Shoulder pain
General
Shoulder pain can occur at any age. Sometimes the shoulder pain acute (e.g. during exercise or after lifting a heavy load), but more and more people also suffer from chronic Shoulder pain (e.g. due to joint wear). The pain can have many different causes and severely restrict and impair the person concerned in everyday life.
Behind the shoulder pain, for example, there can be a so-called Impingement syndrome (Bottleneck syndrome), but also acute injuries, inflammations or signs of wear and tear in the shoulder joint. An example of this is the Bruised shoulder.
Often shoulder pains are due to consistent and long-term applied physiotherapy Treatable to strengthen muscles, surgery is only necessary in a few cases.
Most shoulder pain comes from the soft tissues of the shoulder joint, which means that not the bones, but rather Muscles, Tendons, Joint capsule, Synovial fluid (Synovia) and Bursa are affected.
Pain restricts mobility in the shoulder, many everyday processes, such as putting on a shirt, combing hair or blow-drying, require good coordination Shoulder and arm muscles ahead.
Often there are relieving postures, which is why early therapy is particularly important. Depending on the cause, the shoulder pain can occur in different places and with different movements and activities. Problems with the Cervical spine can lead to pain symptoms in the shoulder and radiate into the arm or hand.
anatomy
The so-called Shoulder girdle is formed by two bones on each side of the shoulder, i.e. the two Collarbones (Clavicles) and Shoulder blades (Scapulae). The shoulder blade and the humerus form the Shoulder joint.
In addition, the shoulder blade forms two bony protrusions, the Shoulder roof (Acromion) and the raven beak extension (Coracoid).
The shoulder joint is largely stabilized by four muscles and their tendons, the so-called Rotator cuff. The four muscles (Supraspinatus muscle, M. infraspinatus, M. teres minor and Subscapularis muscle) pull from the shoulder blade to the humerus and start there with their tendons.
For this reason, they wrap around the head of the humerus like a cuff and form a "roof" over the shoulder joint.
The space under the shoulder roof, the subacromial space, is often affected by wear problems in the shoulder joint. A bursa facilitates the sliding process between the tendons and the bony roof of the shoulder. This can lead to shoulder pain, for example due to inflammation.
The shoulder joint is primarily moved and mobilized by muscles and tendons, resulting in a large range of motion. However, this increases the risk of instability and the shoulder joint is easily injured.
causes
Signs of wear and tear on the shoulder arise from chronic overloading and imbalances in the muscles.
For activities that are performed above the head, such as Painters or Handball or tennis players painful shoulder wear is particularly common.
This mainly affects the movements in the shoulder, causing painful inflammation and swelling. With an impingement syndrome (Bottleneck syndrome) there is a constriction between the roof of the shoulder and the humerus. The tendon and bursa running there are exposed to a constant state of irritation, causing inflammation.
In the shoulder, tears, adhesions and shrinkage of the joint capsule in the soft tissue area can occur, which leads to shoulder pain.
Joint wear and tear (osteoarthritis) can be another cause of shoulder pain. The Osteoarthritis of the shoulder will be favored by excessive stress (such as years of strength training), joint gap narrowing in old age, rheumatic diseases (e.g. rheumatoid arthritis) or circulatory disorders.
Damage or tear to the muscles or tendons of the rotator cuff (Rotator cuff rupture) leads to pain and can severely limit the mobility of the arm.
Read more on this topic at: Pain in shoulder and arm
A painful shoulder joint inflammation (Humeroscapular periarthritis) it can lead to a frozen shoulder (Capsulitis adhaesiva) or the so-called "Frozen shoulder" come.
The so-called lime shoulder (Tendinosis calcarea) denotes a deposit of calcium crystals in the rotator tendon due to recurring minor tendon injuries or local circulatory disorders of the tendon. The calcareous shoulder causes excruciating pain, especially at night.
Accidents, fractures and injuries in the shoulder area can also lead to severe pain symptoms. A broken collarbone (Clavicle fracture) or injuries in the area of the humerus (e.g. Humeral head fracture) are common. Dislocations of the shoulder joint (Shoulder joint dislocations) can trigger severe pain and have various causes. The shoulder often dislocates again and again, resulting in a chronically unstable shoulder that should be treated surgically as part of a joint endoscopy.
