surgeon:
- The pain is intense and continuous
- The shoulder joint looks out of place or deformed
- You are unable to use the shoulder at all
- Your arm or hand feels weak
- The shoulder suddenly swells
- You experience excessive sweating
- You have trouble breathing
- You experience dizziness
Your doctor will conduct a physical examination to establish the extent of the injuries. They will look out for swelling and tenderness as they assess your joint stability and range of motion.
What Are Non-Surgical and Surgical Treatments for Shoulder Pain?
Treatment options depend on the cause and extent of pain on the shoulder. Generally, they fall into surgical and non-surgical surgery options and include:
This procedure can help lessen pain and swelling caused by many shoulder injuries.
Medication
Your doctor might prescribe medications like corticosteroids or nonsteroidal anti-inflammatory drugs to reduce the inflammation.
Corticosteroid Shots and Injections
These are anti-inflammatory medicines that treat joint pain, including shoulder pain. They can be used to treat tendonitis, rotator cuff impingement, and bursitis.
Physical Therapy
Physical therapy is a non-surgical treatment approach that aims to strengthen the muscle around the shoulder to enhance mobility and overall function. It can prevent the need for surgery when done the right way.
Arthroscopy
This surgery procedure uses a tiny camera to examine and treat the tissues around the shoulder joint.
Tendon Repair
may entail reattaching the tendon to the humerus head or trimming and smoothening it through debridement. If you have a complete tear, the doctor may stitch the tendon back to the original site.
When is Surgery Recommended?
If you suffer from shoulder pain in Boise, your doctor may recommend arthroscopic surgery when non-surgical treatments fail to restore your shoulder's function and mobility. Surgery helps to address shoulder instability and improve its function. In addition, it addresses problems like frozen shoulder, rotator cuff repair, soft tissue injuries, dislocations, and torn cartilage or ligaments.
What Kind of Doctor Can Help with Shoulder Pain in Boise, Idaho?
If you or a loved one are experiencing shoulder pain, an orthopedic surgeon can help guide you to the best treatment option. Our providers are passionate about offering personalized treatment that includes non-surgical and surgical options (minimally invasive). We’ve helped thousands of patients from their first appointment to post-op care, and for each we’ve strived to provide them with the best care and treatment outcome. We have surgical privileges at Treasure Valley Hospital, St. Alphonsus Medical Center, and St. Luke's Regional Medical Care, and we accept most insurance plans so you can rest assured you’ll receive the top-quality, efficient, personalized care you deserve.
The Best Orthopedic Surgeon Serving Boise, Meridian and Eagle, Idaho
Dr. Michael Gustavel of Gustavel Orthopedics is Idaho's premier board-certified orthopedic surgeon. You can trust the quality of specialized care you receive from Dr. Gustavel and his team - Mary Ann Ozier PA-C and Amy Waselchuck PA-C. Dr. Gustavel has been practicing in Boise, Idaho, since 2002 and has a 4.6 Google review ranking. His independent practice is located at 1702 W Fairview Ave, Boise, ID 83702, near the Red Lion Hotel Boise Downtowner. Dr. Gustavel specializes in arthroscopy, ligament and tendon repair, sports medicine, and total joint replacement. He treats conditions of the shoulder, elbow, hip and knee.
If the damage to your shoulder is affecting the quality of your life, and you live in the Boise area, consider scheduling a consultation with Dr. Michael Gustavel, experienced orthopedic surgeon, to learn more about available treatment options.