Shoulder Pain: Diagnosis and Treatment

Navigating shoulder pain requires a blend of diagnosis and treatment. In this guide, we explore the complexities of shoulder ailments, from diagnosis to therapy options. We offer practical advice on when to seek medical attention and self-help strategies for relief and prevention. Whether facing acute injury or chronic discomfort, knowledge empowers you to find relief and regain control over shoulder pain.

Guide to Diagnosis and Imaging Techniques

Talking to the doctor and having a thorough physical examination are the mainstays when it comes to diagnosing shoulder problems. In this way, non-orthopedic diseases can largely be ruled out. The orthopedist observes the patient’s physique carefully, also when comparing both sides.

It scans muscles and tendons in the neck and shoulder area, checks the muscle strength and muscle reflexes as well as the sensation of the skin. And he uses targeted movement tests to check the cervical spine, arms, and shoulders. It is mainly about mobility, stability, strength, pain. The doctor also checks the vascular pulses and blood pressure on both arms.

The next step is often a sonography. With this imaging examination, for example, soft tissues such as tendons, bursae, the synovium, and muscles can be clearly depicted. Techniques such as color duplex sonography or magnetic resonance imaging (MRT) can help with special questions.

X-ray procedures including computed tomography (CT), for example, show the bone structures, positional relationships, and joint positions well, including fracture injuries. Arthroscopy of the shoulder allows diagnostic and therapeutic interventions.

Many therapy options for the shoulder

The treatment of shoulder pain knows conservative and operative ways. The focus of conservative therapy: protection of the shoulder (avoiding overhead movements), anti-inflammatory pain relievers, and physiotherapy. Further options are physical therapies, such as cold applications for acute pain, or heat treatment and electrotherapy for chronic complaints such as muscle tension.

On another sheet are cortisone injection treatments. They are still used, but very carefully and economically. In the case of severe pain, combinations of certain medications can help, including in individual cases an opioid preparation (opiate). An externally applied, extracorporeal shock wave therapy can shatter stubborn calcium deposits on a calcareous shoulder, which do not loosen by themselves and cause constant discomfort. The doctor will also treat other underlying diseases, such as internal or neurological diseases, as specifically as possible.

The surgical treatment procedures are also numerous. They include arthroscopic procedures, minimally invasive and classic open interventions. Among other things, it is about correcting the shape and position of the humerus, implanting tendons, repositioning muscles, loosening adhesions, removing diseased bursa and defective but obstructive tissue. A shoulder joint replacement is an option, for example, in the case of complaints caused by shoulder osteoarthritis that cannot be controlled otherwise.

Shoulder pain: when to see a doctor?

You should see a doctor if you suffer from injury or spontaneous shoulder pain. Examples:

  • The shoulder can hardly be moved
  • It hurts with certain movements (active or passive), appears powerless or unstable
  • If, for example, after falling on your outstretched arm, you have to hold it compulsively, possibly at an angle and supported by the other hand
  • The shoulder is swollen, the skin may feel very warm there, and may also be reddened
  • A higher end of the collarbone in the shoulder area can be pressed down like a piano key and pops up again when you let go
  • The shoulder hurts considerably when lying on the affected side, sleep is disturbed
  • If, for example, you are no longer able to clasp your hands over your back due to pain or a blockage (apron grip) or if you cannot place your forearms and hands over your head on your neck / upper back (with your elbows bent)
  • If you experience tingling or numbness or muscle weakness in the arm (signs of neurological failure)
  • For all acute pain in the shoulder, also in connection with other painful joints and fever
  • If pain in the chest or abdomen and alarm symptoms such as shortness of breath and poor circulation occur, call a doctor immediately or call the emergency services.

Self-help with shoulder problems

Shoulder problems are not “homemade”. However, incorrect posture, incorrect movement techniques, or risky maneuvers during sport can put strain on or endanger the shoulders. Here is some advice on how to prevent and manage shoulder problems.

Practical tips for healthy shoulders

You should always take the first symptoms, especially pain or stiffness, seriously:

  • Avoid one-sided postures and movements, as well as drafts and cold
  • Attention: Do not forget to stretch before and after when doing sports.
  • After prolonged exposure to exercise, do not start again until you have regained muscle strength.
  • At work, you should pay attention to an ergonomically favorable working posture. The work chair and armrests should be adjustable in height and have a neck support and a flexible backrest. You should be able to operate your computer with your arms flat. When working, keep your head in the central position, i.e. neither bent, overstretched nor turned to the side. This is important to avoid painful tension in the neck and shoulder area. Also means: checking your eyes from time to time, and correcting a possible visual defect.
  • Avoid overloading the shoulders through bad posture and also the hands, for example on the computer mouse. A few minutes of relaxation gymnastics during the break is always good.
  • Physically fewer active people should adapt and find more exercise.
  • Do not carry loads on one side; Avoid “heavyweights” if possible.
  • In the case of chronic wear problems, after a shoulder disease or an operation, keep the recommended exercises, even after improvement.
  • Hold back on alcohol and give up smoking.
  • A healthy diet protects the metabolism and thus also the joints.
  • Depending on what it is, cold or heat applications, such as ice packs or heat compresses, can have a soothing effect on pain.

And what about the favorite sport that can “finish off” a broken shoulder tendon? After a forced break, all is by no means lost. It all depends on the individual case. Many sufferers return to normal, even if sometimes only with half their strength at first. Even with an artificial joint, you can get active again. With the right strategy, it can be possible to remain pain-free for a long time.

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