Other causes of shoulder pain are tendinitis or bursitis (subacromial bursitis). These are mainly caused by mechanical overload, infections, rheumatic diseases and gout. Tension and hardening of the shoulder muscles due to incorrect posture and stress, for example from sitting too long, strains the shoulder, back and neck and can lead to pain. Shoulder pain can also come from the spine, be caused by inflammation of the nerves or nerve injuries, by rheumatological diseases and also by internal diseases (e.g. heart attack, biliary colic, lung tumors, etc.).
Appointment with a shoulder specialist
I would be happy to advise you!
Who am I?
My name is Carmen Heinz. I am a specialist in orthopedics and trauma surgery in the specialist team of .
The shoulder joint is one of the most complicated joints in the human body.
The treatment of the shoulder (rotator cuff, impingement syndrome, calcified shoulder (tendinosis calcarea, biceps tendon, etc.) therefore requires a lot of experience.
I treat a wide variety of shoulder diseases in a conservative way.
The aim of any therapy is treatment with full recovery without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
You can find more information about myself at Carmen Heinz.
Symptoms
Since the causes of shoulder pain are very different, different symptoms can also be in the foreground.
Often shoulder pain (e.g. due to an impingement syndrome or a rotator cuff injury) affects the mobility of the arm.
The arm can often hardly be lifted due to the pain and many everyday activities are difficult to do. Shoulder pain occurs particularly often when the arm is spread sideways (Abduction) and are particularly strong at an angle of about 60 to 120 degrees, which is why doctors and therapists also use the "painful arch"or"painful arc" speak.
Nocturnal shoulder pain is also typical, when you unconsciously lie down on the painful side or turn there in your sleep. If the pain originates in the cervical spine, it is common for pain to be referred from the shoulder to the arms and hands.
Read more on this topic at: Pain in shoulder and arm
In the case of tendinitis, shoulder pain can be triggered by very different arm and shoulder movements, depending on which muscle tendon is affected.
Please also read our article on this
- Tendinitis in the shoulder
- Tendinitis in the arm
- You can tell when you have frozen shoulder by these symptoms
- Pain under the shoulder blade
Front
There are many different causes of pain in the front of the shoulder. This is where the anterior rotator cuff, the biceps tendon, part of the joint capsule, the ankle joint (Acromio-clavicular joint) and various soft tissue structures such as bursa or tendons. Alternatively, anterior shoulder pain can develop as a result of damage to structures that are not located directly on the anterior shoulder.
On the one hand, front shoulder pain can arise from inflammation or entrapment of the joint capsule. There are also bursa in the front area of the shoulder (Bursa), which ensure that the muscles slide smoothly together. Inflammation of these bursitis (bursitis) in the area can cause anterior shoulder pain. As in the knee or hip joint, osteoarthritis (wear) can occur in the shoulder. Osteoarthritis can affect the actual shoulder joint between the shoulder blade and the humerus (Humero-glenoid joint) as well as smaller joints such as between the collarbone and the shoulder blade (Acromio-clavicular joint). In this case, the pain is projected onto the front shoulder area. Such a degenerative change is always a creeping process, whereby the pain initially only occurs depending on the load. Degenerative changes in the soft tissues such as torn muscles or tendons can also be the cause. The biceps tendon is particularly often affected. A dislocation of the shoulder joint (dislocation) can cause anterior shoulder pain as the forward and downward direction is by far the most common direction of dislocation.
Shoulder pain on the back
With back shoulder pain, the pain is mainly concentrated in the back of the shoulder joint. Here, too, the pain can be caused by structures further away and only transmitted to the rear shoulder joint.
The cause is a vertebral blockage mostly in the cervical spine, more rarely the thoracic spine. The pain, which often occurs immediately, radiates from the cervical spine to the back shoulder and is caused by the interlocking of the vertebral joints of two adjacent vertebral bodies. This often happens through jerky movements while sleeping or through an accident. The pain does not arise directly from the blockage, but rather from reactive tension in the muscles. In addition, there are considerable restrictions on movement.
A herniated disc in the cervical spine can also cause pain in the back shoulder. Movement disorders of the shoulder blade are also a possible cause. This is caused by tendinitis on the shoulder blade (Enthesopathy), Malformations of the shoulder blade or muscle tension.
Another cause can be a tear in the back of the rotator cuff (infraspinatus and muscle Teres minor muscle) be. The pulling, stabbing pain is load-dependent (especially with external rotation), is located under the posterior canopy and can radiate into the upper arm. Often the tear occurs as a result of an impingement syndrome. This bottleneck syndrome, which has existed for years, increasingly leads to wear of the tendons of the rotator cuff muscles. The previously damaged tendons can tear through a sudden movement. The rupture of a not previously damaged tendon as a result of an accident is far less common.
