Shoulder Pain

The shoulder provides the greatest range of motion in the body, and consists of 3 bones forming a ball and socket joint held in a stable position by tendons, ligaments, and muscles. The shoulder allows lifting and rotation of the arms in multiple directions.

Shoulder injuries frequently occur during sports, especially those that require repetitive and excessive overhead motion such as tennis, badminton, swimming and weightlifting. Injuries may also occur during daily activities such as hanging the laundry. Shoulder problems may be minor or serious, depending on the severity of the injury and how long it has been left untreated. In this section, we look at the common shoulder injuries, key signs and symptoms, as well as the treatment options available.

Fracture

Trauma may fracture the bones that make up the shoulder. Symptoms of a shoulder fracture include pain, tenderness, swelling, deformity or discoloration at the affected area, as well as limitation in movement. For minor cases, treatment usually requires immobilisation with a sling support until the bone fragments heal. This normally takes about 6 to 8 weeks. Should the impact result in the bone breaking and displacing from its original position, surgical intervention may be recommended.

Dislocation

Shoulder dislocation occurs when the upper arm bone pops out of the socket that is part of the shoulder blade, often caused by a fall or during contact sports. Common signs and symptoms include intense pain, a visibly out-of-place shoulder, swelling or bruising, numbing sensation along the neck area, and inability to move the shoulder. If treated immediately, shoulder function can be fully regained. However, in some cases, the shoulder joint becomes unstable after a dislocation event. As a result, the shoulder will become more prone to future dislocations. If you suspect that you have a dislocated shoulder, seek medical help promptly to avoid any long-term complications

The rotator cuff aids in shoulder rotation and movement, and consists of tendons and muscles that work together to hold one’s arm in place. A rotator cuff tear occurs when there is partial swelling or tears in the tendon, usually due to trauma or abrupt force. Athletes in contact sports such as tennis, football, or even swimming are prone to this condition. It may also be caused by accidental falls or lifting heavy weights. Tears of the rotator cuff are often painful and can lead to potential disability depending on the severity of the injury.

Signs & Symptoms

The onset of pain in a rotator cuff tear can be sudden or gradual, with or without the accompaniment of weakness at the shoulder area. Common symptoms include:

• Pain
• Limitation in movement
• Weakness or tenderness
• Snapping sound when moving the shoulder
• Inability to sleep on the side

Diagnosis

Your doctor may check your medical history and perform a physical examination. Further diagnostic tests may be prescribed to assess the severity of your injury, such as:

• X-ray
• Magnetic resonance imaging (MRI)

Treatment

Depending on the severity of the injury and usually if diagnostic tests show that shoulder mechanics have been affected, surgical intervention may be required. Without prompt treatment, rotator cuff tears may result in irreversible damage.

Arthroscopic shoulder surgery, a minor surgery, can be used to treat a rotator cuff tear. A scope at the end of a long, thin tube is inserted into the shoulder area to evaluate the entire shoulder joint. The surgeon may then make small incisions to fix the injury. Talk to your doctor to understand your condition and the treatment options available

Frozen shoulder develops gradually and usually stems from an injury. This condition causes inflammation to the joint area, leading to formation of scar tissue and causing the tissue around the shoulder joint to stiffen. This results in pain and difficulty in movement. Certain medical conditions such as diabetes may also contribute to the development of the condition.

Signs & Symptoms

Common symptoms of frozen shoulder include:

• Pain
• Stiffness
• Limitation in movement

Diagnosis

Your doctor may check your medical history and perform a physical examination. Further diagnostic tests may be prescribed to assess the severity of your injury:

• X-ray
• Magnetic resonance imaging (MRI)

Treatment

Depending on the severity of the condition, your doctor may prescribe medication to help alleviate the pain. Physiotherapy may also be recommended to help to increase the shoulder’s range of motion over time. In more severe cases, surgical intervention in the form of shoulder arthroscopy may be required.

Shoulder arthroscopy, or arthroscopic shoulder surgery, is a minor surgery where a scope at the end of a long, thin tube is inserted into the shoulder area to evaluate the entire shoulder joint. The surgeon may then make small incisions to treat the condition. Talk to your doctor to understand your condition and the treatment options available.

Tennis elbow occurs when repetitive motion causes strain to the muscles and tendons attached to the elbow. This leads to tiny tears and inflammation near the bony lump (lateral epicondyle) on the outer elbow. Any sports or recreational activity that involves excessive turning or lifting of the muscles in the forearm near the elbow may lead to this condition.

If your condition is caused by repeated strain on your elbow joint, taking a break from the activity or changing your technique may help to alleviate the problem. Avoiding stress on the muscles and tendons surrounding your elbow area may also help prevent the condition from worsening. Talk to your orthopaedic specialist to understand your condition and the treatment options available.

Signs & Symptoms

Common signs and symptoms for tennis elbow include:

• Pain on the outer part of the elbow
• Tenderness and swelling
• Pain when bending or lifting the arm, writing or gripping objects
• Pain accompanied with stiffness upon full extension of the arm

If you experience any of the above symptoms, consult an orthopaedic specialist for prompt diagnosis and treatment

Diagnosis

Your doctor may check your medical history and perform a physical examination. Further diagnostic tests such as an ultrasound or a magnetic resonance imaging (MRI) scan may be prescribed.

Treatment

Depending on the severity of the condition, your doctor may prescribe medication to help alleviate the pain. Physiotherapy may also help to relieve the pain and stiffness, while assisting to increase the range of motion over time. Surgery may be required should there be damage to part of the tendon.  Talk to your doctor to understand the treatment option best suited for you.