Best Shoulder Pain Treatment
in Bengaluru

What are the causes of shoulder pain

Several factors and conditions contribute to shoulder pain. These include the following:

• Rotator cuff injury (the group of four muscles and tendons that surround the shoulder joint) – These muscle provide stability to shoulder joint but any strain or injury or tear(partial or complete) may lead to pain at shoulder joint associated with restricted joint movements. Supraspinatous muscle is one of the most commonly injured rotator cuff muscle mostly seen if there is a fall on outstretched hand or while playing golf, baseball, swimming.
• Arthritis– osteoarthritis and Rheumatoid arthritis of shoulder joint are common although the incidence is less as compared to knee joint. In initial stages of arthritis the pain is less but then slowly progresses to the stage where the cartilage protecting the joint is completely damaged leading to severe pain and restriction of movements.
• Frozen shoulder (Adhesive Capsulitis)- The capsule over the joint is protective but when the capsule gets inflamed due to injury or other medical condition like Diabetes Mellitus or other autoimmune conditions, then it becomes a potential source of pain. Slowly it progresses to a stage where the joint movements are restricted and finally a stage comes where the capsule adheres to each other forming fibrotic bands within the capsule eventually leading to joint stuck in one position.
• Bursitis (inflammation in the bursa)- These are cushion like structures present over the bones to prevent friction between two structures. But when these bursa are swollen and inflamed it becomes painful.
• Shoulder fracture: stress fracture in old age or fracture due to injury or fall
• Ligament injury– Ligaments are structures that connects two bones. Any injury to ligaments around the joint will lead to inflammation in the joint
• Labral Tear– Labrum is a thick structure present at rim of the joint which helps to keep the ball of the shoulder joint inside the socket and holds the joint in place. Most commonly in sports injuries labrum gets torned either completely from the bone or within the substance of labrum.
• Acromioclavicular Joint arthritis or degeneration– Sometimes a direct blow to the shoulder may damage the ligament above the acromioclavicular joint presenting with pain at and around collar bone.
• Impingement syndrome– Due to excessive rubbing between the muscle tendon passing beneath the bone is a cause of impingement syndrome. Usually seen due to injury or as a result of degeneration.

Symptoms:

There are several causes of shoulder pain, and each cause has a unique set of symptoms. Depending on the cause, shoulder pain is accompanied by:

• Tenderness and warmth around the joint- in of cases of acute inflammation there can be local rise of temperature and tenderness.
• Inability to use the joint – Severe pain may restrict the movement of the joint
• Inability to move your arm away from the body
• Sudden swelling and redness
• A weakness of the shoulder or upper arm
• Neck pain and headaches- shoulder pain may sometimes mimics like a neck pain
• Night pain and cramps in shoulder

Immediate medical care is required if the shoulder pain is sudden and accompanied by dizziness and excessive sweating, as it might be a sign of heart attack.

Diagnosis

To know the exact cause of shoulder pain, the doctor will review your medical history and conduct various physical examination to check the signs and symptoms of the underlying condition and also to identify the cause of pain . Additionally, certain imaging tests can be done depending on the finding of physical examinations

X-Ray- Fractures, impingement, bony outgrowths can be seen

CT Scan and MRI Scan- Rotator cuff injury, labrum tear, ligaments and other soft tissue injury can be seen

Dynamic Ultrasound Imaging is the best diagnostic modality to identify shoulder pain . Rotator cuff strain, tear(complete or partial) calcifications, soft tissue damage can be seen.

Treatment

Minor shoulder pain can be managed and treated at home. Resting the shoulder by avoiding shoulder movement for a few days might be helpful. Surgery may be required to resolve severe shoulder problems. However, in most cases, shoulder pain can be easily treated with non-surgical treatment methods, such as physiotherapy and medications.

• Physiotherapy: Physiotherapy will fix certain problems, such as shoulder stiffness and weakness. It can also include retraining the movements or activities that may aggravate your pain. Applying heat and cold packs may provide temporary relief from pain and stiffness.
• Medications: Painkillers and anti-inflammatory medications are recommended to manage the underlying conditions. NSAIDS, Muscle Relaxants, Opioid are often taken and prescribed for acute onset knee pain. Due to harmful effect of these medicines in long term like gastritis, renal dysfunction, liver dysfunction, they are to be avoided for long term and very harmful if taken without consulting your treating physicians
• Regenerative medicine alternatives for shoulder pain:
  This approach can heal or replace tissues and organs damaged by age, disease, or trauma by eliminating the need for surgery.

This includes:

• Stem cell therapy: Injecting stem cells at the affected site will completely repair the shoulder injuries and manage the symptoms, including shoulder pain.
• Platelet-rich plasma (PRP): This therapy involves usage of part of your blood to heal the damaged tissues, including joint, tendon, ligament, and muscle injuries. Platelets are rich source of growth factors which are capable of regenerating the torn and degenerated tissue. Small amount of blood is taken from your body and is processed in a specialized machine then the concentrated growth factors are injected into the torn tissues with the
  help of various machines which guide the doctor to reach the exact place of damage. Complete healing of the partial or complete tear of rotator cuff muscles is seen over a period of time.
• Hydro dissection of the joint– This is done in cases of frozen shoulder where a mixture of normal saline or dextrose along with local anesthesia is injected into the joint under ultrasound guidance to expand the capsule and break the fibrosis and also decrease the inflammation around it.
• Arthroscopic Surgeries– These may sometimes be advised if no cause of shoulder pain is identified .
• Shoulder Replacement surgery– Shoulder replacement surgery is a tedious surgery requiring a lot of precision. There are better alternatives yielding better results as compared to it.