Finally, the bench press can lead to a wide variety of injuries, especially if exercises are performed incorrectly. These range from simple sore muscles to torn muscles and can all cause pain in the back shoulder.
Read also on this topic Shoulder pain between the shoulder blades
At night
Normally, one expects that sleep and rest at night will also significantly reduce shoulder pain. Often this is not the case, however, so those affected watch after a few hours of sleep by strong pain in the shoulder on. Going back to sleep is out of the question. The pain, insomnia and exhaustion represent a great deal of suffering for those affected.
The cause of this phenomenon are different proportions in the shoulder joint day and night. By day (when sitting / standing) the arm hangs down from the shoulder like a weight with a mass of several kilograms thus enlarges the joint spaceby simply "pulling it apart". The expansion of the structures can be only a few millimeters, but ensures that irritated and inflamed Structures somewhat relieved become. Lying down at night The joint space contracts again and the structures are closer together. So it is precisely this relaxation that causes one Compression of soft tissues (Tendons, bursae), which causes pain and wakes the person affected.
In the short term, a kind Stretching device help prevent pain at night. It will one loop around the wrist and another around the ankle placed, which then with a Expander rope get connected. The pulling force on the arm simulates a hanging arm like during the day. Alternatively, the shoulder joint should stretched at night when the person is awakened by pain, which should make the pain go away for a short time. This type of first aid should only be used for a few weeks until the The cause of the pain clarified and treated becomes.
Night pain in the shoulder is not a diagnostic symptom and can under several diseases of the shoulder occur. Nocturnal pain is possible with osteoarthritis as well as with bottleneck syndrome, as well as with the calcareous shoulder or with bursitis.
diagnosis
In order to make the correct diagnosis of shoulder pain, some information from the medical history is important first (anamnese), as they give first indications of the causes.
Known shoulder injuries, with which movements the pain occurs, how long the symptoms persist, whether nighttime pain occurs and risk factors for increased shoulder wear (e.g. due to sport or work) must be inquired by the attending physician.
A physical exam for shoulder pain can consist of a number of physical exam moves and methods that assess how the Muscles of the shoulder joint enable.
Typical clinical function tests are, for example Jobe test (Side differences speak for you Tendon tear, an irritated tendon, or inflammation of the bursa), of the Neck grip (both hands are placed on the neck), of the Apron handle (you hold your back with both hands) and many more.
Sampling trigger points (stimulus points that cause pain to touch) can provide further clues as to the causes of shoulder pain.
The mobility of the individual joints in the Shoulder joint has to be checked. A neurological examination may be required to rule out the possibility that the shoulder pain is caused by a pinched nerve. Imaging procedures such as Ultrasonic (Sonography), roentgen, Magnetic resonance imaging (MRI, magnetic resonance) or Computed Tomography (CT) allow further insights into the painful shoulder joint.
In some cases, however, even the diagnostic methods described so far do not lead to a clear diagnosis. So it may be necessary to have a Jointoscopy (Arthroscopy). In this minimally invasive operation in "Keyhole technology"A direct view of the shoulder joint is possible and, if necessary, a treatment can also be carried out as part of a joint reflection, such as suturing a torn tendon or removing inflamed tissue.
therapy
In the case of shoulder pain, treatment is always directed against the cause of the discomfort. The earlier treatment for shoulder pain is started, the better the chances of recovery are usually.
With the help of active movement and muscle strengthening, the person affected can often do their part to alleviate the symptoms or even to go away completely.
Taking painkillers e.g. from nonsteroidal anti-inflammatory drugs (NSAIDse.g. Voltaren®) and cold packs can help against pain in the shoulder, especially in the early stages.
Come as well physiotherapy, active muscle strengthening, Chiropractic, acupuncture, TENS treatments or administering anti-inflammatory drugs directly to the painful area in question to treat shoulder pain.
The so-called Blackroll can also be used for shoulder pain.
A joint prosthesis can be used for severe signs of wear and tear in the shoulder joint. For example, if there is a violation of the Rotator cuff is the cause of the pain, it may be necessary to take care of the shoulder for a while in order to promote the healing process.
