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Shoulder pain - causes and treatment

Shoulder pain - causes and treatment



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Shoulder pain: causes and therapy
Shoulder pain is very painful. Everyone affected wants quick help and, above all, pain relief. Unfortunately, even pain relievers often do not help with shoulder pain, which makes the suffering even worse. The possible causes of shoulder pain are extremely diverse.

Causes

The shoulder is a ball joint and the most flexible joint in the human body. This has a large range of motion and is therefore also susceptible to a wide variety of complaints. In addition, the shoulder joint is the most unstable joint in the human body and therefore requires a variety of muscular support. The joint does not always have to be affected in pain. The muscles surrounding the shoulder and vision are often responsible for shoulder pain. The causes include overloads, injuries, wear and tear, inflammation, deposits and the bottleneck syndrome.

The shoulder pain can often be provoked by certain movements, which makes diagnosis easier.

Pain in the shoulder

Pain in the shoulder can affect the normal daily routine quite a bit. Sleep is also often affected by shoulder pain. Patients wake up at night due to massive pain and are unable to fall asleep. This indicates a chronic inflammatory event. The discomfort can be so massive that pain relievers do not provide real relief.

Cause: overload, injury

The following overloads and injuries can lead to shoulder problems: Overloading during sports, for example during strength training, can suddenly cause shoulder pain. The reasons for this are a tear or an overextension of the joint capsule or a tendon. Massive pain is seen in a shoulder dislocation (dislocation of the shoulder joint) or a broken collarbone. As a rule, the affected arm can no longer be moved. Therefore, those affected take a gentle posture by pressing the arm firmly against the body.

Shoulder corner blasting
Another injury that causes severe pain is the shoulder corner joint blast. The shoulder corner joint denotes a firm connection between the outer clavicle and the shoulder blade. In the accident underlying this injury, the ligaments that stabilize the shoulder corner joint are stretched, torn or they tear completely. The pain occurs immediately after the event. The injury can often even be seen from the outside.

Rotator cuff injury
A common cause is an injury to the rotator cuff. It consists of four muscles, the tendons of which form a tendon plate and, as the name suggests, surrounds the shoulder joint as a kind of cuff. Their function is extremely important for a healthy shoulder. With increasing age, a completely natural degeneration sets in, which means that the rotator cuff can tear more easily. An injury occurs above and beyond the age of 50, but is also possible for younger people. If the area has already been damaged, the cuff can tear, for example, in the event of excessive physical exertion.

A fall on the shoulder can also lead to this. This doesn't have to be painful. However, shoulder pain and weakness in the shoulder are more common in rupture. With a complete crack, normal movement is no longer possible. The rotator cuff can also tear only partially - this causes shoulder pain, but the movement is not restricted.

In the event of a partial rupture, conservative therapy alone is often sufficient. First of all, the focus is on inflammation and pain. Medications that are anti-inflammatory and pain relieving are used. After that, regular physiotherapy is important. If the tendon is completely torn, surgery is usually performed. Depending on the extent, there are different methods to choose from. Unfortunately, the complicated shoulder also requires a long rehabilitation period. Six months to full recovery are quite possible.

Impingement syndrome (bottleneck syndrome) of the shoulder
This means a narrowness in the area between the shoulder roof and upper arm head, the so-called subacromial space. This is caused by instability, tendon thickness, wear, an unfavorably shaped shoulder roof or limescale deposits (see lime shoulder). The most frequently affected are athletes who practice overhead sports, such as javelin throws or swimming. But people who work a lot overhead (e.g. painters) also suffer from this disease.

Symptoms include mild to massive shoulder pain. Initially, these are primarily movement-dependent. They occur when the affected arm is lifted back or to the side, such as when pulling on - especially when the movements are made abruptly. Later lying on the shoulder is no longer possible. The patients wake up with massive shoulder pain. Then at the latest, a doctor is consulted. The narrowness creates friction, which in turn leads to inflammation. The pain worsens. In the worst case, the affected structures of the shoulder are so irritated and overused that the tendons can tear or even tear completely. (see injury to the rotator cuff).

In the case of impingement syndrome, the bursa can also be affected. This causes inflammation of the bursa, which leads to additional uncomfortable shoulder pain.

X-rays and MRI are the methods of choice for diagnosing shoulder pain. The pain is treated with medication. This is followed by special physiotherapy and manual therapy. Certain muscle groups that relieve the shoulder joint should be strengthened. If all of this does not help and if the rotator cuff is ruptured, an operation is considered.

Frozen shoulder

The frozen shoulder begins with pain in the shoulder, which becomes more and more frequent and then becomes immobile, as if the shoulder was really frozen. The whole thing either occurs with no apparent cause, or develops after an injury or surgery. Since inflammation is associated with the frozen shoulder, anti-inflammatory and pain-relieving medications are prescribed first.

Special physiotherapy that tries to keep the shoulder flexible is essential. It is important to adjust the treatment to the pain during the inflammatory phase so that the disease does not get worse. The whole thing is supported with heat, cold and electrotherapy. Surgery is rarely necessary.

