Causes of shoulder pain
The shoulder is a complicated joint composed of the scapula (shoulder blade), clavicle (collar bone) and humerus (upper arm bone). The ball and socket part of the joint only rotates to shoulder height or 90 degrees. From that point and above for the arm to raise up higher than horizontal requires the scapulae to rotate and the clavicle to elevate and twist. This complex set of motions requires
a variety of muscles to contract and relax at the right timing and to pull with just the right force. This is called the scapulohumeral rhythm. If there is any imbalance in strength or timing, things begin to wear unevenly, and very quickly pain develops. Imagine the timing being 'off' in your car. This type of situation often produces the typical tendonitis and bursitis problems of the shoulder that are an epidemic. These get treated with drugs and physical therapy, often with some temporary success, but there is no lasting change until balance is restored. At Axis Health we direct our efforts to the careful evaluation of the shoulder, with specific treatment aimed at restoration and preservation of normal function. We do our best to provide rapid temporary relief while you are on the way to a stable state in which your shoulder has fully recovered.
The bursa is a fluid filled sack that reduces friction between several of the bony structures of the shoulder. If the shoulder is struck hard enough in just the right spot it will bruise the bursa, causing it to swell. This most commonly occurs with a repetitive overuse situation caused by a malfunctioning shoulder, in which the bursa is continuously rubbed by internal structures until it is inflamed. It shows up as general aching in the side or front of the shoulder. It usually hurts more with overhead use. Often it is really a problem while trying to sleep, especially lying on that side. Ultimately the solution is getting the shoulder back in balance with specific exercise designed for your problem. If the inflammation is so bad that exercise makes it worse, we concentrate on reducing muscle spasm, relieving inflammation, and generally reducing pain. Our goal is always to alleviate the root cause.
Tendons are the tough little bands of tissue that join a muscle to a bone. In the shoulder there are several areas where tendons have a tendency to get squeezed or rubbed continuously. A shoulder that functions properly does not usually experience this problem, but as soon as the balance is thrown off, you are in trouble. Even though this is different than bursitis, it ends up looking similar and shows up as the same general aching in the side or front of the shoulder. It usually hurts more with overhead use. Often it is really a problem while trying to sleep, especially lying on that side. At Axis Health we deal with it the same way we deal with bursitis: balance out a malfunctioning shoulder with corrective exercise, or pain relief with massage, antiinflammatory care and pain relief until exercise is possible.
This condition can be a nightmare. No one has ever figured out exactly why this condition starts. It is more common in women and diabetics, but it can affect anyone. This comes on over the course of a few weeks, usually after there has been some other problem with the shoulder, either an injury or overuse disorder. The pain becomes fairly severe, and the motion of the shoulder is limited. You lose the ability to lift or rotate the shoulder properly. The shoulder has accordian like folds in the soft tissues that hold it together. These are located in the armpit area. Presumably these folds develop adhesions that are like spiderwebs holding them together. This problem goes away on its own but it can take up to two years! Your best bet is to keep the shoulder functioning well so that this never happens to you. If you are unfortunate enough to encounter this problem, we work with you to speed your recovery, dramatically reducing the healing time.
Pinched nerves in the neck also create shoulder pain, but the pain isn't from the shoulder. This condition causes most of its discomfort betweeen the shoulder blade and the spine on the same side, and radiates pain into the side of the shoulder and arm, then down the forearm to the hand as well.