Shoulder Problems and Injuries
Minor shoulder problems, such as sore muscles and aches and pains, are common. Shoulder problems develop from everyday wear and tear, overuse, or an injury. They can also be caused by the natural process of aging.
Your shoulder joints move every time you move your arms. To better understand shoulder problems and injuries, you may want to review the anatomy and function of the Reference shoulder Opens New Window Reference Opens New Window. The shoulder is a ball-and-socket joint with three main bones: the upper arm bone (humerus), collarbone (Reference clavicle), and shoulder blade (Reference scapula). These bones are held together by muscles, Reference tendons Opens New Window, and Reference ligaments Opens New Window. The shoulder joint has the greatest Reference range of motion Opens New Window of any joint in the body. Because of this mobility, the shoulder is more likely to be injured or cause problems. The Reference acromioclavicular (AC) joint, which lies over the top of the shoulder, is also easily injured.
Shoulder problems can be minor or serious. Symptoms may include pain, swelling, Reference numbness, tingling, weakness, changes in temperature or color, or changes in your range of motion. Shoulder injuries most commonly occur during sports activities, work-related tasks, projects around the home, or falls. Home treatment often can help relieve minor aches and pains.
Sudden (acute) injury
Injuries are the most common cause of shoulder pain.
A sudden (acute) injury may occur from a fall on an outstretched arm, a direct blow to the shoulder, or abnormal twisting or bending of the shoulder. Pain may be sudden and severe. Bruising and swelling may develop soon after the injury. If nerves or blood vessels have been injured or pinched during the injury, the shoulder, arm, or hand may feel numb, tingly, weak, or cold, or it may look pale or blue. Acute injuries include:
- Bruises (Reference contusions Opens New Window Reference Opens New Window), which occur when small blood vessels under the skin tear or rupture, often from a twist, bump, or fall. Blood leaks into tissues under the skin and causes a black-and-blue color that often turns purple, red, yellow, and green as the bruise heals.
- Injuries to the tough, ropy fibers (ligaments) that connect bone to bone and help stabilize the shoulder joints (Reference sprains Opens New Window).
- Injuries to the tough, ropy fibers that connect muscle to bone (tendons).
- Pulled muscles (Reference strains Opens New Window).
- Injuries to nerves, such as Reference brachial plexus neuropathy.
- Reference Separation of the shoulder, which occurs when the outer end of the collarbone (clavicle) separates from the end (acromion) of the shoulder blade because of torn ligaments. This injury occurs most often from a blow to a shoulder or a fall onto a shoulder or outstretched hand or arm.
- Damage to one or more of the four tendons that cover the shoulder joint (Reference torn rotator cuff Opens New Window), which may occur from a direct blow to or overstretching of the tendon.
- Broken bones (Reference fractures Opens New Window). A break may occur when a bone is twisted, struck directly, or used to brace against a fall.
- Pulling or pushing bones out of their normal relationship to the other bones that make up the shoulder joint (Reference subluxation Opens New Window or Reference dislocation Opens New Window).
You may not recall having a specific injury, especially if symptoms began gradually or during everyday activities. Overuse injuries occur when too much stress is placed on a joint or other tissue, often by overdoing an activity or through repetition of an activity. Overuse injuries include:
- Inflammation of the sac of fluid that cushions and lubricates the joint area between one bone and another bone, a tendon, or the skin (Reference bursitis Opens New Window).
- Inflammation of the tough, ropy fibers that connect muscles to bones (Reference tendinitis Opens New Window). Reference Bicipital tendinitis is an inflammation of one of the tendons that attach the muscle (biceps) on the front of the upper arm bone (humerus) to the shoulder joint. The inflammation usually occurs along the groove (bicipital groove) where the tendon passes over the humerus to attach just above the shoulder joint.
- Muscle Reference strain Opens New Window.
- A Reference frozen shoulder, which is a condition that limits shoulder movement and may follow an injury.
- Overhead arm movements, which may cause tendons to rub or scrape against a part of the shoulder blade called the acromion. This rubbing or scraping may lead to abrasion or inflammation of the Reference rotator cuff tendons Opens New Window (also called Reference impingement syndrome).
Other causes of shoulder symptoms
Overuse and acute injuries are common causes of shoulder symptoms. Less common causes of shoulder symptoms include:
- Muscle tension or poor posture.
- Pain that is coming from somewhere else in your body (Reference referred shoulder pain).
- Breakdown of the cartilage that protects and cushions the shoulder joints (Reference osteoarthritis Opens New Window).
- Reference Calcium buildup in the tendons of the shoulder.
- An irritated or pinched nerve or a Reference herniated disc Opens New Window in the neck.
- Reference Infection Opens New Window in the skin (Reference cellulitis Opens New Window), joint (Reference infectious arthritis Opens New Window), bursa (Reference septic bursitis Opens New Window), or bone (Reference osteomyelitis Opens New Window).
- Invasive cancer that has spread to the bones of the shoulder or spine.
- Reference Abuse. Any shoulder injury (especially a dislocated shoulder) that cannot be explained, does not match the explanation, or occurs repeatedly may be caused by abuse.
Treatment for a shoulder injury may include first aid measures, physical therapy, medicine, and, in some cases, surgery. Treatment depends on:
- The location, type, and severity of the injury.
- How long ago the injury occurred.
- Your age, health condition, and activities, such as work, sports, or hobbies.
Reference Check your symptoms to decide if and when you should see a doctor.
|By:||Reference Healthwise Staff||Last Revised: Reference August 23, 2011|
|Medical Review:||Reference William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Reference David Messenger, MD