Pain in the shoulder joint

Injuries to the shoulder joint or degenerative changes in the joint surfaces, such as joint wear, can lead to pain in the shoulder. Rarely, however, only these joint surfaces are affected when the shoulder hurts. In fact, pain in the shoulder joints is often also responsible for “shoulder joint pain“.

This includes the so-called acromioclavicular joint (joint between a bony process of the shoulder blade – acromion – and the collarbone – clavicle). Pain can also occur between the acromion and the head of the upper arm. In addition, the soft tissues that stabilize the joint, i.e. ligaments, muscles and joint capsules, can hurt and thus cause shoulder joint pain.

The following is now an overview of the common causes of shoulder pain. A shoulder dislocation is a dislocation of the shoulder joint, which can be caused by an accident (traumatic) or by a disposition (habitual). There are various forms of dislocation, of which the anterior dislocation is the most common form with over 90%.

In the case of external rotation and abduction, the arm may luxate slightly if it is not moved adequately, such as in an accident. Congenital factors, such as anomalies of the ligamentous apparatus or a misinnervation of the musculature, can also cause the shoulder joint to luxate. A shoulder joint luxation is quite common and is characterized by spontaneous and movement pain.

The arm is resiliently fixed in an abnormal position and is held with the healthy arm. If nerves (axillary nerve) are injured, the motor function and sensitivity of the arm may also be damaged. In most cases, the arm can be repositioned to its normal position without anesthesia, with the administration of painkillers.

If this is not the case, an anaesthetic can be administered. However, this is rather rare. Bursitis is an inflammation of the bursa.

Bursae reduce the friction between bone and soft tissue in the body. Such a bursa is located under the so-called acromion, a bone process of the shoulder blade. Inflammation, which can be traumatic or even infectious, causes shoulder pain.

However, subacromial bursitis is usually traumatic. It can also occur in the course of metabolic diseases such as gout or in the context of rheumatoid arthritis. It is characterized by pain in the shoulder and limited movement of the shoulder joint.

In the acute phase of the inflammation, the joint should be spared. Conservatively, it is treated with physiotherapeutic exercises, glucocorticoid injections and non-steroidal anti-inflammatory drugs. If conservative treatment fails, the inflamed bursa can be surgically removed.

The so-called “calcified shoulder” is a very painful affair. The tendons of various muscles that secure the shoulder joint (supraspinatus/infraspinatus muscle, more rarely the subscapularis/teres minor muscle) have calcium deposits. The lifting of the arm and the pressure on the affected tendons are painful.

Treatment is conservative with local application of non-steroidal anti-inflammatory drugs and physiotherapy exercises. If the complaints do not subside within six months, surgical measures are taken, including arthroscopic removal of the calcific foci or focused orthopedic shock wave therapy. Omarthrosis is a degenerative change in the articular cartilage of the shoulder joint and usually occurs without any organic cause.

However, it can also be the result of frequent dislocations or injuries of the shoulder joint. Pain in the shoulder is a characteristic feature, which is worsened by movement. Restricted movement and night pain are the result.

Conservative therapy includes physiotherapeutic exercises, treatment with non-steroidal anti-inflammatory drugs, but also cryotherapy and ultrasound treatments.In case of doubt, the joint can be artificially replaced in one operation. This is called a total endoprosthesis. The “frozen shoulder” is a form of periarthropathy humeroscapularis.

This collective term describes all possible degenerative diseases of the shoulder girdle. These include bursitis, tendinitis, wear and tear of the muscles of the shoulder joint (rotator cuff), etc. Frozen shoulder is a chronic, inflammatory change of the shoulder joint capsule.

This leads to stiffening of the joint, which ultimately results in pain and restricted mobility. The peculiarity of this disease is that its symptoms progress in 3 stages. In the first stage, the pain is very dominant and particularly strong at night.

However, movement is not restricted. In the second stage the pain subsides, but movement is increasingly restricted and in the third stage the symptoms subside. The frozen shoulder is also treated conservatively with non-steroidal anti-inflammatory drugs and physiotherapy.

If the symptoms have not subsided after 6 months, an anesthetic mobilization is performed. This involves moving the joint in all directions under short anaesthesia to loosen the degenerative “adhesions”. In extreme cases, the frozen shoulder can also be treated surgically.

The impingement syndrome is the painful incarceration of the tendon of the supraspinatus muscle. The muscle belongs to the so-called muscle group of the rotator cuff and secures the shoulder joint. The pain mainly affects the lifting of the arm.

7. tendinitis of the biceps: Tendinitis is an inflammation of the tendons. Inflammation of the long biceps tendon is quite common and occurs at an advanced age due to signs of wear. The tendon runs in the joint capsule of the shoulder joint.

Pain occurs when the arm is raised above shoulder height. The pressure on the tendon is also painful. Non-steroidal anti-inflammatory drugs and physiotherapy exercises can relieve the pain.

If pain persists after 6 months, the long biceps tendon can be shortened in an operation and fixed to the head of the humerus. Pain in the shoulder can also be caused. The therapy depends on the underlying causes for the pain.

The cause does not always have to be localized in the shoulder joint, and can also be located in the cervical spine, for example, as in cervical spine syndrome. Symptomatically, painkillers and analgesic and anti-inflammatory ointments can provide initial relief.

Fractures/fractures
Nerve damage
Degenerative bone changes
Osteoporosis
Osteomyelitis and
Syndromes like the cervical spine syndrome