Pain that occurs in your shoulder seems like it should be pretty cut and dry. If it hurts in your shoulder, there must be something wrong with your shoulder, right?
Actually, this is not always the case. The rule of thumb is, if you move your shoulder or arm and your pain increases, then it’s probably shoulder pain. If, however, you move your shoulder and don’t actually feel any pain while doing so, you might have a problem elsewhere in your body that’s actually sending a message of pain to your shoulder. This is what’s known as “referred pain,” and it is a normal body response.
What Are Some Possible Shoulder Pain Causes?
The possible culprits of shoulder pain causes are varied. However, your age, the event that triggered the feeling of pain, and whether or not you can actually move your shoulder all serve as important clues that may point to the cause of your pain.
Age can play a big role in shoulder pain. The rotator cuff is a group of muscles and tendons that help stabilize the shoulder joint. The tissue around it can become inflamed when the rotator cuff is being used more than normal. A young adult pulling a heavy object may experience little to no pain from the effort, while an older person who attempts the same task may develop inflamed tissue. With age, tissues, including the rotator cuff, lose elasticity. So when the rotator cuff does more work than it can handle, things like tendonitis, bursitis or a torn rotator cuff, may develop. Diseases of the joints, such as osteoarthritis and occasionally rheumatoid arthritis, may also be an issue.
Shoulder pain accompanied by neck pain might indicate that the spine has been impacted. In such a case, your doctor may order a MRI to look for problems in your neck that could explain your symptoms.
Less common, but potentially more serious, cases of shoulder pain are those where the pain is referred. As I mentioned above, referred pain is pain that stems from a specific part of your body, but your body does not recognize its location. So although you may think you have pain in your shoulder, it may in fact be coming from somewhere else. Examples of referred shoulder pain include shingles, heart attacks or cancer.
When Should I Worry About My Pain?
Seek immediate medical attention if your shoulder pain is accompanied by bleeding, tightness in the chest, chest pain, lightheadedness or shortness of breath.
If there is a moderate amount of swelling, tenderness accompanied by a warm sensation around the joints or any abnormal change in skin color, such as redness, at-home remedies can be attempted. Failure to obtain a resolution over several weeks should prompt a call to your doctor for a closer look.
What are My Shoulder Pain Treatment Options?
While determining the root cause of your pain, activity modification is important in order to allow your body time to heal itself. Minimize the use of your shoulder and give it time (several days). If minimizing use does not control your pain, consider the use of a sling. This will restrict the use of your arm and give your shoulder rest. However, the need for a sling for more than two weeks indicates a need for a medical opinion.
To help provide shoulder pain relief and inflammation, you could try over-the-counter medicines such as acetaminophen (Tylenol), Advil, ibuprofen, aspirin or Aleve. For the first 24 hours after the onset of pain, you can apply cold to the affected area for 15 to 20 minutes at a time, up to a few times a day. Topical application of creams that are designed to reduce muscle pain, such as Icy Hot or Bengay, may also reduce discomfort.
For shoulder pain that just won’t seem to go away and lasts more than a month, your doctor may suggest:
• Physical therapy
• Injections of steroids or local anesthetics into the muscles, joints and/or spine
• Prescription pain medication such as muscle relaxants or antidepressants
Dr. Guarino is the Director of Pain Management at Washington University in St. Louis. You can find out more about him and his book at www.painstrategy.com.
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