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The shoulder is the most movable and the most fragile joint in
the body. But its very flexibility makes it prone to both sudden
injury and chronic wear and tear.
Who Gets Shoulder Problems?
After age 25, most problems are caused by the effect of repeated
overhead motions for a long period of time. Weekend athletes and
do-it-yourselfers are especially vulnerable to overuse problems in
Leading Causes of Shoulder Pain
The leading causes of shoulder pain are bursitis, tendonitis,
and irritated rotator cuff. This group of conditions is called
shoulder impingement syndrome.
What is Bursitis?
The bursa is a fluid-filled sac that cushions the rotator cuff
tendons from the shoulder bone. An irritated bursa is caused by an
inflamed rotator cuff. When irritated, the bursa produces extra
fluid, the sac expands, and the pressure creates pain.
What is Tendonitis?
Deep in the shoulder are a group of tendons and muscles called a
rotator cuff. They help stabilize the upper arm bone in the
shoulder joint and rotate the arm. The biceps tendon is also
present in front of the shoulder. When the arm is raised repeatedly
over the head, the tendons rub against the underside of the
shoulder bone and become irritated. The tendons swell, leaving even
less space between tendons and bone. The irritation creates more
irritation. It is much like a rope being drawn again and again
across a jagged rock.
What is an Irritated Rotator Cuff?
Excessive wear on the rotator cuff can lead to severe
irritation, roughening and eventually ulceration and tearing of the
cuff. An irritated rotator cuff feels like a clicking or popping in
the shoulder, due to a ragged piece of the cuff sliding under the
shoulder bone. Occasionally, injuries or infections can also lead
to arthritis, although arthritis of the shoulder is less common
than in the knee or hip. Arthritis in the shoulder causes a
roughening of the joint from worn cartilage and loose fragments of
What are the Symptoms?
Bursitis, tendonitis, irritated rotator cuff and arthritis are
all inflammatory reactions to overuse. With any of these problems,
a continuous dull ache in the shoulder can become a sharp pain when
you try to move your arm, especially over your head. The pain may
be worse at night after a heavy day of activities using your
What is the Treatment for Shoulder Impingement?
- Rest: Avoid strenuous activity and any motion
that causes pain. In some cases a shoulder sling is helpful to rest
fatigued muscles and inflamed tendons.
- Ice: An ice pack on the affected shoulder can
help ease the inflammation when combined with gentle motion.
- Oral medicines: Anti-inflammatory medicines
such as Motrin, Feldene, Volatren, Naprosyn or aspirin will reduce
- Cortisone injections: Cortisone is a natural
hormone and a very powerful medicine for inflammation. When
injected directly into the inflamed area. It decreases swelling and
thus reduces pain.