Shoulder pain is a common condition among middle-aged and elderly people. The pain can affect the movement of the shoulder joint, and the pain at night can affect sleep. We usually think that the main cause of shoulder pain is frozen shoulder or cervical spondylosis, but in fact, there are many causes of shoulder pain, so let’s talk about shoulder pain!
Shoulder pain may or may not be caused by shoulder diseases, which diseases that are not shoulder diseases will cause shoulder pain?
1.Cervical spondylosis
More commonly, cervical spondylosis causes a wide range of shoulder pain, the most obvious pain and discomfort will be in the neck and shoulder joint or the back of the shoulder (as shown in the picture), and the pain will radiate to the whole upper limb, or even to the hand, causing numbness in the fingers.
2.Lung cancer
It is not common, but we find it every year in our shoulder and joint clinic, because when lung cancer compresses or invades the brachial plexus nerve, it will cause radiating burning pain in the shoulder and upper limb. However, these patients usually have no pressure pain in the shoulder, and the shoulder joint movement is basically not limited.
3. Cholecystitis
If the left shoulder pain is not caused by cholecystitis, it is definitely not caused by cholecystitis.
4.Coronary heart disease
Uncommonly, coronary heart disease can cause radiating pain in the left shoulder. This radiating pain is not a point of pain, but a facet from the shoulder to the arm, and this pain is often accompanied by a feeling of pressure, which mostly makes people feel heavy and uneasy. However, if the pain is in the right shoulder, it will not be caused by coronary artery disease.
Of course, the vast majority of shoulder pain is caused by disease in the shoulder itself.
The shoulder joint is the most mobile joint in our body. It is made up of the head of the humerus, the scapular glenoid and the muscles, tendons (rotator cuff) and joint capsule that surround them.
Problems with any structure in the shoulder joint can cause shoulder pain or discomfort, so it is completely wrong for many people to self-diagnose shoulder pain as “frozen shoulder” once it occurs.
What are the diseases in the shoulder that can cause shoulder pain?
1. Rotator cuff injury
The rotator cuff is the general name for the four tendons surrounding the shoulder joint, which are wrapped around the humeral head like a cuff, so it is called the rotator cuff. The main function of the rotator cuff is to drive the shoulder joint and to stabilize the joint. The rotator cuff is easily damaged, and literature shows that the percentage of full rotator cuff tears can reach 30% in people over the age of 60. There are no nerves in the rotator cuff itself, so many people can have no symptoms even if they have a rotator cuff tear.
The pain of a rotator cuff tear will often radiate laterally to the upper arm, but not beyond the elbow joint. The pain of a rotator cuff tear is not severe at first and occurs mainly when doing certain shoulder activities. As the condition becomes more severe, nocturnal pain and resting pain may occur, affecting sleep, and it is accompanied by weakness in supination and even limitation of shoulder joint movement.
2.Shoulder impingement sign
When it comes to shoulder impingement, many people think, “I didn’t bump into anyone, so how can I say I have impingement? How can I say I have impingement?”. In fact, shoulder impingement is an inflammatory condition that causes shoulder pain due to the impingement of the greater tuberosity of the humerus and the scapula of the upper arm.
Many people can hear or feel a “click, click” sound in the shoulder when they lift the shoulder joint, which is actually a sign of impingement. It is possible that the impingement is a cause of rotator cuff tears. The pain is not severe at first, but occurs mainly when the shoulder is lifted and rotated internally. As the condition becomes more severe, nocturnal pain and resting pain may occur, affecting sleep and even restricting shoulder joint movement.
3.Long head biceps tendonitis
It is more common in people aged 45 – 55 years old and is thought to be the initiating factor for “frozen shoulder”. It is often associated with impingement signs and rotator cuff injuries.
Patients with biceps longus tendonitis often complain of anterior and superior shoulder pain, which can extend down the front of the upper arm to the biceps muscle belly of the upper arm, often with nocturnal pain, and anterior shoulder pain during shoulder abduction, external rotation, and posterior extension (reaching backwards in the front seat to hold something in the back of the car).
4.Frozen shoulder – what we people call “frozen shoulder”
This is “a disease that has no clear cause and excludes any disease of the shoulder joint, which is characterized by a significant restriction of both active and passive shoulder movement.” –Definition of frozen shoulder.
The pain of frozen shoulder is mainly severe pain with sudden movement and more severe nocturnal pain, and must be accompanied by limited movement of the shoulder joint, especially external rotation and supination.
5. Calcific Tendonitis
Pain is the main symptom of calcific tendonitis. During the calcification formation phase, the pain is usually mild, while the acute pain during the calcification absorption phase is so severe that the patient refuses to move the shoulder joint because of the pain and unconsciously presses the arm against the chest, but the acute phase usually lasts only 2-3 weeks.
Other shoulder diseases that cause shoulder pain include “acromioclavicular arthritis”, “glenohumeral osteoarthritis”, “shoulder instability”, and “intra-articular free body”. intra-articular free body of the shoulder”, etc.
Therefore, if your shoulder pain has been persistent for some time, please do not self-diagnose, but seek medical advice to avoid misdiagnosis and mis-treatment.