The shoulder is a complex joint consisting of the scapula, clavicle and shoulder blade coming together. In order for the shoulder joint to make normal movements, these three joints must work in harmony. Stabilization of the shoulder occurs thanks to the joint capsule, ligaments and muscles. Considering the position of the shoulder joint, this stabilizing mechanism provided by soft tissues also makes the joint more prone to injuries. For this reason, pain may occur in the shoulder area for many reasons.
The most common complaints in the shoulder area are pain and limitation of movement. For a correct diagnosis, detailed evaluation of the patient is very important. The type, location, and duration of spread of the pain should be questioned carefully. Problems and posture disorders that can be seen in the neck, back and ribs can affect shoulder girdle movements. The patient's daily life, the work he does, and what he has done differently lately should be questioned. The purpose of this questioning is to determine the movement or activity that causes pain and limitation of movement and to raise the patient's awareness about that activity. Sometimes a movement performed once may not cause pain, but repeating this movement may cause recurrent trauma even if it is not a severe activity. Past traumas can give insight into the problem. Knowing the sports activities of the patient can help detect injuries that may occur in young patients. Other diseases that the patient has had and previous treatments should also be questioned carefully.
The most common cause of shoulder pain is impingement syndrome.
This syndrome, which is generally seen in people over the age of 40, occurs when people stand upright for a long time and put their arms over their shoulders. It is common in people who have to work by keeping the muscles above their level.
Such challenging movements have a wearing effect on the tendons that enable the muscles to adhere to the bone. Shoulder pain usually begins with a slight strain. Pain may increase at night and reach levels that prevent sleep. Ultrasonography and MRI help diagnosis. During periods when the pain is severe, short-term rest is required. Painkillers, local injections and physical therapy are used in the treatment.
Shoulder a� Other diseases that cause pain:
Rotator cuff tear
Rotator cuff muscles consist of 4 muscles that surround the shoulder joint and fix the caput humeri of the humerus in the cavitas glenoidales. These muscles, consisting of supraspinatus, infraspinatus, teres minor and subscapularis, are responsible for the rotational movements of the shoulder.
Traumatic rotator cuff tears can occur in sports that use challenging rotational movements such as golf and tennis, and these tears can also occur atraumatically. Depending on the degree of tear, patients may be offered surgery or only a rehabilitation program.
Bursitis
Helps reduce the friction between moving tissues in the shoulder area. There are many fluid-filled sacs. Bursitis or bursitis is a painful inflammatory disease of these sacs. Apart from systemic diseases that can affect the sacs, bursitis can also develop as a result of strains and tendinitis. There is pain and tenderness radiating down the front of the shoulder. Raising the arm from the side upwards is difficult and sometimes impossible due to pain. Although ultrasonography and MRI can be used to make a diagnosis, most of the time only examination is sufficient. If the pain is too severe for treatment, short-term rest is given. Cold application is applied to reduce swelling. Painkillers and anti-inflammatory rheumatism medications are given. In cases that cannot be controlled by these methods, local injection and sometimes physical therapy are performed.
Frozen Shoulders
Trauma, cardiovascular disease, chronic lung disease, tuberculosis, lung tumors, diabetes, neck diseases and most importantly, long-term immobility of the arm can lead to frozen shoulder.
It starts insidiously with shoulder pain and shoulder stiffness. There is a limitation of movement that becomes increasingly evident. Physical therapy may be required. Local injection and stretching are performed in cases resistant to treatment.
Polymyalgia rheumatica
Polymyalgia rheumatica in the neck, shoulders and/or hips lasting more than a month in the elderly. It is a disease characterized by pain and stiffness in the girdle. Night pain and morning stiffness are observed. Fatigue, mild fever, weight loss, loss of appetite may occur. Temporary swelling in knees and wrists and pain occurs.
Sudeck atrophy
It is also called “complex regional pain syndrome”. It is characterized by pain, loss of function and disability. Shoulder, hand and foot stiffness is common. When you hold the arm, it is called shoulder-hand syndrome. In shoulder-hand syndrome, although there are changes in the shoulder and hand, the elbow remains intact. Most patients are over 50 years old. Pain and swelling in the affected area, skin changes, and sweating are the signs and symptoms seen in this syndrome. Radiography, computed tomography and bone scintigraphy are used in diagnosis. Physical therapy should also be given along with analgesic medications.
These suggestions to avoid shoulder pain:
• If your shoulder hurts, do not lie on the painful side.
• While sitting. Place your arms on a support.
• Do not frequently raise your arms above shoulder level.
• Do not carry heavy loads with your arms.
• If you have shoulder pain, you can consult a Specialist doctor or Physiotherapist for exercises and treatment.
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Healthy days….
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