Shoulder pain can be a debilitating injury. It occurs with a frequency of 10-15% in the general population and increases to 25% in those who are above 50 years of age. Most shoulder pain will affect an individual’s daily activities as well as disturbs his or her sleep due to the inability to sleep on the side of the affected shoulder.
Most people with shoulder pain suffer from it for months and sometime years before seeking treatment. The longer the delay in treatment, the more difficult it becomes to treat.
Causes
There are many causes of shoulder pain. They can be divided to:
1. Acute causes
i. Fractures/dislocations
ii. Acute rotator cuff tear
2. Chronic causes
i. Impingement
ii. Tendinitis/ tendinopathy
iii. Rotator cuff tear
iv. Biceps tendinitis
v. Adhesive capsulitis (frozen shoulder)
vi. ACJ OA
vii. Glenohumeral OA
viii. Inflammatory arthritis
3. Other causes
i. Radicular pain – cervical and thoracic spine
ii. Referred pain – cardiac, GI
iii. Tumour – benign or malignant
iv. Infection – TB, septic arthritis
Treatment
1. Conservative
i. Physiotherapy
ii. Preserve ROM – function
iii. Pain control
iv. Electrical modalities
v. Injections (subacromial)
2. Surgical intervention
Arthroscopic (key-hole surgery) or Open Surgery
i. Subacromial decompression
ii. Biceps tenotomy/tenodesis
iii. Rotator cuff repair
iv. ACJ reconstruction/excision
3. Prolotherapy
i. PRP injection
ii. Stem cell injection
iii. Growth factor injection
Shoulder pain has various causes and treatment modalities. Not all shoulder pains are frozen shoulders. Early treatment will require identifying the cause and treating accordingly. Early treatment will restore function and improve the quality of life for those afflicted with shoulder pain.
This article is by Dr Leong Wan Hee, Orthopaedic Surgeon (with a sub-specialty in Sports Injuries) at Timberland Medical Centre.
*The information in this article is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice to diagnose or treat a health problem or disease. You should consult your health care provider if you have or suspect you may have a health problem.