16.JUL.2020 5 MIN READ | 5 MIN READ

Shoulder pain can be caused by simple problems such as overuse, or it could be the early stages of a chronic medical condition. Whichever the case may be, an orthopaedic specialist can help.

Have you ever wondered why, when people complain of soreness, they commonly massage the shoulders? That’s because the shoulders bear the brunt of heavy lifting, long days at the computer, endless hours of cooking and housework, or training in sports like CrossFit, tennis, and swimming.

If you’ve ever felt pain when attempting to move your arms or been unable to lift even normal items, you would know how frustrating it is to have sore or injured shoulders.

Depending on the extent of the pain, some of us have either tried to ignore the pain and power through, slapped on a medicated patch or taken a dose of painkillers to ease those muscle aches. The problem is, these measures are not effective for severe pain, and may worsen an injury.

As shoulder injuries can be caused by a variety of factors – and sometimes a combination of more than one – here’s a look at some common causes and what you can do about them.

Overuse

Sometimes, doing the same action over and over can lead to injury. Frequent, repetitive movements can damage the cartilage (the smooth rubbery layer that encircles the surfaces of the shoulder joint) or tear the rotator cuff (the group of muscles and tendons that hold the shoulder bones together). Both these injuries would make it difficult to raise your arms over your head or cause pain when you try lifting things.

Sometimes, overuse of the shoulder can also lead to bursitis, when small sacs between the bones and soft tissues known as bursae get inflamed or swollen. This leads to shoulder pain even when performing simple daily tasks like getting dressed.

Trauma

Trauma
A fall or hard direct impact to the shoulder can cause serious injury such as a dislocation, which means your arm has popped out of its socket, or a fracture, which would mean either a broken collarbone (clavicle), upper arm (humerus) or shoulder blade (scapula).

Medical conditions

There are 2 kinds of arthritis which can lead to shoulder stiffness and pain. In osteoarthritis, the cartilage between bones breaks down, while in rheumatoid arthritis, the body’s immune system attacks the protective lining in joints.

Other causes

Stiffness and pain can also be caused by a condition known as frozen shoulder which begins gradually, worsens and then resolves within 1 – 3 years. You may be more likely to have this problem if you have certain associated medical conditions, or a recent injury or procedure that prevents you from lifting your arm.

Another common cause is known as impingement, where part of the shoulder blade presses on the soft tissues every time your arm is lifted away from the body, with the resulting pain limiting the movement of your arms.

Treating your shoulder pain

Treatment would naturally depend on the cause or type of injury.

RICE
In many cases, rest and applying cold or hot treatment can help to relieve the pain. Pain and/or anti-inflammatory medications can help too, but they should be taken for no more than a few days unless advised by a doctor.

If there is no improvement after a few days of self-care, it may be time to seek further medical advice from a doctor who specialises in bone and joint injuries, known as an orthopaedic specialist.

Several tests may be required such as an x-ray, magnetic resonance imaging (MRI) or computed tomography (CT) scan, among others. These tests will help the specialist to see if the pain may be a sign of a medical condition or an injury that needs further treatment.

Treatment can range from corticosteroid injections into the joint to relieve swelling and pain, or arthroscopy, a procedure that has the ability to diagnose as well as treat joint problems, without the need for open surgery. As arthroscopy is minimally-invasive, it’s even possible for patients to undergo the procedure as an outpatient and recuperate at home.

The Role of Arthroscopy

Here’s how arthroscopy works: a small incision is made to allow the insertion of a fibre optic camera and the image is transmitted to a high-definition video monitor. This allows the specialist to clearly see inside the joint. With the help of additional small insertions, arthroscopy even allows certain types of surgery to be performed to treat shoulder injuries involving damaged cartilage, muscle tendons and torn ligaments. However, should the injuries be severe or extensive, alternative surgical approaches may be needed.

For trauma-related injuries such as dislocations or fractures, you should seek immediate medical treatment at the nearest A&E department to place the bones back in their proper position. You will likely need to wear a sling to hold things in place while you heal, followed by exercises to strengthen your muscles and improve range of movement.

Overall, any form of shoulder pain should not be ignored – an untreated injury could become more difficult to treat while a chronic or degenerative condition could worsen. As pain can affect a person’s quality of life, from preventing sleep to impacting work and social activity, treatment should not be delayed.

For more information on shoulder pain and treatment options, speak to an orthopaedic specialist. However, if you experience sudden and severe pain, with symptoms like numbness, weakness or swelling, you should seek medical attention immediately at your nearest A&E department.

 

Following the end of the circuit breaker period, Gleneagles Hospital and our 24-hour A&E clinic have resumed all healthcare services. If you or your family members require treatment for a medical condition, make an appointment with a specialist.

Our services are also available at other Parkway Pantai hospitals at the Mount Elizabeth Hospitals and Parkway East Hospital.

Rest assured we have implemented measures to safeguard the health of our patients, visitors and staff. Learn more about how we keep our hospitals safe.

 

Article reviewed by Dr Ruben Manohara, orthopaedic surgeon at Gleneagles Hospital

References

(May 17, 2019) Why does my shoulder hurt? Retrieved on 6 June 2020 from https://www.webmd.com/pain-management/why-does-my-shoulder-hurt#1

(July 2009) Common Shoulder Injuries. Retrieved on 6 June 2020 from https://orthoinfo.aaos.org/en/diseases--conditions/common-shoulder-injuries/

(March 2018) Shoulder Pain and Common Shoulder Problems. Retrieved on 6 June 2020 from https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-pain-and-common-shoulder-problems/

(n.d.) Frozen Shoulder. Retrieved on 11 June 2020 from https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/symptoms-causes/syc-20372684

(16 August 2018) Arthroscopy. Retrieved on 11 June 2020 from https://www.mayoclinic.org/tests-procedures/arthroscopy/about/pac-20392974

(May 2010) Arthroscopy. Retrieved on 11 June 2020 from https://orthoinfo.aaos.org/en/treatment/arthroscopy/

16.JUL.2020
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Manohara Ruben
Orthopaedic Surgeon
Mount Elizabeth Hospital