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What are the causes of shoulder pain?
The shoulder is a complex joint where tendons normally slide freely between the top of the humerus (arm) and the acromion (tip of the shoulder). If the tendons or bursa become inflamed, the space narrows and these tendons become pinched causing pain.
Shoulder pain can be caused by problems in the joint itself but also by dysfunction in the cervical (neck) and thoracic area or in the muscles surrounding the shoulder girdle. The referred pain in the arm/hand can have a neurological but also a muscular origin. The pain can be followed by loss of strength or feeling in some part of the arm and fingers.
Sometimes the impingement is caused by poor technique in your sport, usually racquet sports or swimming. Sometimes, in non-athletes, it is caused by weak or tight muscles and poor posture. It is extremely important to get shoulder pain diagnosed early and focus on reducing inflammation and correcting poor biomechanics around the shoulder joint. It is also important to rule out rotator cuff tears within the tendons.
What is the best treatment?
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Physiotherapy can help first of all to find the reason for the pain. Muscular problems are often caused by overuse or wrong technique in sport or repeated strain. Besides treating the muscle the physiotherapist will check the quality of the movement and the muscular balance.
Where needed, you will then be instructed how to stretch and strengthen the involved muscles. For nerve problems, the spine and nerves will be carefully assessed and, if needed, the patient will be referred to a specialist for furthers examination such as X-rays or MRI. Manual therapy, traction and exercises are usually of great benefit. Shoulder pain is commonly diagnosed as shoulder bursitis, shoulder tendonitis or impingement syndrome. These terms all refer to inflammation of the rotator cuff tendons and the bursa (fluid filled sac).