In severe cases, surgery can also be performed. Therapy for frozen shoulder includes in particular one physiotherapy treatment, with the aim of making the shoulder flexible again. There are also treatment options using electricity, electromagnetic waves or ultrasound to treat the painful shoulder.
There are numerous surgical techniques that can be used for specific causes of shoulder pain. With the help of an operation, for example, the shape and position of the humerus can be corrected, tendons can be sutured, muscles transferred, adhesions loosened, diseased bursa or tissue removed and much more.
homeopathy
Some sufferers want to use homeopathic remedies first to relieve their symptoms. Homeopathic remedies are free of side effects, you Benefits are controversial among medical professionals. However, homeopathy can be worth a try, especially with mild and occasional complaints, before other measures have to be taken. However, the cause of the shoulder pain should be clarified by a doctor before this type of self-medication is used.
Ferrum phosphoricum (iron phosphate) is said to help combat tension and inflammation in the shoulder area and is usually used over several days and weeks. Arnica is said to have a similar, additional decongestant effect. Rhus toxicodendron, the oak-leaved poison sumac, helps with chronic joint diseases such as osteoarthritis and arthritis and can alleviate the symptoms in the shoulder joint caused by them.
Tapes
KinesioTapes (short for kinesiology, kinetics) should help against tension, relieve pain and improve movement restrictions. The Joint function is supported (augmentation) and by compression Decrease in swelling.
The tape strips are made of cotton and are coated with an acrylate adhesive that adheres firmly to the skin. The tapes are available in rolls or in pre-made cuts for specific parts of the body. They are used individually or in combination glued to the shoulder and follow the course of the muscles, ligaments or nerves. The strips are doing this stretched depending on the desired effect. As a rule, the taping is carried out by specially trained physiotherapists. Affected people who acquire knowledge of the anatomical structures can also learn certain tape methods themselves. However, it is best to use the to learn the correct method in each case from a specialist, otherwise the symptoms can be exacerbated.
Exercises
Simple complaints in the shoulder (pain, restricted mobility) are often caused by insufficiently trained or tense muscles. In this case, certain Exercises help that To loosen, strengthen and stretch muscles and so to alleviate the symptoms quickly. However, there are many other causes for shoulder problems (osteoarthritis, bone damage, entrapment, etc.). So if in doubt it should always consult a doctorwhich confirms that training to strengthen the muscles is the right way to go. In addition, when performing the exercises, always refer to the correct posture and a correct execution be respected. For this reason, it is recommended that inexperienced users first come from a professional trainer or Physiotherapists be guided.
To the stretch stand upright with the shoulder, the legs should be hip-width apart. The head should be kept straight, looking forward. Now circle your shoulders forwards 5 times, inhaling when lifting the shoulders and exhaling slowly when lowering them. Then let your shoulders circle backwards 5 times.
At the Shoulder puller the shoulders are first pulled up towards the ears and held briefly before they are slowly lowered again. This exercise is also repeated 5 times, paying attention to a breathing rhythm.
To Strengthening of the shoulder an exercise can be performed in a quadruped position. A blanket or mat is used as a base and the knees are bent to 90 ° so that they are placed under the hips. The hands are under the shoulder. The head and back are in one line, keeping your eyes on the floor. The right arm is now slowly brought horizontally while exhaling, with the thumb pointing up and the fingers pointing forward. When breathing in, the arm is brought back, but before touching the floor it is brought back to the horizontal. The exercise is repeated 5 times and then carried out for the other arm.
There are many different exercises for individual muscle groups that should be shown to you by a physiotherapist or trained trainer if possible. It is always important that the exercises regularly (preferably daily) and carried out over a longer period of time so that a long-term effect is achieved. When Pain during exercises or one Worsening of symptoms should do the exercises stopped immediately become.
prevention
It is important to have a healthy shoulder good posture and to move the shoulder a lot and sensibly. Otherwise the position of the Joint and to a stunting of the inactive Muscles.
Overloading should be avoided. Targeted muscle training can be used to prevent shoulder pain and premature wear of the shoulder joint. It can be especially with permanently sedentary activities Muscle tension come. Here you can Relaxation exercises, regular short breaks and relaxation exercises for the shoulder and neck muscles have a preventive effect.
Drafts and cold such as one-sided postures and movements should be avoided. The shoulder muscles and the shoulder joint should be used before and after exercise stretched and get warmed up. A healthy diet is also gentle on the metabolism and the joints, which means Shoulder problems can be avoided. If it is known which stimuli trigger or exacerbate shoulder pain, they should be avoided at all costs.
