Most pains of the shoulder involve soft tissues like tendons,
ligaments, or muscles. Shoulder pain has many causes, and
proper diagnosis is the first step towards successful
treatment. Whether pain is caused by shoulder arthritis,
shoulder dislocation, clavicle fracture, sports-related injury,
tendonitis or impingement, rotator cuff injury, frozen
shoulder, or even a history of untreatable shoulder conditions,
the good news is that the outlook for patients with shoulder
problems has never been better.
The most frequently treated shoulder injuries include:
Burners and Stingers
Characterized by a surge of pain traveling from the shoulder
down to the hand - in a burning or stinging sensation - burners
and stingers are the result of an applied force driving the
individual's head downward and sideways away from the shoulder.
This forced, stretching head motion impinges on the surrounding
nerves supplying the upper arm. Contact sports and injury are
the leading causes of burners and stingers.
Rotator Cuff Tear
The covering composed of both muscle and ligament securing the
head of the upper arm bone (humerus) into the shoulder socked
is known as the rotator cuff.
The rotator cuff is susceptible to tearing as a result of
overuse sustained for a period of years, as well as injury,
trauma, fracture, and dislocation. Rotator cuff tears can
result in either acute or chronic pain. Athletes,
weightlifters, and workers participating in activities with a
great range of shoulder motion - or overhead shoulder motion in
particularly - are susceptible to rotator cuff tears. The
frequency of tears among individuals in excess of forty years
of age increases.
A shoulder dislocation is the result of the head of the upper
arm bone (humerus) becoming either partially (subluxation) or
entirely dislodged from the shoulder socket (glenoid).
Resulting symptoms may include painful shoulder spasms,
shoulder swelling, shoulder numbness, shoulder weakness, and
bruising. More aggressive shoulder dislocations may also result
in ligament tears, tendon tears, shoulder nerve damage, and
damage to the shoulder socket's soft fibrous tissue rim
(Labrum). Many dislocations are the result of sustained wear on
the cuff through lifting and repetitive motion. Accurate
diagnosis - including the identification of tendon, ligament,
nerve and tissue damage - as well as the cause and direction of
the dislocation are important in factors determining the best
course of treatment. Improper or insufficient treatment may
lead to shoulder instability; the propensity for additional
Chronic Shoulder Instability
As the shoulder's rotator cuff muscles, ligaments, and tendons
are loosened or weakened through wear, damaged by injury, tear,
or dislocation they may become less effective in keeping the
upper arm bone correctly seated in the shoulder socket.
Dislocation of the shoulder can increase in frequency, or
dislocation may result from less range or frequency of motion,
or milder injury than initially experienced producing a
dislocation. This ongoing reduction in the shoulder's capacity
to correctly confine the humerus within the rotator cuff is
referred to as chronic shoulder instability.
Shoulder Joint Tear
As much as fifty-percent of the shoulder socket is comprised of
a soft fibrous tissue (labrum) which aids in securing the upper
arm bone (humerus) in place. The shoulder's range of rotational
motion and use in activities and repetitive motion, as well as
susceptibility to acute injury and trauma can expose the labrum
to tissue damage and tears. Continued wear through athletics or
weight-lifting can increase the likelihood of labrum damage.
An impingement of the shoulder is a common condition producing
a painful limit to the range of shoulder motion. The shoulder
impingement condition is the result of the front edge
(acromion) of the shoulder blade (scapula) compressing against
the rotator cuff during shoulder motion or rotation.
Frozen shoulder produces pain and stiffness, as well as a
limitation in the shoulder joint's range of motion. The
condition is the result of the thickening and shortening of the
muscles, ligaments, or tendons (contracture) of the shoulder
joint's rotator cuff.
Frozen shoulder is associated with the advance of age (ranging
from forty to sixty years), and in some cases, failure to
employ physical therapy for the shoulder joint following the
treatment of a condition or injury.