What are the common causes of upper arm pain. How is upper arm pain diagnosed. What are the treatment options for upper arm pain. How can you prevent upper arm pain. When should you see a doctor for upper arm pain. What exercises can help relieve upper arm pain. How long does it take for upper arm pain to heal.

Understanding Upper Arm Pain: Causes and Symptoms

Upper arm pain can be a distressing condition that affects daily activities and quality of life. It’s crucial to understand the various causes and symptoms to effectively manage and treat this discomfort. Let’s explore the 13 common causes of upper arm pain and their associated symptoms.

1. Shoulder Impingement/Rotator Cuff Tendinitis

Shoulder impingement and rotator cuff tendinitis are among the most frequent causes of upper arm pain. The rotator cuff, a group of muscles and tendons surrounding the shoulder joint, can become irritated or damaged, leading to pain and discomfort.

Symptoms of shoulder impingement and rotator cuff tendinitis include:

• Local swelling and tenderness in the front of the shoulder
• Pain and stiffness when lifting the arm
• Pain radiating from the front of the shoulder to the side of the arm
• Sudden pain with lifting and reaching movements
• Difficulty performing overhead activities

2. Bursitis

Bursitis occurs when the bursa, a small fluid-filled sac that acts as a cushion between bones, tendons, and muscles, becomes inflamed. In the shoulder, bursitis can cause upper arm pain, especially during movement.

Common symptoms of shoulder bursitis include:

• Aching pain in the shoulder and upper arm
• Pain that worsens with movement or pressure
• Stiffness and limited range of motion
• Swelling and warmth in the affected area

3. Cervical Radiculopathy (Pinched Nerve)

A pinched nerve in the cervical spine can cause pain that radiates down the arm. This condition, known as cervical radiculopathy, occurs when a nerve root in the neck is compressed or irritated.

Symptoms of cervical radiculopathy may include:

• Sharp, burning pain that travels from the neck to the arm
• Numbness or tingling sensation in the arm or hand
• Weakness in the affected arm
• Neck pain that may worsen with certain movements

Diagnosing Upper Arm Pain: Medical Evaluation and Imaging

Accurate diagnosis is essential for effective treatment of upper arm pain. Healthcare providers use a combination of medical history, physical examination, and imaging tests to determine the underlying cause of the pain.

Medical History and Physical Examination

During the initial evaluation, your doctor will ask about your symptoms, medical history, and any recent injuries or activities that may have contributed to your pain. They will then perform a physical examination to assess:

• Range of motion in your shoulder and arm
• Strength of your arm muscles
• Tenderness or deformities in the affected area
• Signs of inflammation or swelling

Imaging Tests

To further investigate the cause of your upper arm pain, your doctor may recommend one or more imaging tests:

1. X-rays: While X-rays don’t show soft tissues, they can reveal bone spurs or other skeletal abnormalities that may contribute to your pain.
2. Magnetic Resonance Imaging (MRI): MRI scans provide detailed images of soft tissues, including muscles, tendons, and ligaments, helping to identify issues such as rotator cuff tears or inflammation.
3. Ultrasound: This non-invasive imaging technique can be used to visualize soft tissue structures and detect inflammation or fluid accumulation in the shoulder area.

Treatment Options for Upper Arm Pain: From Conservative to Surgical Approaches

The treatment of upper arm pain depends on the underlying cause and severity of the condition. In many cases, conservative approaches are the first line of treatment, while surgical interventions may be necessary for more severe or persistent cases.

Conservative Treatment Options

Conservative treatments aim to reduce pain, inflammation, and improve function without invasive procedures. These may include:

• Rest and activity modification
• Ice or heat therapy
• Over-the-counter pain medications (e.g., NSAIDs)
• Physical therapy exercises
• Corticosteroid injections

Surgical Interventions

If conservative treatments fail to provide relief, surgical options may be considered. The type of surgery depends on the specific condition causing the upper arm pain. Some common surgical procedures include:

• Arthroscopic rotator cuff repair
• Subacromial decompression
• Biceps tenodesis
• Joint replacement (in severe cases of arthritis)

Preventing Upper Arm Pain: Lifestyle Changes and Exercise

While not all causes of upper arm pain can be prevented, there are several steps you can take to reduce your risk of developing or exacerbating the condition:

• Maintain good posture
• Practice proper lifting techniques
• Incorporate shoulder-strengthening exercises into your routine
• Take regular breaks during repetitive tasks
• Warm up before engaging in physical activities

Exercises to Strengthen and Stabilize the Shoulder

Incorporating specific exercises into your routine can help strengthen the muscles around your shoulder and upper arm, improving stability and reducing the risk of injury. Some beneficial exercises include:

1. Shoulder blade squeezes
2. Wall push-ups
3. Pendulum swings
4. Doorway stretches
5. Resistance band external rotations

Always consult with a healthcare professional or physical therapist before starting a new exercise program, especially if you’re experiencing pain or have a pre-existing condition.

When to Seek Medical Attention for Upper Arm Pain

While some cases of upper arm pain may resolve on their own with rest and home care, there are instances where medical attention is necessary. Seek professional help if you experience:

• Severe pain that doesn’t improve with rest or over-the-counter medications
• Sudden, intense pain following an injury
• Visible deformity or swelling in the shoulder or upper arm
• Inability to move your arm or perform daily activities
• Pain accompanied by fever, redness, or warmth in the affected area
• Numbness or tingling that persists or worsens

Early intervention can prevent the condition from worsening and improve your chances of a full recovery.

