Shoulder pain is common in all age groups ranging from adolescents to elderly. The presentation, symptoms, causes, diagnosis is varied this distribution. The most common underlying ailment is usually an altered biomechanics of the shoulder joint or an asynchrony of the ball (Arm bone) and the socket (Shoulder blade).
To understand the basic cause of shoulder and related neck pains, it is imperative to learn the mechanics of shoulder joint. Shoulder is a ball and a socket joint. The ball rotates internally, externally and lifts up with the help of the muscles attached to it. These muscles are called the rotator cuff. Whenever one tries to lift the arm, the ball in socket moves 2 parts and in synchrony with the shoulder blade moving (Rotating) 1 part.
Whenever this 2:1 ratio of synchronous movements is disturbed, there is a change on the pattern or rhythm of movement. This is popularly called shoulder dyskinesia. These movements of the shoulder have been illustrated in the following diagrams for better understanding.
Shoulder dyskinesia is the basic cause of pain, stiffness and restricted range of motion in a non-traumatic shoulder.
In an acute traumatic shoulder associated with fracture and soft tissue injury the initial management differs from a chronic painful shoulder. Since shoulder is a very mobile joint offering a large range of movements, it is also quite liable to dislocate in comparison to other joints. Cases with diagnosed fracture/dislocation are usually an emergency and need urgent medical/surgical attention.
The important causes of shoulder pain are:
- Fractures around shoulder
- Shoulder dislocation
- Infections of the shoulder joint
- Rotator cuff tendinopathy
- Rotator cuff tears
- Shoulder arthritis
- Shoulder Impingement
- Biceps Tendon injury
- A-C Joint arthritis
- Congenital structural abnormality
- Metabolic diseases
To address the shoulder pain, it is imperative to make the correct diagnoses first. Before the initiation of treatment, the biomechanical disturbance should be assessed by a sports medicine specialist or an arthroscopy surgeon as there are overlapping symptoms in these pathologies.
Physiotherapy and rehabilitation forms an essential part of treatment in these cases which is responsible for correction of the underlying cause and preventing recurrence.
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