Lime shoulder

As the name suggests: lime deposits in the tendon roots of the lime shoulder. This disease has a long history. The causes are trauma, sports, improper stress, overuse, aging processes and poor blood circulation. Due to constant irritation and insufficient blood circulation, tendon tissue turns into fibrous cartilage. In the next phase, the body stores lime in the tissue. This is then also visible with imaging methods. All of this does not have to hurt, but it can lead to massive complaints.

As already mentioned with the other painful illnesses, the treatment tries with suitable medication to control the inflammation and to relieve the pain. Painkillers or narcotics are also injected. As soon as the pain allows easy movements, targeted physiotherapy is carried out. Other methods are shock wave therapy and matrix therapy. The lime often dissolves in connection with the appropriate treatment and the pain is a thing of the past. However, if all therapy is unsuccessful and the pain is unbearable, the limescale is surgically removed using a keyhole surgery.

Causes off the shoulder

Shoulder pain can also occur if the causes are outside the shoulder, for example due to diseases of the cervical spine and complaints in the area of ​​the neck. The pain then radiates up to the shoulder.

An organ that is far from the shoulder can also be to blame for the symptoms. That is the bile. If she is ill, the pain can extend to her right shoulder. Especially if the affected patients have digestive problems and problems with eating fatty foods in addition to the pain, the bile should be considered.

Treatment methods for shoulder pain

Treatment naturally depends on the underlying cause. A detailed medical history, an examination and imaging procedures such as X-rays, ultrasound and MRI are used to find the diagnosis. The first thing that is usually prescribed is drugs that have anti-inflammatory and analgesic effects. This is also intended to break the vicious circle in which the patient finds himself: pain - careful posture - one-sided stress - even more pain. Medications may be administered by injection.

An individual physiotherapy follows. Bad postures are recognized, corrected, muscles strengthened. The patient is shown exercises that he or she should perform regularly at home. If the disease is too massive and too advanced, surgery may be advised. Today, this is usually minimally invasive. Since the shoulder joint is a very complicated joint, an operation should never be rushed. Long convalescence should also be considered.

If surgery is required, the guidelines of doctors and therapists must be followed. An early, too massive load must be avoided in order not to negatively influence the healing process. The shoulder just takes time to heal.

Naturopathic therapies for shoulder pain

A wide variety of naturopathic therapies are used. Acupuncture in particular can be helpful for acute shoulder pain. Anthroposophic medicine has ampoules ready, which are injected and have an anti-inflammatory effect, relieve pain and additionally strengthen the holding apparatus and the joint. Bursitis, which occurs in connection with shoulder problems, is also treated with the above-mentioned procedures.

Homeopathic remedies for the treatment of shoulder pain are bryonia, arnica, ruta and rhus toxicodendron. These agents are often also used in the form of syringes. Baunscheidt therapy relieves the pain somewhat and has an anti-inflammatory effect. Neural therapy according to Huneke is also an effective means. A local anesthetic such as procaine is injected at certain points.

Nettle, dandelion, devil's claw and comfrey help from phytotherapy. Rubbing and wrapping with slightly warmed St. John's wort oil has a pain-relieving effect. Patients have to find out for themselves whether they get better heat or cold. If you want warmth, an ointment made from cayenne pepper is recommended. This warms the entire tissue. If you need cold, curd cheese wrap is good for you.

Enzymes from papaya and pineapple are anti-inflammatory and thus also pain-relieving. These can be obtained in tablet form from the pharmacy. But be careful: Patients who take blood-thinning medication must keep their distance.

Reflexology can treat the entire body, including the shoulders. This is a very pleasant therapy, far from the actual pain, but with success.

Diet for shoulder pain

Patients suffering from shoulder problems are often overacidified. This is quite obvious, especially with muscle cramps and / or limescale deposits. And the more pain there is, the more acid the body produces. It is therefore essential to think of a basic diet here. It is low in animal products and rich in vegetables and fruits. Adequate hydration with tea and still water is equally important.

Final word

In summary, shoulder pain should not be taken lightly. The earlier the appropriate therapy begins, the easier it will be to treat this pain. So please don't be a hero, but go to the doctor soon. (sw)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • Danielle Campagne: Shoulder Luxation, MSD Manual, (accessed September 3, 2019), MSD
  • Ulrich Brunner et al .: S2e guideline "Rotator cuff", German Society for Orthopedics and Orthopedic Surgery (DGOOC), (accessed on September 3, 2019), AWMF
  • Ina Aschenbrenner, Peter Biberthaler: AC joint dislocation (shoulder corner joint blast), German Society for Trauma Surgery, (accessed on September 3, 2019), DGU
  • Hussein Elkousy, T. Bradley Edwards: Impingement Syndrome, Gartsman's Shoulder Arthroscopy, pp. 203-219, Elsevier Verlag, 3rd edition, 2019
  • Volker Echtermeyer, Stefan Bartsch: Praxisbuch Shoulder, Thieme Verlag, 2nd edition, 2004
  • Nikolaus Wülker et al .: Pocket textbook on orthopedics and trauma surgery, Thieme Verlag, 3rd edition, 2015
  • Jens Schönbeck: Shoulder Physiotherapy - Conservative and Postoperative Rehabilitation, Urban & Fischer Verlag, Elsevier GmbH. 2012


Video: Dealing with Chronic Shoulder Pain (August 2022).