The Role of Physical Therapy in Managing Upper Arm Pain

Physical therapy plays a crucial role in the treatment and rehabilitation of upper arm pain. A skilled physical therapist can develop a personalized treatment plan to address your specific needs and goals.

Benefits of Physical Therapy for Upper Arm Pain

Physical therapy offers numerous benefits for individuals suffering from upper arm pain:

• Improved range of motion and flexibility
• Increased strength and stability in the shoulder and upper arm
• Pain reduction through targeted exercises and manual therapy
• Education on proper body mechanics and posture
• Customized home exercise programs for ongoing management

Common Physical Therapy Techniques for Upper Arm Pain

Physical therapists employ a variety of techniques to address upper arm pain, including:

1. Manual therapy (e.g., joint mobilization, soft tissue massage)
2. Therapeutic exercises
3. Stretching and flexibility exercises
4. Ultrasound therapy
5. Electrical stimulation
6. Kinesiology taping

Alternative and Complementary Therapies for Upper Arm Pain Relief

In addition to conventional medical treatments, some individuals find relief from upper arm pain through alternative and complementary therapies. While the effectiveness of these approaches may vary, they can be used in conjunction with traditional treatments under the guidance of a healthcare provider.

Acupuncture

Acupuncture, an ancient Chinese healing practice, involves inserting thin needles into specific points on the body to alleviate pain and promote healing. Some studies suggest that acupuncture may help reduce shoulder and upper arm pain, particularly in cases of rotator cuff tendinitis and frozen shoulder.

Massage Therapy

Massage therapy can help relax tense muscles, improve circulation, and reduce pain in the upper arm and shoulder area. Different massage techniques, such as Swedish massage, deep tissue massage, and trigger point therapy, may be beneficial depending on the underlying cause of the pain.

Herbal Remedies and Supplements

Certain herbs and supplements are believed to have anti-inflammatory and pain-relieving properties that may help alleviate upper arm pain. Some commonly used natural remedies include:

• Turmeric
• Ginger
• Boswellia
• Omega-3 fatty acids
• Glucosamine and chondroitin

It’s important to consult with a healthcare professional before using any herbal remedies or supplements, as they may interact with medications or have side effects.

Recovery and Rehabilitation: What to Expect

The recovery process for upper arm pain varies depending on the underlying cause and severity of the condition. Understanding what to expect during rehabilitation can help you set realistic goals and stay motivated throughout your recovery journey.

Typical Recovery Timeline

The duration of recovery from upper arm pain can range from a few weeks to several months. Factors that influence recovery time include:

• The specific condition causing the pain
• The severity of the injury or condition
• Your overall health and fitness level
• Adherence to treatment recommendations
• Whether surgical intervention was required

Phases of Rehabilitation

Rehabilitation for upper arm pain typically progresses through several phases:

1. Acute phase: Focus on pain management and protecting the injured area
2. Recovery phase: Gradual introduction of gentle exercises to improve range of motion
3. Strengthening phase: Progressive resistance exercises to build strength and stability
4. Functional phase: Incorporation of task-specific exercises to prepare for return to normal activities

Your healthcare provider or physical therapist will guide you through these phases, adjusting your treatment plan as needed based on your progress and individual needs.

Returning to Normal Activities

As you progress through rehabilitation, you’ll gradually be able to return to your normal activities. This process should be carefully monitored and guided by your healthcare provider to prevent re-injury or setbacks. Some tips for a successful return to activities include:

• Following a gradual progression of activity intensity and duration
• Continuing with maintenance exercises to support long-term shoulder health
• Listening to your body and avoiding activities that cause pain
• Using proper form and technique during physical activities
• Incorporating regular stretching and warm-up routines

Remember that recovery is a process, and it’s important to be patient with yourself as you work towards regaining full function and pain-free movement in your upper arm.

Shoulder Impingement/Rotator Cuff Tendinitis – OrthoInfo

One of the most common physical complaints is shoulder pain. Your shoulder is made up of several joints combined with tendons and muscles that allow a great range of motion in your arm. Because so many different structures make up the shoulder, it is vulnerable to many different problems. The rotator cuff is a frequent source of pain in the shoulder.

This illustration of the shoulder highlights the major components of the joint.

Your shoulder is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle).

Your arm is kept in the shoulder socket by the rotator cuff. These muscles and tendons form a covering around the head of the upper arm bone and attach it to the shoulder blade.

There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm.

The rotator cuff is a common source of pain in the shoulder. Pain can be the result of:

• Tendinitis. The rotator cuff tendons can be irritated or damaged.
• Bursitis. The bursa can become inflamed and swell with more fluid causing pain.
• Impingement. When you raise your arm to shoulder height, the space between the acromion and rotator cuff narrows. The acromion can rub against (or impinge on) the tendon and the bursa, causing irritation and pain.

Rotator cuff pain is common in both young athletes and middle-aged people. Young athletes who use their arms overhead for swimming, baseball, and tennis are particularly vulnerable. Those who do repetitive lifting or overhead activities using the arm, such as paper hanging, construction, or painting are also susceptible.

Pain may also develop as the result of a minor injury. Sometimes, it occurs with no apparent cause.

Rotator cuff pain commonly causes local swelling and tenderness in the front of the shoulder. You may have pain and stiffness when you lift your arm. There may also be pain when the arm is lowered from an elevated position.

