Shoulder pain can restrict the freedom of movement strong and make everyday life difficult. Causes are many, often inserted a so-called impingement syndrome behind the complaints. But even acute injuries and wear loose from shoulder pain. Often a long-term, consistently applied physiotherapy is needed to the muscles strong - to avoid surgery can in many cases.
What are shoulder pain?
Shoulder pain are predominantly so-called Soft tissue pain in the shoulder joint. The bones are not affected. The complaints arise in the range of:
Shoulder Pain has restricted the activities that you want to pursue, strong one: both in everyday normal movements like putting on a jacket, as well as at work or in sports.
Shoulder pain can have diverse causes. It does a great role that the shoulder the most mobile joint is the human body. In many other joints such as the hip, a deep joint socket accommodates the joint head and stabilized him so much. When the shoulder is different: Here muscles, tendons and ligaments holding the head of the humerus in the correct position. Meet those their job poorly, often shoulder pain result.
Common causes Shoulder pain:
Schematic representation of the shoulder from the front
Schematic representation of the shoulder from behind
A Dislocation of the shoulder joint can also cause shoulder pain. There are three different types of Schultergelenksluxation:
can cause chronic inflammation due to wear and tear on the tendons of the shoulder joint. In tendinitis of certain shoulder muscles (supraspinatus, infraspinatus and teres minor muscle) takes a local Pain above and the side of the shoulder as to the larger muscle stud bump (the greater tuberosity) the humerus on.
In addition, diseases of other organs or structures can cause pain to radiate into the shoulder. The exact cause and diagnosis of such a disease sometimes requires clarification by other specialists, such as internists and neurologists.
Examples of radiating complaints:
Depending on the cause and Origin stand shoulder pain different symptoms in the foreground. However, the symptoms may very similar despite different triggers.
Common causes of shoulder pain, such as the so-called impingement Syndrome (Bottleneck syndrome) or rotator cuff tear, affect agility of the armHe can often be due to pain barely lift. Many everyday activities - such as putting on a shirt or a light bulb overhead - are possible only with difficulty. The shoulder hurts then in certain positions - especially when lateral abduction the arm (abduction) - or under load (impingement).
Because symptoms often occur during lateral deploying the arm and show themselves in certain ranges of motion, doctors refer to as the so-called painful arc (Engl. Painful arc). Pain caused by bottleneck syndromes can radiate far toward shoulder.
Also typical is the nocturnal pain, which occurs when the person lies on the affected side or unconsciously turns in his sleep there. Many people with shoulder pain do not know how to lie down properly in order to be able to sleep without pain.
If, at the cervical spine mechanically-induced disease processes, motion and function of this range may be eingeschfänkt. Pains radiate into the shoulders and arms from here.
If nerve roots are stimulated which reduces the mobility of the cervical spine. As a result, until the hand radiating pain. From the place of pain, the doctor can draw conclusions on each affected nerve root, as there is a clear anatomical mapping. The pain may be accompanied by sensory disturbances and muscle weakness.
A disease of the lateral Clavicle joint (Acromioclavicular) mostly caused Discomfort in the upper shoulder.
Shoulder joint pain make often deeply felt. In addition, sufferers move their shoulder and her arm in these symptoms typically. This movement pattern called doctors capsule pattern - it suggests a deterioration of the joint or surrounding structures (rotator cuff). On the encapsulated pattern several movements of the joint are limited.
If there by accident changes in nerve, often occurs a distinctly different feeling: It comes in the coverage area of the affected nerve to a burning and einschießenden pain.
The Frozen Shoulder or shoulder stiffness is accompanied by pain, affecting tendons, joint capsule, and bursae in the rotator cuff. The English term frozen shoulder derived from the limited or reversed motion of the joint from (frozen = solidified). The pains are aggravated by particularly Internal and external rotation of the arm and radiate in the so-called deltoids, a triangular muscle on the shoulder joint out.
at tendonitis shoulder pain act accordingly, which tendon is inflamed:
Because shoulder pain are among the most common complaints in the orthopedic everyday life, examination and diagnosis represent routine procedure. As a rule, the doctor first asked the medical history (Anamnesis):
The answers give the first indications of possible causes of shoulder pain.
This is followed by the physical examination: The patient pulls his shirt off, sometimes reveal themselves disturbed movement and an avoidance behavior is noticeable: The person concerned is easy on the arm in order to escape pain. Important in the diagnosis, the shape and state of the shoulders, shoulder blades and collarbones and the position of the arms and possible abnormalities of the muscles.
