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Shoulder Pain


What are the causes of shoulder pain?

The causes of shoulder pain are impingement syndrome, bursitis, adhesive capsulitis (frozen shoulder), fibromyalgia, osteoarthritis, traumatic and athletic injuries, nerve injuries, infections, tumors, pain spread from the neck, inflammatory rheumatic diseases (rheumatoid arthritis, ankylosing spondylitis), complex regional pain syndrome (Sudeck atrophy), metabolic and endocrine diseases (such as gout, diabetes), polymyalgia rheumatica, thoracic outlet syndromes, myopathies, and internal organ diseases (heart disease, lung tumors, gallbladder diseases, aortic aneurysm).

What is impingement syndrome? What are the symptoms? How is it treated?

Standing upright and daily activities have a detrimental effect on the tendons that allow the muscles to adhere to the bone. Especially in those who have to work with the arm at and above the shoulder, tendons are more easily worn because they are stuck between the shoulder bones. It is one of the most common causes of shoulder pain. Patients are often over forty years of age. Shoulder pain usually begins with a slight strain. Shoulder pain is blunt. At night, the pain may increase and reach intensities that will prevent sleep. Active movements are limited and painful. Ultrasonography and MRI help the diagnosis. During periods of severe pain, short-term rest is required. Pain relief rheumatism medications are given. Local injections and physical therapy are applied to patients who do not benefit from them.

What is Bursitis? How is it treated?

In the shoulder region, there are a plurality of bursae (liquid filled sacs) which help to reduce friction between the moving parts. Bursitis is a painful inflammatory disease of bursae. It develops as a result of strains and tendinitis, except for systemic diseases that can affect the bursae. Pain and tenderness spread down the front face of the shoulder. Lifting the arm from the side up is difficult, sometimes impossible, due to pain. Ultrasonography and MRI can be used to diagnose, but often only examination is sufficient. If the pain is too severe for treatment, short-term rest is given. Cold application is applied to reduce swelling. Pain relief and inflammation-relieving rheumatism drugs are given. In the cases that cannot be controlled by these methods, local injection and sometimes physical therapy are performed.

What is adhesive capsulitis (frozen shoulder)? How is it treated?

Trauma, cardiovascular disease, chronic lung disease, tuberculosis, lung tumors, diabetes, neck diseases and, most importantly, prolonged immobility of the arm can lead to frozen shoulder. Frozen shoulder (adhesive capsulitis) is more common in women. It occus after the age of 40. It starts insidiously with shoulder pain and stiffness. Limitation of movement becomes apparent gradually. The patient cannot sleep due to pain. There is sensitivity when touched around the joint. Shoulder movements are limited.

The best treatment is to move the shoulder as early as possible. Once settled, it is very difficult to reverse the natural course of the disease. Treatment requires active effort and patience. Patients should be willing and diligent. Treatment consists of physical therapy and exercises. Local injection and stretching are performed in the cases resistant to treatment.

What is polymyalgia rheumatica? How is the diagnosis and treatment done?

Polymyalgia rheumatica is a disease in the elderly with pain and stiffness in the neck, shoulder belt and / or hip belt that lasts for more than one month. Patients are over 50 years old. It is 2 times higher in women than in men. Night pain and morning stiffness are common. Fatigue, mild fever, weight loss, loss of appetite can accompany. Temporary swelling and pain in the knees and wrists are observed. Response of the polymyalgia rheumatoid to the cortisone is dramatic.

What is Sudeck atrophy? How is it treated?

Reflex sympathetic dystrophy syndrome (RSDS) is also called complex regional pain syndrome. Sudeck atrophy is characterized by pain, loss of progressive function and disability.

Shoulder, hand and foot involvement is common in Sudeck atrophy. Involvement of the arm is called shoulder-hand syndrome. In the shoulder-hand syndrome, despite the changes in the shoulder and hand, elbow remains intact. Most patients are over 50 years old. Pain and swelling in the affected region, skin changes and sweating are the signs and symptoms of this syndrome. Radiography, computed tomography and bone scintigraphy are used for diagnosis. The sooner the treatment is started, the better the outcome. There is a low chance of treatment in the late period. Analgesic drugs are used to break the vicious circle by reducing pain. Physical therapy should be given together with analgesic drugs. Exercises should be started immediately. In resistant cases, stellar ganglion in the neck is blocked.

What should be done to get rid of shoulder pain or not to be caught?

  • If you do not have pain, put your hands on your head, neck and back at least once a day.
  • If your shoulder hurts, do not lie on your sore side.
  • Place your arms on a support while sitting.
  • Do not raise your arms frequently above shoulder level.
  • Do not carry heavy loads with your arms.
  • If you have shoulder pain, repeat the exercises 2 times a day to 5 times according to your doctor's guidance.