Beginning symptoms may be mild. Patients frequently do not seek treatment at an early stage. These symptoms may include:

• Minor pain that is present both with activity and at rest
• Pain radiating from the front of the shoulder to the side of the arm
• Sudden pain with lifting and reaching movements
• Athletes in overhead sports may have pain when throwing or serving a tennis ball

As the problem progresses, the symptoms increase:

• Pain at night
• Loss of strength and motion
• Difficulty doing activities that place the arm behind the back, such as buttoning or zipping clothing

If the pain comes on suddenly, the shoulder may be severely tender. All movement may be limited and painful.

Medical History and Physical Examination

After discussing your symptoms and medical history, your doctor will examine your shoulder. They will check to see whether it is tender in any area or whether there is a deformity. To measure the range of motion of your shoulder, your doctor will have you move your arm in several different directions. They will also test your arm strength.

Your doctor will check for other problems with your shoulder joint. They may also examine your neck to make sure that the pain is not coming from a pinched nerve, and to rule out other conditions, such as arthritis.

Your doctor will test your range of motion by having you move your arm in different directions.

Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Imaging Tests

Other tests which may help your doctor confirm your diagnosis include:

X-rays. Because X-rays do not show the soft tissues of your shoulder like the rotator cuff, plain X-rays of a shoulder with rotator cuff pain are usually normal or may show a small bone spur. A special X-ray view, called an outlet view, sometimes will show a small bone spur on the front edge of the acromion.

(Left) Normal outlet view X-ray. (Right) Abnormal outlet view showing a large bone spur causing impingement on the rotator cuff.

Magnetic resonance imaging (MRI) and ultrasound. MRI scans can create better images of soft tissues, like the rotator cuff tendons, than X-rays. They can show fluid or inflammation in the bursa and rotator cuff. In some cases, partial tearing of the rotator cuff will be seen.

The goal of treatment is to reduce pain and restore function. In planning your treatment, your doctor will consider your age, activity level, and general health.

Nonsurgical Treatment

In most cases, initial treatment is nonsurgical. Although nonsurgical treatment may take several weeks to months, many patients experience a gradual improvement and return to function.

Rest. Your doctor may suggest rest and activity modification, such as avoiding overhead activities.

Non-steroidal anti-inflammatory drugs (NSAIDs). Drugs like ibuprofen, aspirin, and naproxen reduce pain and swelling.

Physical therapy. A physical therapist will initially focus on restoring normal motion to your shoulder. Stretching exercises to improve range of motion are very helpful. If you have difficulty reaching behind your back, you may have developed tightness of the posterior capsule of the shoulder (capsule refers to the inner lining of the shoulder and posterior refers to the back of the shoulder). Specific stretching of the posterior capsule can be very effective in relieving pain in the shoulder.

Once your pain is improving, your therapist can start you on a strengthening program for the rotator cuff muscles.

Steroid injection. If rest, medications, and physical therapy do not relieve your pain, an injection of a local anesthetic and a cortisone preparation may be helpful. Cortisone is a very effective anti-inflammatory medicine. Injecting it into the bursa beneath the acromion can relieve pain.

A cortisone injection may relieve painful symptoms.

Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Surgical Treatment

When nonsurgical treatment does not relieve pain, your doctor may recommend surgery.

The goal of surgery is to create more space for the rotator cuff. To do this, your doctor will remove the inflamed portion of the bursa. They may also remove part of the acromion. This is also known as a subacromial decompression. These procedures are usually done with an arthroscopic technique.

Arthroscopic technique. In arthroscopy, thin surgical instruments are inserted into two or three small puncture wounds around your shoulder. Your doctor examines your shoulder through a fiberoptic scope connected to a television camera, then guides the small instruments using a video monitor, and removes bone and soft tissue. In most cases, the front edge of the acromion is removed along with some of the bursal tissue.

Your surgeon may also treat other conditions present in the shoulder at the time of surgery. These can include: 

• Arthritis between the clavicle (collarbone) and the acromion (acromioclavicular arthritis)
• Inflammation of the biceps tendon (biceps tendinitis)
• A partial rotator cuff tear 

Rehabilitation. After surgery, your arm may be placed in a sling for a short period of time. This allows for early healing. As soon as your comfort allows, your doctor will remove the sling to begin enabling exercise and use of the arm.

Your doctor will provide a rehabilitation program based on your needs and the findings at surgery. This will include exercises to regain range of motion of the shoulder and strength of the arm. It typically takes 2 to 4 months to achieve complete relief of pain, but it may take up to a year.

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10 Possible Causes of Arm Pain

Published on 21st April 2020
Posted by Majid Ghauri

1. Many Ways the Arm Can Hurt
2. Possible Causes of Arm Pain
3. What to Do and When to See a Doctor?
4. Taking Care of Yourself

Pain in the arm can develop for many different reasons, ranging from a mild muscle strain to a disease like fibromyalgia or rheumatoid arthritis. The pain can take many different forms too, from a dull ache to sharp, sudden pain. There are common causes of arm pain, and learning about them can help you determine when to see a physician.

Many Ways the Arm Can Hurt

There are so many ways pain or discomfort is experienced in the arm. Sometimes, the pain is described as stiffness, mild discomfort or a dull ache, as opposed to a sharp pain in a specific area. The pain can occur anywhere along the arm too, from the shoulder area to fingers.

The symptoms in the arm can vary widely, and include:

• Pain or discomfort in one or both arms
• Swelling
• Bruising
• Numbness
• Weakness
• Stiffness
• Dull ache
• Tingling
• Muscle spasms
• Burning pain
• Pain when making certain arm movements
• Sharp pain
• Soreness

No two people experience the exact same arm pain in the same way. That makes it challenging at times to determine the cause without seeing a doctor for a diagnosis.

