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Shoulder pain

The shoulder is the most mobile joint in the body. It is composed of numerous anatomical structures, with even more giving it support and thus there are numerous potential sources of pain. In addition, there are distant causes which provokes pain to spread to the shoulder (e.g. related to the cervical spine, numerous surrounding nerves). In the case of pain originating from the shoulder, it is important to determine whether the pain originates from the joint itself or from the surrounding structures (rotator cuff muscles). The diagnostic protocol involves examinations and, if necessary, images (X-rays, ultrasound and magnetic resonance imaging of the shoulder). The most common causes of pain are damage to the muscles of the supraspinatus, the tendon of the biceps muscle, the bursa (shoulder bursitis), the joint between the collarbone and the shoulder blade (acromioclavicular joint).

Picture – The most common pain points on the front of the shoulder. In order to provide effective treatment, it is important to find out which anatomical structures the pain corresponds to and what pathological process is occurring in them (inflammation, degeneration, injury).

It is important to determine what the exact triggers of shoulder pain are. The most common error in diagnosis is excessive reliance on individual shoulder images such as X-rays. Namely, in most cases of shoulder pain, an X-ray of the shoulder comes back normal or shows joint pathology that could lead to a wrong diagnosis. The correct diagnosis is made with the help of a detailed examination, which includes specific tests, ultrasound imaging of soft tissues, nerves and blood vessels, and, if necessary, pain interventional diagnostic methods.

Treatment is symptomatic (analgesics, injection of drugs in the form of crystals that dissolve for weeks and calm down inflammation into the structure determined to be the cause of the pain, etc.) and physical therapy. In order to increase the chances of the physical treatment being successful, it is important to reduce the pain as much as possible before beginning treatment.