What Are Shoulder Problems?

What Are Shoulder Problems?
Fast Facts: An Easy-to-Read Series of Publications for the Public by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) 

Who Gets Shoulder Problems?
Men, women, and children can have shoulder problems. They occur in people of all races and ethnic backgrounds.

What Causes Shoulder Problems?
Many shoulder problems are caused by the breakdown of soft tissues in the shoulder region. Using the shoulder too much can cause the soft tissue to break down faster as people get older. Doing manual labor and playing sports may cause shoulder problems.

Shoulder pain may be felt in one small spot, in a larger area, or down the arm. Pain that travels along nerves to the shoulder can be caused by diseases such as:

Gallbladder disease
Liver disease
Heart disease
Disease of the spine in the neck.

How Are Shoulder Problems Diagnosed?
Doctors diagnose shoulder problems by using:

Medical history
Physical examination
Tests such as x rays, ultrasound, and magnetic resonance imaging (MRI).

How Are Shoulder Problems Treated?
Shoulder problems are most often first treated with RICE (Rest, Ice, Compression, and Elevation):

Rest. Don’t use the shoulder for 48 hours.

Ice. Put an ice pack on the injured area for 20 minutes, four to eight times per day. Use a cold pack, ice bag, or a plastic bag filled with crushed ice wrapped in a towel.

Compression. Put even pressure (compression) on the painful area to help reduce the swelling. A wrap or bandage will help hold the shoulder in place.

Elevation. Keep the injured area above the level of the heart. A pillow under the shoulder will help keep it up.
If pain and stiffness persist, see a doctor to diagnose and treat the problem.

What Are the Most Common Shoulder Problems?
The most common shoulder problems are:

Dislocation
Separation
Rotator cuff disease
Rotator cuff tear
Frozen shoulder
Fracture
Arthritis.

The symptoms and treatment of shoulder problems vary, depending on the type of problem.

Dislocation

Dislocation occurs when the ball at the top of the bone in the upper arm pops out of the socket. It can happen if the shoulder is twisted or pulled very hard.

To treat a dislocation, a doctor performs a procedure to push the ball of the upper arm back into the socket. 

Once a shoulder is dislocated, it may happen again. This is common in young, active people. If the dislocation injures tissues or nerves around the shoulder, surgery may be needed.

Separation
A shoulder separation occurs when the ligaments between the collarbone and the shoulder blade are torn. The injury is most often caused by a blow to the shoulder or by falling on an outstretched hand.

Rotator Cuff Disease: Tendinitis and Bursitis
In tendinitis of the shoulder, tendons become inflamed (red, sore, and swollen) from being pinched by parts around the shoulder.

Bursitis occurs when the bursa—a small fluid-filled sac that helps protect the shoulder joint—is inflamed. Bursitis is sometimes caused by disease, such as rheumatoid arthritis. It is also caused by playing sports that overuse the shoulder or by jobs with frequent overhead reaching.

Rotator Cuff Tear
Rotator cuff tendons can become inflamed from frequent use or aging. Sometimes they are injured from a fall on an outstretched hand. Sports or jobs with repeated overhead motion can also damage the rotator cuff. Aging causes tendons to wear down, which can lead to a tear. Some tears are not painful, but others can be very painful.

Frozen Shoulder
Movement of the shoulder is very restricted in people with a frozen shoulder. Causes of frozen shoulder are:

Lack of use due to chronic pain.
Rheumatic disease that is getting worse.
Bands of tissue that grow in the joint and restrict motion.
Lack of the fluid that helps the shoulder joint move.

Fracture
A fracture is a crack through part or all of a bone. In the shoulder, a fracture usually involves the collarbone or upper arm bone. Fractures are often caused by a fall or blow to the shoulder.

Arthritis of the Shoulder
Arthritis can be one of two types:

Osteoarthritis—a disease caused by wear and tear of the cartilage.

Rheumatoid arthritis—an autoimmune disease causing one or more joints to become inflamed.

Osteoarthritis of the shoulder is often treated with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. People with rheumatoid arthritis may need physical therapy and medicine such as corticosteroids.

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