Possible Causes of Arm Pain

Arm pain can indicate a mild strain or a serious injury or disease. Ten possible arm pain causes include, but are not limited to:

1. Broken bone – bone in arm or wrist is broken; there may be arm weakness and pain; pain normally starts quickly, feels sharp and gets worse with arm movement
2. Sprain – ligaments connecting bones are stretched or torn; there may be a pain, bruising, swelling and/or limited joint mobility; a sore upper arm is common due to a shoulder sprain
3. Tendinitis – tendon is inflamed or irritated; pain is often a dull ache that worsens when moving the arm or joint; may be swelling and tenderness
4. Arthritis – rheumatoid arthritis is an inflammatory disease that can impact joints, blood vessels, heart, and other tissues; pain can occur due to swollen tender joints and joint stiffness; there can be general painful arm inflammation
5. Heart attack – pain starts due to reduced blood flow to the heart which reduces oxygen flow to the tissues in the arms, shoulder, neck, jaw or back; arm feels heavy, and chest feels pressure; pain in right arm and hand is common, but pain can occur in either arm
6. Bursitis – fluid-filled sacs called bursae that serve as cushions for bones, muscles, and tendons near joints become inflamed; symptoms include joint pain which can be a sharp or shooting pain; may hurt more when moving the joint
7. Cervical disk herniation – spinal disc in the neck experiences a tear or splits open, and some of the soft gel-like centers oozes out; if disc presses on a nerve root, there may be tingling, numbness or pain that goes down the arm
8. Carpal tunnel syndrome – pressure is placed on the median nerve in the wrist/hand; tingling and numbness, or a feeling like an electric shock, may travel up the arm from the wrist
9. Brachial plexus injury – brachial plexus is a network of nerves that send signals from the spinal cord to the shoulder, arm and hand; nerves in the brachial plexus are compressed, stretched or torn; depending on the injury, there may be a shooting burning sensation down the arm, arm weakness, an inability to move the arm and/or severe pain
10. Fibromyalgia – widespread musculoskeletal pain that can be a constant dull ache or stronger pain feelings

These are just some of the more common causes of arm pain. There are many more, including muscle strain, dislocated elbow, rotator cuff injury, nerve entrapment, and even cancer. Pain in top of the arm could be due to rotator cuff tendinitis or tear.

What to Do and When to See a Doctor?

When your arm hurts, the next steps depend a lot on how fast the pain develops and the presence of other symptoms. For example, during a heart attack, one or both arms will suddenly hurt due to the reduced flow of blood into the muscles.

During a heart attack, there are other symptoms accompanying the arm pain too. They include chest pain, nausea, shortness of breath and pressure in the chest. In this situation, call 911 immediately.

If the arm pain starts right after an injury, there are likely other symptoms that rapidly appear. If a bone was broken, it may protrude or lead to an obvious deformity. A broken bone can lead to arm pain, weakness, bruising and swelling. It is important to see a physician right away to ensure the bone is set and heals properly.

In some cases, it is more difficult to identify the source of arm pain when it is radiating pain (occurring due to a medical condition not in the arm) or a disease impacting tissues. If arm pain persists for more than a two weeks for no apparent reason, or the pain is interfering with your daily activities or work, see a doctor for evaluation.

Taking Care of Yourself

Fortunately, many cases of arm pain are due to mild injuries to muscles, ligaments or tendons from overuse or overexertion. Unless it is a heart attack or broken bone, most people end up treating themselves for a period of time.

Many conditions causing arm pain, like overuse or tendinitis, can be treated by resting the arm, placing ice packs on the sore area, applying compression or elevating the arm to reduce swelling.

The important point to keep in mind is that persistent pain in arm that does not subside with self-treatment needs to be evaluated by a physician. It is better to get a doctor’s diagnosis than to take the chance of making a medical condition worse through lack of proper treatment.
Pain specialist at SAPNA Dr. Majid Ghauri has superior training in identifying causes of shoulder and arm pain and performs pain treatments to comfort patients’ lives.

Call (703) 520-1031 today for a consultation with a doctor.

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Further Reading

Shoulder Pain Treatment in Kiev ✔️ When raising the arm to the side

The Center diagnoses the causes of pain in the shoulder joint
and treats orthopedic and rheumatological diseases
for more than 40 years.

Who treats pain in the shoulder joint in Kiev –

250 m from metro station Darnitsa

Gongalsky Vladimir Vladimirovich

Doctor of Medical Sciences, orthopedist-traumatologist, neurologist, vertebroneurologist

Kopyl Evgeny Gennady jevich

Orthopedist-traumatologist, vertebrologist

Maksimov Grigory Alexandrovich

Doctor of Neurology, Candidate of Medical Sciences

Shityuk Mikhail Yurievich

Orthopedist-traumatologist, vertebrologist

Dia gnostics MRI, ultrasound, X-ray on site in one building

MRI machine Toshiba Vantage Elan 1. 5 Tesla

Ultrasound machine Philips AFFINITY 50

X-ray complex «Radspeed» SHIMADZU

Ultrasound machine GE LOGIQ F8

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Pain in the shoulder may appear when raising the arm. Why?

Raising the arm to a horizontal position is carried out without problems. To raise the arm from a horizontal position and further upward, it is necessary to rotate (expand) the arm. Otherwise, the region of the head of the humerus will rest against the collarbone. If the arm in the shoulder hurts when it is actively raised within 60-120 ⁰ , this indicates problems with the soft tissues of the shoulder head area. These, more often inflamed, tissues touch the collarbone. There is pain in the shoulder.

