At some point in our lives, we've all experienced a certain degree of shoulder pain. However, not all types of shoulder pain are created equal. The location of your pain can actually tell you a lot about what might be going wrong.
Whether you're a fitness enthusiast dealing with a sports injury or you just woke up with a stiff shoulder, we'll explore what your body might be trying to communicate through the pain. We will also discuss common causes and potential treatments for different types of shoulder problems.
Understanding Shoulder Anatomy
The shoulder is a complex joint with multiple components working together to allow a wide range of motion.
- Humerus (Upper Arm Bone): This is the long bone in your upper arm. It fits into a socket in your shoulder blade to create the shoulder joint. The top part of the humerus is shaped like a ball, which fits into the round socket portion of the shoulder blade. This ball and socket design allows your arm to have the widest range of motion of any joint in the body.
- Scapula (Shoulder Blade): This is a triangular bone that anchors the muscles of the shoulder and arm. The scapula has a socket that forms part of the shoulder joint, and this is where the upper arm bone fits in.
- Clavicle (Collar Bone): The clavicle links the shoulder blade and the sternum (chest bone). It provides support and enables the arm to move freely.
- Rotator Cuff: This is a group of four muscles and tendons that surround the shoulder joint. They stabilize the shoulder and facilitate its wide range of motion.
- Bursa: These are small fluid-filled sacs that cushions and reduces friction between the bones and surrounding soft tissues.
- Cartilage: This is a soft, rubbery tissue that covers the end of the ball and socket sides of the shoulder joint. It reduces friction and protects the joint during movement.
It's important to understand the basics of shoulder anatomy because injury or damage to any of these components can lead to shoulder pain and dysfunction.
Pain Along the Front of the Shoulder
If you're experiencing pain along the front of your shoulder, it could be a sign of:
- Biceps Tendonitis:This condition is characterized by inflammation in the tendon that connects the biceps muscle to the shoulder. It is typically caused by repetitive motion or overuse, resulting in a dull ache that is often worsened by arm movement.
- Superior Labrum Anterior to Posterior (SLAP) Tears: A SLAP tear refers to an injury to the labrum, a ring of cartilage that surrounds the shoulder socket. Such tears typically result in sharp, catching pain in the front of the shoulder, particularly during overhead activities or movements that involve lifting heavy objects.
- Shoulder Arthritis: Arthritis in the shoulder typically leads to a deep, pervasive ache in the front of the shoulder or into the armpit area. This happens as the cartilage that cushions the bones wears away, leading to the bones rubbing against each other during movement.
Pain on the Top of the Shoulder
If you're feeling pain at the top of your shoulder, you might have a condition like:
- AC Separation: Also known as shoulder separation, this is an injury to the ligaments that hold the acromioclavicular (AC) joint, which connects the shoulder blade to the collarbone, at the top of the shoulder. It's often caused by a hard fall or direct blow to the shoulder, and it can cause severe pain at the top of the shoulder, sometimes accompanied by a visible bump over the AC joint.
- AC Arthritis: This condition involves degeneration of the cartilage of the AC joint, leading to inflammation and pain. Pain from AC arthritis is felt at the top of the shoulder, typically worsening with overhead activities or when the arm is fully extended across the body.
- Distal Clavicle Osteolysis (DCO): DCO is a condition typically seen in weight lifters and individuals who perform repetitive overhead lifting. It involves the breakdown of the end of the collarbone where it meets the shoulder blade, and it can lead to chronic pain over the top of the shoulder.
Pain Surrounding the Shoulder or Into the Upper Arm
If your pain is more generalized or it goes into the upper arm, there are a number of possible causes to consider:
- Bursitis/Impingement: This happens when the bursa, the sacs that cushion the joint, become inflamed or pinched between bones with motion of the shoulder. This typically results in a dull, achy pain that worsens with movement or pressure on the shoulder.
- Rotator Cuff Tendonitis: This condition is characterized by inflammation and swelling in the tendons of the rotator cuff. It's usually caused by repetitive overhead movements such as throwing a ball or lifting weights. The pain can be a dull ache or a sharp, severe pain, especially when lifting the arm overhead or sleeping on the affected side.
- Rotator Cuff Tears: This involves a torn rotator cuff tendon. While a rotator cuff tear can occur as a result of a sudden injury, it's more commonly a result of wear and tear over time. Symptoms can range from a dull ache deep in the shoulder to arm weakness and difficulty lifting objects. Rotator cuff surgery may be required for severe tears.
- Shoulder Instability: This problem falls into two general categories:
- Sudden injuries where the ball is forced out of the socket (dislocated) and often has to be put back into place (reduced) in the ER. These most often occur in younger contact athletes and more frequently end up requiring surgical treatment to avoid subsequent dislocations.
- More gradual injuries that occur due to weak rotator cuff muscles or loose ligaments. There is usually no actual dislocation of the shoulder joint, but it can feel like it is unstable with certain movements. This type of problem can usually be effectively treated with physical therapy but does require surgery in some cases.
- Adhesive Capsulitis or 'Frozen Shoulder': This condition involves the gradual stiffening of the shoulder joint, causing a reduction in its range of motion. It usually starts with mild pain that worsens over time, eventually leading to difficulty performing everyday activities like dressing or reaching overhead.
When to See Dr. Brian Kelly
If your shoulder pain persists despite rest, over-the-counter pain relievers, and physical therapy, it's time to seek help from a professional like Dr. Brian Kelly. Dr. Kelly specializes in arthroscopic shoulder surgery, a minimally invasive procedure that can provide effective pain relief and restore mobility.
Shoulder arthroscopy can address several shoulder conditions, including rotator cuff repair, shoulder arthritis, and SLAP tears among others. Using small instruments and a camera, Dr. Kelly can view the inside of your shoulder joint and perform the necessary treatment with minimal impact on the surrounding tissues.
In some severe cases, such as advanced arthritis or significant rotator cuff tears, more extensive shoulder surgeries like a shoulder replacement may be necessary. These procedures can provide profound pain relief and significantly improve your quality of life. Dr. Kelly has a wealth of experience in performing these operations and will work closely with you to determine the best course of treatment for your individual situation.
Remember, enduring pain is not a solution. Taking the first step towards pain relief can be as simple as scheduling a consultation with Dr. Brian Kelly. His extensive experience ensures that you are in capable hands. Don't let shoulder pain limit your life—seek professional help today.
Dr. Brian Kelly, MD is an orthopaedic surgeon and sports medicine doctor experienced in treating a variety of injuries and conditions. Dr. Kelly and his expert team will make sure that you get the treatment you need to get back in the game. Schedule an appointment with us at our offices in Sewickley or Moon Township today.
