The shoulder is a ball and socket joint that has several complex mechanisms for its movement. Any discrepancy in any of the parts involved in these mechanisms can lead to pain in the shoulder. The three main bones of the shoulder joint are the humerus, clavicle and scapula, which are further cushioned by a layer of cartilage. Damage to any of these structures can be a cause for pain.

Signs and Symptoms of Shoulder Pain

Complaints from patients range from sharp pain in the joint to a dull ache. Other symptoms that may be seen along with pain include-

• Swelling in or around the joint. Doing daily activities like combing hair, and shampooing may be difficult
• Redness around the joint may be seen in cases of injury or trauma to the shoulder. Sometimes infections lead to redness with increased temperature around the joint.
• Persistent pain that does not go away even after sufficient rest.

What Causes Shoulder Pain?

The shoulder, being one of the most commonly used joints, can be affected by a variety of pathologies leading to pain. Common pathologies affecting the shoulder include arthritis of the acromioclavicular joint between the shoulder and collar bone, arthritis of the shoulder ball and socket joint or tears in the muscles and tendons around the shoulder. Most of these pathologies ultimately lead to restricted shoulder movements and the patient often presents to the doctor with a “Frozen Shoulder”.

• Injury– shoulder injuries are fairly common. From road accidents to playing games like badminton, tennis etc. any damage to the joint causes acute and sharp pain.
• Arthritis– Long-term conditions like osteoarthritis, rheumatoid arthritis etc. can lead to pain and difficulty in shoulder movements.
• Fracture– a fracture in any of the bones involved in the joint, or those around it, can lead to pain and discomfort.
• Sudden movement or jerking of the shoulder, may lead to injuries in the ligaments and tendons around the shoulder joint leading to pain and restricted mobility.
• Picking up heavy objects without the appropriate support can put stress on the shoulder.

Treatment Options for Shoulder Pain

Detailed history and clinical exam are the cornerstone of diagnosing and treating any clinical condition affecting the shoulder. The mode of onset and preceding events help the clinician in establishing probable causes. These are further confirmed by some physical tests and manoeuvres. Ultrasound exam of the shoulder is an excellent tool to diagnose the problem and assess it in real-time, meaning the pain increasing at certain manoeuvres is confirmed by ultrasound, further compared with the opposite unaffected side.

Based on these, the treatment plan can be formulated and offered to the patient. Treatment options include injections into the joints in and around the shoulder, and treating the muscle and tendon tears by way of regenerative techniques like PRP and GFC or hydrodistension of the shoulder joint to release the frozen shoulder. These procedures are performed on a care basis with early and lasting relief from symptoms and early return to normal activities. Certain patients, based on their pathologies may need surgical interventions on the shoulder.