When raising the arm to the side, pain can occur not only in the shoulder, but also up to the forearm.

Such pain in the forearm is referred to as referred pain. Its main cause is more often to be found in the region of the head of the humerus.

This is where the attachment points of the muscles of the shoulder joint are concentrated. Muscles that provide movement in the shoulder. Some of them are shown in the figure below.

Complaints of shoulder pain are common. Differential diagnosis in this case is not easy, since pain can be caused by various reasons: damage to the bones and muscles of the shoulder girdle and upper limb, shoulder and acromioclavicular joints, cervical spine or internal organs, arthrosis, arthritis of the shoulder joint, etc.

Some information about the shoulder joint

• The shoulder joint and almost all surrounding tissues are innervated by the roots of C5-Sb.
• Pain in the shoulder occurs when the following formations are affected:
  • cervical spine,
  • superior roots of the brachial plexus,
  • inflammation of the mucous bags of the shoulder joint (bursitis),
  • rotator cuff of the shoulder joint (muscles that provide movement in the shoulder joint), enthesitis
  • inflammation of the periarticular tissues (with polymyalgia rheumatica),
  • internal organs innervated by the phrenic nerve (roots C3-C5).
• Pain in the shoulder can be observed in angina pectoris , pericarditis, Pancoast syndrome (cancer of the upper lobe of the lung with germination in the cervical plexus), tumors of the mediastinum , irritation of the phrenic nerve (subphrenic abs cess or intra-abdominal bleeding).
• Approximately 25% of people at the age of 50 have degeneration of the muscular cuff , which predisposes to damage to the muscles that form it and their tendons [ Sloane P. D., Slatt L. M., Baker R. M. Essentials of family medicine. Baltimore: Williams and Wilkins, 1988,242. ]

Functional anatomy of the shoulder joint

The humerus and scapula form the shoulder joint, while the scapula and clavicle form the acromioclavicular joint.

• the shoulder joint is spherical, enclosed in a spacious joint capsule;
• a large range of motion in the shoulder joint predisposes to its damage and the development of osteoarthritis.

The clinically important subacromial space lies above the shoulder joint. It is limited from above by the acromion and the coracoid process of the scapula and the thick acromioclavicular ligament stretched between them, and from below by the head of the humerus. This relatively cramped space contains subacromial bursa and tendons of the muscles that form the muscular cuff of the shoulder joint . These formations are often injured and inflamed.

Hand movements of the head of the humerus may impinge on the tendons of the muscles located in the subacromial space. This is manifested by pain in the shoulder when raising the arm. Compression results in inflammation of the tendons (especially the biceps and supraspinatus muscles) as well as subacromial bursitis .

Possible causes of shoulder pain are listed here.

The most common causes of shoulder pain are referred pain in osteochondrosis and osteoarthrosis of the cervical spine and periarthritis of the shoulder joint.

Periarthritis of the shoulder joint is a disease characterized by inflammatory and degenerative changes in the periarticular soft tissues – the muscle cuff of the shoulder joint. Periarthritis occurs as a result of constant trauma to the periarticular tissues.

The most dangerous diseases

First of all, it is necessary to exclude malignant neoplasms (including Pancoast syndrome with cancer of the upper lobe of the lung ), infectious arthritis and osteomyelitis . If the pain is localized in the region of the left shoulder joint, IHD is excluded – coronary heart disease (pain on the right in this case is 20 times less common). With paroxysmal pain, rheumatoid arthritis should be suspected and gout .

A list of diseases that can cause pain in the arm (shoulder) is presented here.

Difficulties in diagnosis

Diagnosis of polymyalgia rheumatica is especially difficult . It should be suspected in all patients over 60 who complain of bilateral shoulder pain that worsens in the morning.

Difficulties also present the diagnosis of posterior dislocation and habitual shoulder subluxation, ischemic necrosis of the head of the humerus after a fracture, rupture or degeneration of the muscle cuff and differential diagnosis for referred pain in the shoulder (in diseases of the internal organs).

One of the most common causes of shoulder pain is diseases of the spine (osteochondrosis, osteoarthritis). Pain in the shoulder is observed with depression , diabetic arthropathy , taking corticosteroids (ischemic necrosis of the head of the humerus) and anabolic steroids (necrosis of the acromion and collarbone), with mental disorders.

Diagnostics for pain in the shoulder joint

1. Questioning and examination
2. Orthopedic Joint Function Testing
3. X-ray of the shoulder joint
4. Ultrasound of the shoulder joint
5. Shoulder MRI

What to do about shoulder pain?

1. Determine the cause of shoulder pain (diagnose).
2. The cause of shoulder pain will be determined by an orthopedic traumatologist or rheumatologist. The diagnosis is established by clinical and hardware examination.
3. Management of shoulder pain depending on the diagnosed cause.
4. For shoulder pain, it is important to ensure that the pain does not reoccur. To do this, we offer various methods, including physical rehabilitation of the spine, physiotherapy, kinesitherapy, etc.

Treatment of shoulder pain

Treatment of uncomplicated shoulder pain associated with inflammation of the soft tissues of the shoulder joint usually does not cause problems. For example, for the treatment of pain in the shoulder when raising the arm, in some cases it is enough to carry out local targeted anti-inflammatory therapy: medication, ultrasound shock wave therapy, physiotherapy.