Pain and a feeling of stiffness in the shoulder should be at the first appearance should be taken seriously and a doctor should be consulted.
Disorders related to shoulder pain
Shoulder pain can be caused by a variety of medical conditions.
The most common cause of shoulder pain in the shoulder area is tension and hardening of the shoulder and neck muscles.
Stress and incorrect posture (e.g. from sitting too long), the shoulder, back and neck are stressed, which can lead to painful tension.
Mostly through trauma, but also through unfavorable or abrupt movements with a "unheated"Shoulder, the joint capsule can crack, stick and shrink in the soft tissue area, which leads to shoulder pain.
The rotator cuff muscles or tendons may also be torn (Rotator cuff rupture), which often severely restricts the mobility of the arm.
A painful shoulder joint inflammation (Humeroscapular periarthritis) is caused by a lack of exercise and in extreme cases can lead to a frozen shoulder (Capsulitis adhaesiva) or the so-called "frozen shoulder".
Other diseases that cause shoulder pain are tendinitis or bursitis (Subacromial bursitis).
Such inflammations are mainly caused by infections, mechanical overload, rheumatic diseases and gout.
The joint wear (arthrosis) can be another cause of shoulder pain.
Shoulder joint arthrosis is caused by:
- chronic overloads (e.g. through years of strength training),
- Muscle imbalances,
- Joint space narrowing in old age,
- Circulatory disorders,
- rheumatic diseases like rheumatoid arthritis.
For jobs or leisure activities that are carried out above the head (e.g. Painter, handball or tennis player) painful shoulder wear is particularly common.
The impairment of movement sequences in the shoulder leads to painful inflammation and swelling.
In the so-called impingement syndrome (Bottleneck syndrome) there is a constriction between the roof of the shoulder and the humerus.
There is a tendon that is constantly exposed to irritation, which causes inflammation.
Spinal disorders can also cause shoulder pain.
Under certain circumstances, nerve inflammation or injuries, but also rheumatological diseases or internal diseases (e.g. Heart attack, lung tumors, biliary colic) with the symptom "shoulder pain".
If the shoulder pain occurs particularly at night, a so-called lime shoulder (Tendinosis calcarea) behind it.
Calcium crystals are deposited in the rotator tendon due to recurring minor tendon injuries or local circulatory disorders of the tendon.
Injuries, accidents and fractures can also lead to severe pain symptoms in the shoulder area.
The collarbone fracture (Clavicle fracture) or injuries in the area of the humerus (e.g. Humeral head fracture).
A dislocation of the shoulder joint (Shoulder joint dislocation) can trigger severe pain and have various causes (e.g. Trauma, unstable shoulder).
Rotator cuff tear
The shoulder joint is mainly stabilized by the muscles of the shoulder girdle.
As "Rotator cuff"is the name given to the four muscles that hold the humerus in the socket of the shoulder Rotator cuff tear one or more muscles or tendons in this important muscle group are damaged.
Such a crack can be a traumatic (accident-related) or degenerative (wear-related) Have cause.
In the event of a fall or external violence, for example, it can lead to a Dislocation of the shoulder come, in some cases a rotator cuff muscle tears.
In addition, such a tear can occur with increasing age, as there is a loss of cartilage substance and a loss of strength in the tendon attachments of the muscles.
A rotator cuff tear causes pain of varying intensity and limits shoulder mobility.
Especially those lateral lift of the arm (Abduction) can no longer or only very painfully be carried out in the event of a rotator cuff tear.
There are several ways to treat a rotator cuff tear. For one, the crack can surgically sewn or locked become.
After that it is usually a laborious one Physiotherapy follow-up treatment Necessary for months or years to restore physical performance.
In addition, in about a fifth of cases, shoulder pain persists after the operation.
On the other hand, a conservative (non-operational) Therapy should be sought.
Come for this Cortisone injections in the shoulder and nonsteroidal anti-inflammatory drugs in question.
Physiotherapy exercises are also used in the conservative treatment of a rotator cuff tear, if necessary with local pain relief.
Biceps tendon tendinitis
Inflammation of the long biceps tendon becomes too Biceps tendonitis called.
Such inflammation is common in people with Postural weaknesses shoulders drooping forward and causes severe shoulder pain.
