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Shoulder pain can be related to a sprain, strain, dislocation or other problem. Injury and overuse are common causes of shoulder pain, but it can also result from a degenerative process, or from disease.
Pain in the shoulder is a symptom rather than a condition in itself and as such can be caused by a number of problems ranging from injury to disease. Common conditions causing shoulder pain include frozen shoulder and rotator cuff disorders.
A frozen shoulder, also known as 'adhesive capsulitis', affects movement in the shoulder and occurs when the tissue surrounding the joint becomes thick, swollen and tight. Movement becomes painful and stiff as there is less room for the upper arm bone (the humerus) within the joint.
Frozen shoulder has no clear cause but factors such as injury and surgery immobilises the arm for long periods resulting in the tissue becoming tight. People with diabetes are more at risk of developing frozen shoulder and conditions such as heart or lung disease, neurological conditions (such as Parkinson's disease) and hyperthyroidism increase the chances of developing the problem.
A rotator cuff disorder such as tendonitis, bursitis or a tear to the tendon can cause frozen shoulder. The rotator cuff is a group of muscles which surround the shoulder joint and hold it in the correct position and control its movement. Injury or overuse can trigger a rotator cuff disorder.
Symptoms of shoulder problems will depend on the type of shoulder condition experienced. Pain can be isolated to one area or radiate out from the shoulder to the arm or neck. Movement may also be restricted.
Symptoms of a frozen shoulder are characterised by three stages. In stage one, the shoulder aches and becomes stiff before pain is experienced. Pain is often worse during the night when laying down or when putting pressure on the affected side. Stage one typically lasts 2-9 months.
Stage two is the adhesive stage whereby movement becomes stiff and the muscles start to waste due to lack of mobility. Stage two frozen shoulder may last between 4-12 months.
Stage three is when movement gradually improves and pain begins to ease although there may be periods of pain as the stiffness diminishes. Not everybody regains complete movement after recovery but day-to-day tasks are possible. Stage three frozen shoulder can last from 5 months to 4 years. With a rotator cuff disorder, the symptoms are distinct depending on the problem. Tendonitis causes a sudden pain that is made worse by lifting the arm above the shoulder. Impingement syndrome causes a chronic pain which worsens at night or when lifting the arm above shoulder level.
A tear in the tendon causes pain over the front and outer shoulder made worse when reaching out or above. With a tear, the arm and shoulder may feel weak and be accompanied by a clicking sensation.
A visit to your GP will help to diagnose the cause of your shoulder pain. The GP will ask about your symptoms and any events which may have caused the problem.
The GP will perform a physical examination looking for redness, swelling or dislocation. With a dislocation, the shoulder will be in an abnormal position.
The doctor will assess the mobility of the joint by asking you to do any specific arm movements which cause you pain. If the GP needs to rule out damage or disease to the joint they may refer you for an X-ray or MRI scan.