The name of the painful shoulder syndrome includes not one, but many diseases related to the shoulder. Pain and limited range of hand movements can be caused by overloading the muscles, injuring the tendon, or inflammation of the subacial bursa. The method of treatment depends on determining the causes of pain.

Painful shoulder syndromecan have a variety of causes. Shoulder - how important it is in everyday life, we realize when we cannot perform ordinary activities. For if any of the elements of its structure starts to function worse, there are ailments limiting hand movements.

Painful shoulder syndrome - symptoms

The main symptom of shoulder pain syndrome is pain. Sometimes it is small at first, it appears only when you raise your arm above the shoulder line. Over time, it intensifies and teases also with other movements of the limb.

It should be remembered that pain does not always have to be associated with physical activity. It often appears at night when we are trying to fall asleep on our sick side. It also happens that it appears suddenly, e.g. after making a sudden movement, and is so sharp and strong that we keep our hand in one position all the time to avoid suffering.

Pain may be accompanied by a swelling in the shoulder area. If we ignore these two symptoms, a third joins - a significant limitation of the range of movements in the shoulder joint. Regardless of whether the pain appeared suddenly or gradually increased, we should see an orthopedist. The key issue is to establish its cause.

Painful shoulder syndrome - causes

The most common sources of ailments are:

  • muscle overload,
  • posture disorders,
  • tendon injuries,
  • Subacial bursitis,
  • rheumatic diseases (RA, osteoarthritis)
  • neurological diseases (cervical and brachial plexus inflammation).

Imaging tests help the doctor to find the cause:

  • X-ray (X-ray),
  • ultrasonography (USG),
  • magnetic resonance imaging (MRI).

Overload of the shoulder muscles

  • Reasons:

It occurs during activities that require raising a hand above the shoulder line, which we do not do on a daily basis (e.g. washing windows) or carrying heavy objects.

CauseThe problem may also include repetitive, steady movements, sleeping in an uncomfortable position, jerking your hand violently, and exercising too vigorously. The result of overstraining the muscles during exercise may be their contracture - they are constantly tense, which causes pain.

  • Treatment:

It consists in discontinuing activities causing the exacerbation of symptoms, taking painkillers and muscle relaxants, and using manual therapy. It is better not to delay it, because the longer the contracture lasts, the more difficult it is to remove it, and the rehabilitation lasts longer.

Injured shoulder tendons

  • Reasons:

The source of shoulder pain may be damage to the tendons of the rotator cuff, which consists of 4 small muscles (infraspinatus, supraspinatus, subscapular, and rounder). These tendons surround the head of the humerus and are fused with the joint capsule.

The supraspinatus tendon is most often injured, for example when throwing the ball with the hand raised above the shoulder line. But the pain can also be caused by an injury to another tendon in the shoulder area, the biceps tendon. They are easy to stretch even during such a trivial activity as reaching in the car for a handbag lying on the back seat.

Stretch, torn tendons accumulate and can cause chronic shoulder pain, or even a tendon rupture.

  • Treatment:

When a breakup is complete, surgery is usually required. The most common procedures are arthroscopic. Their goal is to reconstruct damaged tendons. In the case of the biceps tendon, it is often cut, shortened and attached to the bone elsewhere.

Partial damage can be treated better and better by injecting tendons with platelet-rich plasma (PRP) under ultrasound control, not forgetting the very important role of properly conducted motor rehabilitation.

Subacial bursitis

  • Reasons:

A he althy sub-shoulder bursa resembles a glued foil bag, a sick one - a thickened bag filled with fluid. This change occurs when the rotator cuff is weakened or damaged. Then, when the arm is raised above the shoulder line, the bursa conflicts with the shoulder process, and a painful subacromial tightness (structures rub against each other).

  • Treatment:

It consists in administering oral analgesic and anti-inflammatory drugs, injecting steroids directly into the bursa, one or a maximum of two times, preferably under ultrasound guidance. An important element of the treatment isrehabilitation that restores the proper mobility of the joint.

In some cases it is necessary to surgically remove the bursa. If the rotator cuff tendons are ruptured, surgery is required to reconstruct them with anchors.

"Freezing" the shoulder

  • Reasons:

This is what we say about the thickening and stiffening of the articular capsule, which results in a significant limitation of the range of movements in the shoulder joint. Avoiding hand movements due to pain may contribute to "freezing" of the shoulder.

  • Treatment:

In the case of this ailment, a long rehabilitation conducted by an experienced therapist is necessary. The disease can last up to 1.5 years, so it is very important to explain to the patient what its course is, what symptoms may be disturbing.

If it is not implemented at the right time, adhesions form in the joint capsule and the subacromial space, which stiffen the joint. When this happens, they need to be removed operationally.

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Our Expert:Michał Konik, MD, PhD - orthopedist, Rehasport Clinic, Medicover Hospital

Rehabilitation is needed in both non-surgical and surgical methods of treating shoulder diseases. It requires a lot of patience on the part of the patient, because only after a series of treatments it improves, but it is effective. First of all, physiotherapy helps: kinesiotherapy (treatment with movement) and manual therapy (involves mobilization, manipulations on joints and soft tissues). Physical therapy (with the exception of cryotherapy) has little benefit.

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Spine, bones, joints