The long biceps tendon lies in a narrow bony canal in the shoulder joint and is prone to overloading and injuries as it is often exposed to friction in its narrow course.
The constant irritation can cause the tendon to swell and become inflamed. In some cases, further damage to the biceps tendon occurs in the form of fraying and the tendon becomes unstable.
Biceps tendon tendonitis can also be caused by a muscular imbalance the rotator cuff of the shoulder.
This is a mistake in the Thoracic spine This means that the holding muscles at the back of the rotator cuff are too weak.
The dominant one Chest muscles pulls the shoulders forward, it comes to "shoulders sloping forward"and the narrow canal through which the biceps tendon runs continues to contract.
The diagnosis of biceps tendon tendons is made with the so-called Yergason test in which the arm rests against the body with the elbow bent at right angles and an attempt is now made to lift the forearm against the doctor's resistance.
In the case of a biceps tendon tendon, pain in the front shoulder area is provoked.
In order to treat a muscular imbalance and to achieve relief in the area of the irritated and inflamed biceps tendon in biceps tendon tendinitis, targeted muscle training must be carried out under physiotherapeutic guidance to strengthen the rear rotator cuff. In most cases this can avoid surgical transection of the biceps tendon.
Osteoarthritis of the shoulder
Severe shoulder pain also occurs in one Osteoarthritis of the shoulder (Omarthrosis).
The abrasion of cartilage in the humerus head and / or the shoulder joint socket leads to a Joint wear in the shoulder joint.
The shoulder osteoarthritis turns into a primary (without recognizable cause, age-related wear of the joint) and a secondary (after bone fractures or as a result of humerus head necrosis) divided.
On the X-ray image a deformation of the humerus can be seen.
In addition, the decrease in the articular cartilage can be seen as a narrowing of the visible joint space.
Shoulder osteoarthritis is common Restrictions on movement result.
Besides, it comes to movement-dependent pain in the shoulder joint and in many cases to one Bursting inflammatory activation of the joint.
The shoulder osteoarthritis is with Medication, physical therapies, cooling or operational measures (e.g. Arthroscopy, prosthesis, artificial shoulder joint) treated.
Bankart lesion
In most cases, a Bankart lesion is caused by a Dislocation of the shoulder (dislocation) forward in the course of an accident.
The Bankart lesion describes a condition in which the so-called Joint lip (Glenoid labrum) the socket of the shoulder blade is partially or completely torn off.
This joint lip actually stabilizes the shoulder joint in the socket and further dislocations of the shoulder can easily occur.
Often the Bankart lesion goes with one Feeling of instability in the shoulder joint.
From a Bankart lesion with shoulder pain, younger and physically active people with an overmobile ligamentous apparatus are usually found.
ACG osteoarthritis
As Shoulder joint (Acromioclavicular joint, AC joint, ACG) becomes the articulated connection between the upper end of the shoulder blade, the so-called Shoulder height (Acromion), and the outer end of the Collarbone (Clavicle) named.
If there is one in this area Joint wear (arthrosis), this is usually expressed in a painful restriction of movement the shoulder.
The treatment of such ACG osteoarthritis usually depends on the individual complaints.
Therapy is usually with physiotherapy and physical applications (e.g. Cold, electrotherapy) tries.
If the shoulder pain is not sufficiently relieved and the restriction of movement is not removed, a Resection of the AC joint be considered.
To do this, the joint surfaces are milled off and a type of meniscus made from the body's own material is placed between the joint surfaces.
Often the shoulder can already be worn after such an operation after two months can be fully loaded again and is painless.
Herniated disc of the cervical spine
Also a Herniated disc of the cervical spine can be caused by the symptom "Shoulder pain" to make noticable.
In the case of a herniated disc, part of the Intervertebral disc in the Spinal canal and may press the Spinal cord or from him outgoing nerve roots.
A herniated disc can occur without an external cause, but it is common Overload in the case of previously damaged intervertebral discs, the cause of the incident (Prolapse).
Typically kick Herniated discs in the lumbar spine on and cause Back pain, the radiate into the legs can.
But a herniated disc can also occur in the Area of the cervical spine occur and lead to severe pain in the shoulder area due to the compression of the nerve roots, as the nerves supplying the shoulder originate from the cervical spine.
It is not advisable to have such a herniated disc To keep bed rest and the To spare your shoulder.
Much more, the shoulder pain therapy consists of one drug pain therapy and then carried out Physiotherapy exercise therapy.
