![]() The thinking now is that the pain likely arises from either isolated degeneration (tendinosis) of the rotator cuff or tendinosis, along with a reactive inflammation of the overlying bursa (bursitis) and, on occasion, the underlying joint lining, the synovium (synovitis). Most now agree that a spur is not needed to develop these symptoms, nor is the primary problem pressure on the rotator cuff from above. Many believed the primary source of this issue was a spur on the undersurface of the overlying bone, the acromion, pressing down on the rotator cuff from above. The exact cause of these symptoms is somewhat controversial. It often follows overuse, as may occur with swimming, throwing, or doing overhead chores, such as painting a ceiling. This discomfort is worse with overhead activities and sleeping. Pain on the side of your shoulder or upper arm is frequent. The common symptoms seen with this problem are as described above. Some in medicine take offense to the term impingement syndrome since it implies an incorrect mechanism of causation. In fact, there is a slew of titles that describe this same process. It may also be called rotator cuff tendinitis or tendinosis or subacromial pain syndrome. This process is traditionally known as Impingement Syndrome. Tendinosis/Bursitis (Impingement Symptoms) If there is any alteration from this pattern, then pain, dysfunction, and injury can occur.Īlthough this is a very complex system, six diagnoses are responsible for most of the issues in these non-traumatic cases. All the parts of your shoulder have specifically defined roles and timing of action. Your shoulder is a complex system that must work like an orchestra. The pull of the tendons is what moves your arm. When the muscles shorten, the contraction force passes to the tendons. These muscles ultimately become tendons that end on your arm. Surrounding this capsule are muscles that originate from the shoulder blade or collarbone. The capsule, a tissue that contains ligaments within it, helps hold the ball to the cup. ![]() ![]() The humerus sits directly on the glenoid like a ball on a tee. The ball is at the top of your arm (humerus), and the socket (glenoid) is the most outer part of your shoulder blade. It is essential to understand how the shoulder works if you are to understand why pain develops. Frequently it feels better with rest and seems to come out of the blue. This pain is often described as “throbbing” but can be sharp. Often the symptoms in these cases are pain on the side of the shoulder, particularly with lifting your arm overhead and at night. So except in protracted cases or if treatment has failed, and we are considering surgery, knowing the exact diagnosis is not always critical. Fortunately, early on, the non-surgical treatment for most of these diagnoses is very similar. Much of the time, the causes are at least in part, degenerative (wear and tear over one’s life), or from the accumulation of effects of other health factors over time.Īlthough the causes may differ, many of the symptoms are alike or at least overlap – often making the specific diagnoses a little difficult to pin down – at least initially. But this, unfortunately, is not the case. One would think that without an injury, pain in the shoulder would be rare. In this post, I’d like to focus on shoulder pain arising in middle aged and older folks that occurs without trauma. Often the diagnoses can be grouped according to age and cause, resulting from trauma or arising without an injury. There are numerous causes of shoulder pain, but as with most things, there are a handful of sources that account for most of the diagnoses. Shoulder pain is common at all ages, in both active and sedentary people.
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