The shoulder joint is a very mobile joint made up of the scapula or shoulder blade, and the humerus or arm bone. It contains joint fluid which is contained by a joint capsule, and is surrounded by a cuff of tendons known as the rotator cuff which envelope the joint and are responsible for powering the various shoulder movements.
Shoulder pain can be a result of injury or pathology of these various structures. Patients may also have difficulty with moving their shoulder due to stiffness, or may suffer from shoulder instability, when a sensation of the shoulder coming out is felt during certain positions or activities. Outright dislocation of the shoulder may occur once or repetitively due to injury to the shoulder.
There are various shoulder conditions that can cause shoulder pain. Some of them are listed below -
This usually presents with shoulder pain which can be exacerbated by abducting or 'lifting' the shoulder up by the side of the body. In many cases, there may be no history of a specific trauma to the shoulder and the pain develops slowly over a period of weeks or months. Wearing clothes and performing overhead activities, or lifting heavy objects may precipitate an increase in the pain.
In this condition, the shoulder usually feels unstable and patients may feel like the shoulder is 'coming out' during certain positions, or there may be a frank dislocation. There may be an episode of an initial injury to the shoulder during sports or after a fall.
A the name suggests, the shoulder joint feels 'frozen' as stiffness is frequently the main complaint, although patients may also experience varying amounts of pain associated with the stiffness.
If you have shoulder pain, stiffness, or instability that is interfering with your daily activities and causing difficulty with sports, or if a recent shoulder injury is not recovering well, you may wish to consult an orthopaedic surgeon.
It is usually helpful to write down your symptoms and make a list of any treatment and investigations that you may have undergone so far, including medications and X-rays.
On the day of the appointment, your doctor will take a full medical history and is likely to ask a number of specific questions regarding your shoulder.
This may include details such as:
Your doctor will then perform an examination of your shoulder and may also order additional investigations including X-rays, and in some cases, a magnetic resonance imaging appointment or MRI.
Blood tests may also be required for some patients.
After a diagnosis has been established, your doctor will then discuss treatment options. This commonly includes a course of physiotherapy, medications, and in some cases, surgery may be discussed to reconstruct your shoulder joint. Keyhole surgery may be recommended for sports injuries as it is minimally invasive and recovery is faster.
Sometimes, your surgeon may also prescribe an injection into your shoulder to assist in diagnosis or to provide immediate relief. This is a local injection done in the clinic which contains a local anaesthetic together with a low dose of a steroid to provide pain relief and to reduce inflammation in the shoulder joint.
The clinical outcome after reconstructive shoulder surgeries to correct sport injuries is generally very good. In many cases, the surgery performed is minimally invasive and designed to promote a rapid recovery and a return to sports. However, individual outcomes will vary with the type and severity of injury sustained and, your surgeon should discuss this with you when making preparations for surgery.
The post-operative care after shoulder surgery varies with the type of surgery performed, and will also be customised according to your needs. Your doctor will usually discuss this with you before your surgery so that you will be clear as to what kind of post-operative recovery programme to expect.
The recovery period after shoulder surgery may vary from a few weeks to many months. Very often, your post-operative care will also include advice on caring for your wound and icing your shoulder to reduce swelling.
You will likely also be given an appointment with the physiotherapist to assist in your post-operative rehabilitation after shoulder surgery. After certain surgeries, you may also require a shoulder brace to support your shoulder, and in some cases your surgeon will recommend restriction of certain positions of the shoulder while awaiting healing of the reconstructed tissues in your shoulder joint.
Click here to access our Find A Doctor directory for a list of doctors treating this condition across our NUHS institutions.
