The
shoulder is the most movable and the most fragile joint in the body. But its
very flexibility makes it prone to both sudden injury and chronic wear and
tear.
 Who Gets Shoulder Problems?
After age 25, most problems are caused by the effect of
repeated overhead motions for a long period of time. Weekend athletes and
do-it-yourselfers are especially vulnerable to overuse problems in the
shoulder.
The leading causes of shoulder
pain are bursitis, tendonitis, and irritated rotator cuff. This group of
conditions is called shoulder impingement syndrome.
What is
Bursitis?
The bursa is a fluid-filled sac that cushions the rotator cuff tendons
from the shoulder bone. An irritated bursa is caused by an inflamed
rotator cuff. When irritated, the bursa produces extra fluid, the sac
expands, and the pressure creates pain.
What is Tendonitis?
Deep in the shoulder are a group of tendons and muscles called a rotator
cuff. They help stabilize the upper arm bone in the shoulder joint and
rotate the arm. The biceps tendon is also present in front of the
shoulder. When the arm is raised repeatedly over the head, the tendons
rub against the underside of the shoulder bone and become irritated. The
tendons swell, leaving even less space between tendons and bone. The
irritation creates more irritation. It is much like a rope being drawn
again and again across a jagged rock.
What is an Irritated Rotator Cuff?
Excessive wear on the rotator cuff can lead to severe irritation,
roughening and eventually ulceration and tearing of the cuff. An
irritated rotator cuff feels like a clicking or popping in the shoulder,
due to a ragged piece of the cuff sliding under the shoulder bone.
Occasionally, injuries or infections can also lead to arthritis,
although arthritis of the shoulder is less common than in the knee or
hip. Arthritis in the shoulder causes a roughening of the joint from
worn cartilage and loose fragments of bone.
 What are the Symptoms?
Bursitis, tendonitis, irritated rotator cuff and
arthritis are all inflammatory reactions to overuse. With any of these
problems, a continuous dull ache in the shoulder can become a sharp pain
when you try to move your arm, especially over your head. The pain may be
worse at night after a heavy day of activities using your shoulder.
What is the Treatment for Shoulder Impingement?
Rest: Avoid
strenuous activity and any motion that causes pain. In some cases a
shoulder sling is helpful to rest fatigued muscles and inflamed tendons.
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Ice: An ice pack
on the affected shoulder can help ease the inflammation when combined
with gentle motion.
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Oral medicines: Anti-inflammatory medicines such as Motrin, Feldene, Volatren, Naprosyn
or aspirin will reduce inflammation.
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Cortisone injections: Cortisone is a natural hormone and a very powerful medicine for
inflammation. When injected directly into the inflamed area. It
decreases swelling and thus reduces pain.
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