The shoulder is one of the most flexible joints in our body and is under heavy strain, especially for tennis players but also for various professions such as craftsmen. Inflammation in the shoulder can have many causes, but is always associated with pain and reduced mobility. For this reason, an inflammation in the shoulder should always be treated by an expert doctor.
Causes of inflammation of the shoulder
Inflammation in the shoulder occurs mainly in older patients, but can also occur in younger patients due to heavy strain. In order to enable the high mobility of the arm, there is a bursa in the area of the shoulder. This allows the muscles to slide smoothly together with every movement, especially when we stretch the arm upwards.
This movement is called elevation. Only through the bursa in the upper part of the shoulder under the palpable bony prominence, the acromion (bursa subacrominalis), can we perform this movement without pain. If an inflammation of the bursa (bursitis) occurs, the patient feels severe pain due to this type of shoulder inflammation.
The cause of bursitis is usually an overloading of the arm and the too frequent elevation of the arm. This can lead to small tears in the bursa, which then allow bacteria to reach the bursa and cause a painful inflammation. In medical terminology, inflammation of the shoulder is also known as shoulder arthritis or omarthritis.
Inflammation of the shoulder can be bacterial, i.e. infectious, or it can be non-infectious due to a rheumatic disease. The cause of rheumatoid shoulder inflammation is often based on a so-called autoimmune disease. This means that, as after an infection with rubella or another disease, the body forms antibodies which then fight the infection and, in the best case, contain it.
In the case of rheumatoid arthritis, which can lead to inflammation of the shoulder, antibodies are directed against the inner skin of the joint and damage it. In most cases, other joints besides the shoulder are also affected, such as the finger joints or the knee. In addition to the pain, patients complain about swelling of the joints and limited mobility.
Since the shoulder consists not only of the shoulder joint itself but also of ligaments and muscles, tendon sheath inflammation can occur in the muscle area, especially in the supraspinatus muscle, whose tendon extends over the shoulder joint and is constricted by the bony projection, the acrominone. The supraspinatus muscle originates from the upper part of the shoulder blade (scapula) and extends from here over the shoulder to the humerus. When the muscle contracts, we can stretch the arm sideways upwards, as if we wanted to fly with our arms.
Inflammation of the shoulder occurs when the attachment tendon of the supraspinatus muscle is inflamed; this is known as tendosynovitis. Above all, excessive strain often leads to an inflammation, for example if the patient very often sleeps with raised arms. In addition to the supraspinatus tendon, the tendon of the biceps muscle (the prominent biceps on the upper arm) can also become inflamed.
The causes of this inflammation in the shoulder are the same as for the supraspinatus tendon – including overloading in the area of shoulder movement. Bursitis of the shoulder is usually caused by the bursa under the acromion, the so-called bursa subacromialis. This ensures that the thigh bone does not touch the acromion when the arm is raised and causes pain with every movement.
If the bursa is inflamed, however, it can cause stabbing pain. The inflammation is usually caused by stress such as overhead movements of the arms. The pain is initially felt when the arms are raised above the shoulder level.
If the shoulder is not spared in the further course, the pain can become stronger and can also occur at rest. The shoulder can also become sensitive to pressure and cause pain at night. Swelling and redness of the shoulder joint are rarely observed.
The shoulder should always be examined by a physician. Imaging examinations such as ultrasound, X-ray or MRI may be necessary.Bursitis is usually treated with cold compresses, anti-inflammatory painkillers such as ibuprofen or sports ointments. In addition, physiotherapy can accelerate the healing process.
If, despite these therapies, there is no healing and permanent pain that restricts everyday life, surgery may be necessary. An inflammation in the shoulder primarily causes the patient severe pain. Especially whenever he moves the shoulder and puts strain on it.
In the case of an inflammation of the bursa, the elevation, i.e. the movement of the arm away from the body, is particularly difficult, as it is associated with severe pain. In addition, there may be a slight swelling in the area of the shoulder joint. If the inflammation of the bursa in the shoulder is caused by bacteria, so-called B-symptoms, which are typical for bacterial inflammation, can also occur.
These include night sweat, fever, aching limbs and general feeling of discomfort with associated tiredness. In a classic shoulder inflammation, however, the patient usually has inflammation in other joints in addition to the inflammation in the shoulder. In most cases, the pain improves after some time of movement, as the joints are then warmed up.
With this type of inflammation in the shoulder, it is typical that the symptoms occur with the same intensity with each type of movement. So it makes no difference whether the arm is lifted to the side, forward or backward. Every time the shoulder is strained, this causes pain.
The patient should also mention when the symptoms occur. If the patient complains of intermittent pain in the shoulder area due to inflammation, this indicates rheumatoid omarthritis. In addition to the pain due to the inflammation in the shoulder, there can also often be a loss of function, in which the patient can hardly use the shoulder at all and therefore has very limited use of the arm.
In the case of tendosynovitis, the patient often complains of general pain in the shoulder area, but the pain is worst when the patient tries to lift the arm in an extended position only laterally (i.e. neither forward nor backward). Typically, the patient can lift the arm up to a 90 degree angle, anything above that, causes him severe pain due to the inflammation of the tendon, that he cannot move the arm further up. To be able to distinguish an inflammation in the shoulder from a capsule tear in the shoulder area, it is also recommended to deal with the following topic: Capsule rupture in the shoulder In order to be able to distinguish between an inflammation in the shoulder and a capsule rupture in the shoulder area, it is recommended that you also deal with the following topic: Capsule rupture in the shoulder
