Painful shoulder injury
The shoulders enable us to perform various tasks such as lifting objects, pushing, throwing, and maintaining a good posture. These joints that also act as connecting links between the arms and trunk are often subjected to various injuries. Several movements occur at the shoulder joint. The ability for a varied range of motion at the shoulder comes at the cost of stability of the shoulder joints. Various structures including the muscles and their tendons, nerves, and blood vessels are present at the shoulder. The shoulder is made of two joints. One joint is between the shoulder blade (scapula) and collar bone (clavicle) called the acromioclavicular joint. The other joint is a ball and socket type of joint between the upper end of the bone of the arm (humerus) and shoulder blade. This joint is called the glenohumeral joint. It is one of the largest and most mobile joints in the body. Any of the structures at the shoulder can get injured or diseased, leading to pain, discomfort, and restricted range of motion.
Several injuries may occur at the shoulder causing considerable pain. The intensity of the pain may vary depending on the severity of the injury, structures injured, and individual’s pain-bearing capacity. Most shoulder injuries involve soft tissue structures such as the muscles, tendons, ligaments, and nerves rather than the bone. Some of the most painful shoulder injuries include:
- Fracture: The bones involved in forming the shoulder joint may fracture (break) causing significant pain, swelling, deformity, and limitation of movement. The clavicle (collar bone) and humerus are most commonly involved in fractures. A fractured bone needs urgent medical attention.
- Shoulder instability: It may be seen especially in children and people involved in rigorous physical activities such as athletics. In children, the shoulder becomes stable with growth. In athletes, however, intense physical activity may stretch the muscles and ligaments at the shoulder joint beyond the normal limit. Shoulder dislocation or separation may occur following an accident, fall, or strenuous physical activity. It can lead to severe pain, bruising, swelling, and reduced shoulder movement. The treatment mainly involves giving rest to the shoulder, applying ice packs, taking pain medications, and wearing a sling to limit the movement at the shoulder. Physical therapy under an expert’s supervision aids quick and complete therapy. Severe injuries may need surgical intervention.
- Rotator cuff injury: A rotator cuff is a group of four muscles that together form a covering around the head of the humerus (the upper end of the arm bone). It keeps the head of the humerus attached to the socket in the shoulder blade to facilitate movements such as lifting and rotating the arm. Rotator cuff tears are common injuries causing significant pain and disability in performing everyday tasks such as combing hair or getting dressed. Thus, medical attention is necessary for managing a rotator cuff tear. The doctor may prescribe rest, pain medications, steroid injections, and physical therapy. Surgical treatment is rarely needed.
- Impingement: This refers to the entrapment of the torn rotator cuff fibers between the bones of the shoulder. It is a painful and disabling condition requiring prompt medical attention.