Also Heat therapy, Massages and Electrotherapy represent treatment options.
A surgical treatment of a herniated disc in the cervical spine is usually only displayed if the Pain are no longer controllable on an outpatient basis or if neurological deficits occur.
It is very rare that a slipped disc that causes shoulder pain has to be treated by surgery.
Consistent muscle building of the back and shoulder muscles is advisable to prevent a herniated disc.
Through gymnastic exercises or back-friendly sports (e.g. Swimming, dancing, running, cycling) the back muscles can be strengthened and pain relieved.
In addition, the intervertebral discs experience changing pressure loads in these sports, which is important for the supply of the intervertebral discs with nutrients.
Also a ergonomically correct workplace is an important measure to prevent a herniated disc of the cervical spine (Cervical spine).
Static sitting positions should be avoided and you should be aware of changing pressure loads (e.g. Standing, walking, sitting, etc.) be respected.
Read a lot more information on this topic at: Herniated disc of the cervical spine
Vertebral blockage
In theory, any part of the Spine be affected by a blockage.
If nerve roots are irritated by a vertebral block, misinformation occurs in the brain Pain sensations trigger.
So shoulder pain from blockages in the Cervical spine go out.
This means that there is a misalignment or displacement of joints in the spine, which is caused by sudden, unusual stress (e.g. Lifting heavy loads) or caused by long-term incorrect posture caused by curvature of the spine (e.g. sitting for a long time).
Often there is also a vertebral blockage reflex tension of the Back muscleswhich can also be felt painfully in the shoulder.
Vertebral blockages can be released by themselves through gentle massage, application of heat and relaxation of the muscles.
If this does not relieve the symptoms, a chirotherapeutic treatment be considered. The blocked joint can "adjusted" become.
However, chiropractic only makes sense if the tension in the muscles is released at the same time, as the Vertebral blockage otherwise can come again.
For more information, see Vertebral blockage.
Subacromial bursitis
In subacromial bursitis, the bursa is between the shoulder joint and the tendon of the upper bone muscle (M. supraspinatus, an important part of the rotator cuff) lies.
This bursa is a "shifting layer" between muscle and bone. If there is an inflammatory change in this bursa (Subacromial bursitis), this sliding layer sticks together and the tendon of the muscle becomes thinner.
As the process progresses, the upper bone muscle is usually torn (Rotator cuff rupture) and the result is chronic pain that severely restricts the mobility of the shoulder.
The diagnosis of subacromial bursitis can usually be made easily. For this purpose, precise information about the medical history (anamnese) and performed a physical exam.
As a rule, subacromial bursitis causes pain in the shoulder joint when the arm is between 80 and 120 degrees led away from the body (abducted) becomes.
In addition, imaging examinations such as ultrasound (Sonography), Magnetic resonance imaging or X-ray provide information about the extent of the bursitis.
The treatment of acromial bursitis consists first of all in avoiding further loads and protecting the shoulder joint.
Physiotherapy exercises and pain reliever medication can also be helpful.
A cortisone injection into the subacromial space can in many cases relieve the symptoms.
However, if conservative measures do not bring about any improvement, surgical removal of the shoulder bag may be indicated.
Impingement
Shoulder pain caused by a tightness between the head of the humerus (Caput humeri) and the roof of the shoulder develop, are called so-called Impingement Syndrome designated.
In this area of the shoulder there is already a certain tightness, which is why there is often chronic irritation of the bursa and the tendons (mostly supraspinatus tendon, rotator cuff) come.
Certain occupational groups such as painters or overhead athletes have an increased risk of impingement syndrome (e.g. Tennis or volleyball players).
At the beginning the shoulder pain occurs only with loads on (especially when doing activities with a raised arm), later you can even at rest occur.
The pain is usually particularly pronounced when abrupt lifting of the arm to the side or under load.
In order to alleviate shoulder pain in impingement syndrome, therapeutic measures such as Electrotherapy, Ointment treatment, Cold therapy, Movement exercises and targeted muscle training can be used.
Also anti-inflammatory drugs can be used.
If the conservative treatment options fail, the cause of the irritation of the shoulder should be treated.
The space under the shoulder roof can be used for this purpose surgical intervention be expanded.
The inflamed (and mostly thickened) Bursa is removed and bony protrusions are removed. This should also prevent progressive damage to the rotator cuff tendons and possibly threatening damage Tendon tear be prevented.