Plasma therapy can be used for joint arthrosis. Plasma therapy allows you to relieve inflammation of the joint with the help of your own plasma.

With the so-called “ frozen shoulder ” ( frozen shoulder ) a special two-stage tactic. The first step is to establish the cause of the pathology and eliminate the pain. Then proceed to the development of the joint. The healing process can take from 2 weeks to several months. This is a complex pathology that requires persistent treatment. But, as a rule, it is possible to defeat her.

If pain in the shoulder joint, including pain in the shoulder when raising the arm, is caused by pathology of the spine, autoimmune processes , fibromyalgia , the treatment tactics change dramatically. Apply methods to eliminate the cause of pain .

The treatment of shoulder pain is determined by the established diagnosis and understanding of the causes of the pathology.

We have been treating diseases of the musculoskeletal system (pain in the spine and joints) and neurological pathology since 1978 years since we created the first in the USSR clinic of vertebroneurology (vertebrology) on the basis of the neurological department of the Central City Clinical Hospital in Kyiv.

Gongalsky Vladimir Vladimirovich

Doctor of Medical Sciences in the specialty “Neurology”, the highest category in the specialty “traumatology-orthopedics”

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Shoulder pain – causes, diagnosis and treatment

Shoulder pain is a symptom that often occurs not only in the elderly, but also in young and active people. There can be many reasons for it, but they are all treatable. In order to understand why pain occurs, you should familiarize yourself with the structure of the shoulder joint, its functions and possible pathological conditions in this area.

Anatomy and function of the shoulder joint

The shoulder joint is located between the humerus and the shoulder blade. It provides connection of the upper limb with its girdle. On the one hand, this joint is represented by the head of the same-named bone (the spherical end of a long tubular bone), and on the other hand, by the scapular bone.

The shoulder blade has a recess to which the head of the shoulder adjoins. The recess is not congruent to the head, that is, it does not completely repeat its shape. Therefore, along the edge of the recess there is a spongy cartilaginous tissue that covers the tubular bone, forming an anatomical neck on it.

The humerus has two necks: anatomical and surgical. The latter is not part of the joint, but it is here that a bone fracture most often occurs.

Above the articulation of the shoulder and scapula hangs the coracoid process of the scapula, from which the ligament extends to the joint. In addition, in the same area there is an articulation of the acromial process of the scapula with the clavicle. Tendons also extend from the acromion and clavicle to the joint. Between the joints of the bones are synovial bags with synovial fluid. The latter is necessary for depreciation of the articular surfaces.

The ligamentous apparatus of the shoulder is positioned so that the bones can move relative to each other. Several types of movements are possible in the shoulder joint:

• flexion and extension;
• abduction and adduction;
• inside and outside rotation;
• circular movements.

It should be noted that the movement in the shoulder joint is limited by the acromion and clavicle. For example, raising the arm above shoulder level is carried out by the movement not of the shoulder joint, but of the girdle of the upper limb.

What to do at home if your shoulder hurts

It is difficult to cure a specific disease at home, but pain can be alleviated. Sometimes this is enough. Often at home they resort to the help of tablets and ointments.

Self-help

An often described symptom is that of inflammation. If this is the case, non-steroidal anti-inflammatory drugs will help to remove it. Among them, it is better to choose the following:

• Diclofenac – available in the form of tablets, ointments or injections;
• Analgin – tablets and injections;
• Ibuprofen – tablet form.

In addition, drugs with muscle relaxant activity, such as sirdalud in ampoules, can help. Also, ointments with analgesic properties sometimes help – menovazin, bystromgel, fastumgel.

For the duration of treatment, mobility in the shoulder joint should be limited, but not completely immobilized.

What not to do

Do not make sudden movements or lift heavy things. In addition, you can not completely immobilize the hand on your own – this is dangerous by the occurrence of contractures. In the case of inflammation, you can not warm this area and use “hot” ointments. Heating dilates blood vessels and increases blood flow to the site of inflammation, which increases swelling and only contributes to the development of inflammation. For the same reason, alcohol should be avoided during treatment. In some cases, moderate physical activity is allowed, but it is better to ask your doctor about its need. Extra movements can only increase the damage.

When to see a doctor urgently

In some cases, treatment at home does not help – this is the first reason to see a doctor. In addition, sometimes self-treatment is obviously doomed to fail. Such cases include:

• shoulder injuries accompanied by sharp pain, swelling, crunching;
• symmetrical pain in the left and right shoulder joints, accompanied by weakness and fever;
• violation of the configuration of the joint;
• impaired joint mobility;
• feeling of numbness, blanching of the upper limb. In all these cases, it is better not to waste time and immediately consult a doctor.

Various causes of shoulder pain

Shoulder pain is a symptom that can occur in various diseases. First of all, the localization and nature of the pain indicates a particular pathology. It should be understood that in the everyday sense, “shoulder pain” means discomfort in the shoulder joint, but when doctors use this term, they mean the area from the shoulder to the elbow joint. Due to the difference in understanding of terms, misunderstandings often arise.

Pain in the left or right shoulder

Shoulder pain often occurs on one side only. Symmetrical bilateral pain is extremely rare. Often, they indicate an autoimmune lesion of the joints (when immune cells begin to attack the joint tissues). In most cases, the pain syndrome occurs either in the right or left shoulder.

The causes of unilateral lesions may not depend on the location of the pain. For example, trauma, degenerative changes, inflammation are equally common on both sides. But there are reasons that are characteristic of pain in a particular shoulder, and these reasons are associated with damage to internal organs.