Just as important as optical diagnostic investigation of the person concerned is equipped with special investigation handles and methods. Of them, there are a number - they are used to assess the function of the muscles of the shoulder joint. Thus the causes of shoulder pain can narrow down precisely.
typical clinical function tests with shoulder pain are:
Jobe test: The patient is standing or sitting upright and leads both arms in the horizontal (90 °). Now he bends it in this plane by approximately 30 ° and rotates the hands so that the thumbs point to the ground (as if you pour a can). Now, the examiner tries to press the arms of the patient against the resistance downward. Can the person on one side put up a poor, this argues for a torn tendon, an irritated tendon or inflammation of the bursa under the acromion.
Neer test: When Neer- or impingement test, the doctor considers the patient's shoulder quiet and then moves the arm outstretched laterally stretched upward to then rotate it inward. If this causes pain, it is an indication of an impingement syndrome.
Hawkins test: The doctor raises his arm at the elbow bent upward and rotates it inwards simultaneously. Even with this test, impingement syndrome can be diagnosed or excluded.
Painful arc-test: In this test the arm beyond a certain point of time is to be raised. The movement of the patient should carry themselves. If this causes pain, it may be a so-called painful arc. The pain may be absent when the doctor raises his arm to the patient.
Codmann handle: The Codmann handle describes a specific grip technique with which the doctor scans the shoulder. He can firstly determine the origin of the pain and, if available grope, aneinanderreibende bone parts.
Lift-off test: The patient puts his hands in the so-called apron handle behind the back. Then he is to solve the hands against the pressure of the doctor from the back. Depending on how well that works and whether it produces pain, the doctor can evaluate the result of the diagnosis.
Drop-arm sign: The doctor lifts the patient's arm and asks him to keep this up. If this does not work, this is an indication of a rotator cuff injury.
apron grip and nerve pinch serve to check the mobility of the shoulder. When apron handle the patient is to put both hands on the lower back (the thumbs facing up). When nerve pinch both hands back down to the neck (the thumb facing down).
In addition to the functional tests the doctor scans the tendons, joints and trigger points. trigger points are trigger points, whose touch can cause pain. The pain does not always occur only at the pressure point on, but possibly also in other parts of the body. The doctor examined the shoulder area to muscle shortening and checks the mobility of joints. He also looks at how the person moves the arm against resistance and makes an active and passive motion check.
If necessary, is followed by a neurological examination in order to clarify a pinching of a nerve, for example.
To determine whether it is in the shoulder pain is a nervous or muscular disorder, a electromyogram (EMG) are made. The physician measures the electrical activity of the muscles at rest or in motion. So he can assess which area is a fault: in the muscle or nerve involved. A measurement of the nerve conduction velocity (electroneurography) can provide information.
allow further insights into the shoulder joint imaging procedures as:
The combined assessment medical history, clinical tests and the results of the ultrasound, X-ray or MRI allows the physician most effective diagnostics.
Enter all of these non-surgical procedures no clear indication of the cause of shoulder pain, can entires a arthroscopy (Arthroscopy) help. In this operation, in so-called Keyhole surgery The doctor can give a direct impression of the structures in the shoulder joint and surrounding anatomy. If necessary, it can also treat directly - about sew a tendon tear or wear out inflamed tissue.
The treatment of shoulder pain depends on its cause. In most cases, the person concerned can themselves contribute significantly to alleviate the shoulder pain or completely get rid of. Because in many cases, lack of exercise and stuck with it muscle weakness and a bad attitude behind the complaints. Causes that can actively change each.
Basically, there are the following treatments for shoulder pain:
With some regular exercises you can get rid of shoulder pain or prevent. Such shoulder exercises are recommended for most people who suffer from shoulder pain. There are many shoulder exercises that you can make at home. For most exercises, you need only one flexible exercise band.
What exercises are appropriate for you, you may get the best with your doctor or a physiotherapist.
But train yourself not simply go on it! For instance, if a tendon is injured or for any other serious injuries that require other therapy, you can make the situation worse. If you have acute problems and pain, you conserve your shoulder until an accurate diagnosis is present!
In addition, some help Rules for everyday life, to improve the shoulder pain or prevent symptoms:
run depending on the cause shoulder pain vary widely:
How well the therapy strikes, therefore depends on your cooperation. Have shoulder pain caused by the practice of certain sports, it may be useful to do without this for a while or even long term. Recommends the doctor, the shoulder area initially immobilize or to spare, you should heed this advice.
The sooner you do something lasting shoulder pain, the better the chances of cure are.
A bad attitude and lack of exercise are the greatest enemies of the shoulder. On the one hand lead to an incorrect position of the joint, on the other hand wither the inactive muscles over time. In such a case, even minor stresses and movements damaging individual structures - this is irritating and overloaded shoulder.
One problem is permanently sedentary activities. Here it comes quickly to muscle tension. Make therefore regular short breaks, where you loosen the shoulder and neck area through relaxation exercises. Make sure when prolonged sitting on the right attitude. Even with short walks you can prevent tension and relax the muscles.