The left shoulder may hurt with necrosis of the heart muscle. Often such pains begin in the left side of the chest, and then spread to the left arm. Pain in the right shoulder can occur with inflammation of the gallbladder. In this case, it begins in the right hypochondrium, and then spreads to the right hand.

During movement

The occurrence of discomfort during movement may indicate damage to the components of the joint, inflammatory or degenerative processes in it. In this case, the nature of mobility impairment is of great importance.

Pain and stiffness at the beginning of the movement often indicates arthritis, while the nature of the movements does not matter. If pain is caused not by any mobility, but by a specific movement, then the pathology must be sought in the muscles surrounding the joint. For example, if pain in the joint occurs when the arms are raised to shoulder level, then we can talk about muscle damage, if higher – the shoulder girdle.

After injury

Injuries to the shoulder can lead to damage to the bones, the joint itself or its ligaments. A dislocation is characterized by severe pain and impaired movement. Also, these symptoms occur with a fracture, but often the fracture does not occur in the joint itself, but in the region of the surgical neck of the humerus. Torn ligaments and muscles cause acute sharp pain and swelling in the affected area. Sprains may not appear immediately, the pain occurs gradually as the swelling increases. The most favorable variant of injury is a bruise. In this case, the pain is not intense, dull, the mobility of the joints is only partially impaired.

Pain from the shoulder joint to the elbow

The area from the shoulder joint to the elbow is called the shoulder in the anatomical sense of the term. Often, pain here occurs when muscles are damaged or inflamed, nerve damage, circulatory disorders, and fractures.

If the symptom is indicative of muscle damage, then mobility in the shoulder or elbow joints is often impaired. If the nerves, then the mobility of the shoulder or elbow may not suffer. With vascular damage, in addition to pain, tingling may be felt, skin color may change. Fractures are accompanied by sharp intense pain, crunching, swelling, visible deformity.

Shoulder and forearm

The forearm is the area between the wrist and elbow. The forearm and shoulder are closely connected with each other, they are supplied with blood and innervated by the branches of the same vessels and nerves. Often, pain occurs simultaneously in both areas either due to a lesion in the elbow joint, where the muscles of both areas are attached, or due to disorders of the vessels and nerves.

If the elbow joint is affected, the pain is localized and is located in the upper third of the forearm and lower third of the shoulder. In case of damage to the nerves, the pain is prolonged. At the same time, it spreads vertically along the arm. With the defeat of the vessels of this area, the blood supply to the entire arm is often disturbed, which is accompanied by its blanching and numbness.

Pain in the neck and shoulders

This combination of symptoms may be associated with inflammatory changes in the muscles of the girdle of the upper extremities. Inflammation is accompanied by edema, compresses the nerves and blood vessels. Also, pain at the same time in the shoulders and neck can occur due to compression of the nerve roots of the spinal cord in the spine.

Radiating to the scapula

Often, such pain indicates a displacement of the vertebrae of the cervical or thoracic spine. At the same time, the roots that innervate the region of the girdle of the upper extremities and the shoulder are compressed. In addition, these symptoms can occur if the muscles of the shoulder girdle, which are attached to the shoulder blade, are damaged. In this case, the pain will mainly occur when raising the arm above shoulder level.

When lifting and abducting the arm

If the shoulder hurts only when lifting and abducting, but does not hurt with any other movement and at rest, you can suspect damage to the muscles that set the shoulder joint in motion. It can be the muscles of the shoulder or shoulder girdle. Based on the movement and the level at which the pain begins, one can suspect which muscle is affected.

After training

In this case, the symptom can be both normal and pathological. If it develops gradually during the day, is localized in the area of ​​the muscles and is facilitated by movement – this is the norm. Most often this happens in untrained people due to the accumulation of lactic acid in the muscles after exercise. This problem is solved by regular moderate training.

Pathology is severe pain that occurs during exercise – it can be associated with damage to the muscles, tendons or dislocation of the joint itself. Also, the pathology is pain that develops gradually after training, accompanied by swelling or numbness of the upper limb.

The best solution for pain is to immediately contact an experienced specialist.

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Diseases that cause pain in the shoulder

In most cases, shoulder pain is due to a specific medical condition. Diagnosis of a specific pathology allows you to choose not only symptomatic, but also pathogenetic treatment, that is, to eliminate the cause, not the symptom.

Arthritis and polyarthritis of the joint

Arthritis is inflammation of the joint. Polyarthritis is an inflammation of several joints. Inflammation is always accompanied by swelling, dysfunction and joint pain. If the symptoms come on suddenly and are of high intensity, it can be said to be acute arthritis. In this case, the pain is severe, but it is easily treatable. Prolonged pain of low intensity with periodic exacerbations is a sign of chronic arthritis. It is dangerous because it can destroy the joint and eventually lead to its complete immobility.

Arthritis can be caused by an infection in the joint or by damage to the body’s own immune cells. Polyarthritis is a sign of an autoimmune disease that can have many complications. It needs to be treated as soon as possible.

Arthrosis and osteoarthritis of the joints

Arthrosis is a degenerative lesion of cartilage tissue. Osteoarthritis is damage to cartilage and bone. In these cases, tissues are destroyed without inflammation. Often this occurs in older people due to impaired blood supply. Osteoarthritis of the shoulder joint at a young age can occur in athletes after repetitive injuries. It is very difficult to stop such a process, but you can slow it down and reduce the intensity of pain.

Periarthritis of the shoulder blade

This term used to be used to describe any inflammation in the shoulder joint. As new diagnostic methods emerged, it became clear that in fact the same symptoms cause different pathological conditions. Now humeroscapular periarthritis is a collective concept that is used before it is possible to identify a specific localization of inflammation. In a generalized version, this is inflammation of any tissues surrounding the shoulder joint. This diagnosis requires clarification.

Osteochondrosis of the cervical or thoracic spine

With degenerative changes in the cervical or thoracic spine, the vertebral bodies are displaced. Displaced vertebrae compress the nerve roots that extend from the spinal cord to the arm. If sensitive roots are compressed, pain occurs in the shoulder area. If the motor roots are compressed, paresis and plegia occur, that is, the mobility of the hand is impaired.

Bursitis of the joint

Bursitis is the inflammation of the synovial sac in the shoulder joint. Most often, bursitis occurs simultaneously with arthritis. It may be purulent or non-purulent. In the first case, bursitis is caused by a bacterial infection, in the second – by traumatic injury, viruses or immune cells. Often this disease affects athletes and people of professions associated with the same type of manual labor.

Tendonitis of the tendons

Tendovaginitis is an inflammation of the tendons of the muscles and their fascia. Occurs with excessive physical activity and injuries. Accompanied by aching pain in the shoulder area. Tendonitis is dangerous because with prolonged inflammation, muscle cells will begin to break down, and connective tissue will form in their place. Ultimately, this will lead to a violation of the mobility of the joint. Tendonitis of the tendon can occur on one or both sides. More often affects the most active hand.

Shoulder plexitis

Plexitis is an injury to the nerves of the brachial plexus that is accompanied by pain. Symptoms of plexitis are similar to signs of osteochondrosis. The difference lies in the fact that with osteochondrosis, the roots are compressed, and with plexitis, the nerve plexus is affected. The latter can be caused by trauma, infection, or pressure, such as when lifting heavy objects.

If the symptoms do not go away for a long time, it is urgent to visit an osteopath.

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Diagnostics

In order to understand what disease has caused shoulder pain, you need to see a doctor. First of all, diagnosis is carried out by collecting complaints and anamnesis. Also, the doctor should examine the joint and palpate it. Thus, a specialist will be able to suspect a particular disease and choose one or more additional diagnostic methods. These methods include:

• X-ray of the shoulder joint and bones that surround it is necessary if there is a suspicion of bone damage. Cartilage and soft tissues are practically invisible on x-rays, but fractures and dislocations are recognized very well.
• Ultrasound . Joints are often examined using ultrasound. It allows you to see the state of cartilage, muscles, synovial space. With the help of ultrasound, inflammation and degenerative processes are diagnosed.
• Magnetic resonance imaging . This method is more expensive, but also more informative than ultrasound. With it, you can see the condition of bones, cartilage, and soft tissues. MRI is used to diagnose most diseases in the shoulder joint.
• Upper limb angiography . This study allows you to see the circulatory system of the hand. Helps in the diagnosis of vascular diseases at any extent.
• Synovial fluid testing . Used when arthritis or bursitis is suspected. Fluid analysis will confirm the presence of inflammation and indicate its nature, that is, identify the cause of inflammation.

Consultation of our specialists will help to make the correct diagnosis.

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Treatment of causes of pain

All types of therapy for shoulder pain can be divided into conservative and surgical. The former include taking tablets, injections, applying ointments, physiotherapy, massages. Surgical treatment is a surgical intervention that is carried out in the case when a conservative one does not have the desired effect.

Therapeutic treatment

Conservative treatment can take place at home or in a hospital. In some cases, it is enough for the patient to come to the procedures during the day several times a week.

Painkillers and anti-inflammatory tablets can be taken by the patient at home as prescribed by the doctor. The same applies to the application of ointments. Injections, often intramuscular, are either given in a hospital or at home with the help of a stranger who can give the injection. In some cases, injections must be made into the joint itself, for example, with arthritis and bursitis, only doctors do this manipulation.

Physiotherapeutic procedures are also carried out in hospital conditions, for example, electrophoresis or myostimulation; massages and therapeutic exercises. The latter can be done at home after training with an instructor. Osteopaths are also included in conservative treatment methods.

Surgical treatment

Surgical operations are not often prescribed. It is necessary for complex fractures, torn ligaments and tendons, complex dislocations. In degenerative diseases, sometimes a joint replacement is required, which also takes place through surgery. In most cases, conservative therapy is sufficient to relieve pain.

Treatment methods in our clinic

Our clinic specializes in a treatment method called osteopathy. It also belongs to conservative therapy and does not require invasive intervention. This is a technique of manual influence on tissues in order to relieve pain, improve trophism, and normalize function. Osteopathy is often used for lesions of the musculoskeletal system. This treatment is effective and completely safe.

Our specialists will conduct an examination and prescribe the optimal treatment.

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Answers to frequently asked questions

Prevention does exist for a number of diseases. For example, in order to avoid fractures, dislocations and ruptures, it is necessary to be more careful in traumatic situations. To prevent tendinitis, bursitis and plexitis, one should reasonably approach physical activity and strictly dose them. The prevention of arthrosis is, first of all, the rejection of bad habits such as smoking and alcoholism, as well as the treatment of chronic diseases, such as diabetes. Arthritis is not amenable to prevention, in this case, early detection and timely treatment are necessary.

If you go to a public institution, you should start with a general practitioner. He will conduct an examination and give a referral to another specialist. When contacting a private clinic, you can start with a traumatologist.