Pain in the shoulder

What conditions is it associated with?

The shoulder joint is characterized by great flexibility, but at the same time by reduced stability. This is because its stability is ensured mainly not by the bones but by the ligaments and muscles, which allow a large range of movement in the upper limb.

When shoulder pain occurs, many daily activities such as driving, lifting objects, housework and even sleeping can become quite difficult and painful. The onset of pain in this particular joint and the loss of upper limb functionality can affect every aspect of patients' lives.

The pain can be felt either during shoulder movement or at rest, severely limiting the movement of the joint. Shoulder pain can be caused by one or more factors, such as an acute injury (dislocation), chronic strain or occur due to a degenerative condition.
Shoulder pain
Shoulder pain & tendon inflammation or rupture

One of the main causes of shoulder pain is inflammation of a tendon, or shoulder tendinitis. The shoulder joint ensures its stability through a set of muscles, called the rotator cuff of the shoulder, as well as through the biceps tendon.

Shoulder tendinitis is the most common cause of pain and stiffness in the joint, as the tendon becomes swollen and swollen, making every movement of the upper limb painful. Shoulder tendinitis occurs after repetitive strain and repeated minor injuries, but it can also occur after a single, acute injury.

If tendinitis is accompanied by subacromial friction syndrome, which occurs when the distance between the head of the humerus and the acromion is reduced, the inflammation is aggravated.

In addition to shoulder tendinitis, rupture of shoulder tendons, especially those belonging to the so-called rotator cuff tendon, can also cause severe pain in the joint even during sleep. The aetiology of the rupture may be either traumatic or degenerative.

At the same time, it may be partial or total and may involve one or more tendons of the rotator cuff, significantly limiting the movement of the hand. The rupture of a tendon in the shoulder occurs either as a result of long-term stress and repeated minor injuries or as a result of an acute injury.
Arthritis & manifestation of shoulder pain

Arthritis of the shoulder presents with the destruction of the articular surfaces of the area, causing increasing pain and limitation of shoulder mobility. The most common form of arthritis is osteoarthritis of the shoulder, but rheumatoid arthritis, which is an autoimmune disease, may also occur.

Shoulder osteoarthritis is caused in older people due to chronic degeneration and wear of the articular surfaces, and in younger people it occurs as a result of rupture of the tendons of the rotator cuff of the shoulder or an injury such as a fracture.

Shoulder pain & acute injury

An acute injury to the shoulder, such as a fracture or dislocation, causes severe pain and loss of upper extremity function. The most common mechanism for causing a fracture in the shoulder area is a fall, usually on the shoulder.

The most common fractures in the shoulder area are fractures of the humeral head and fractures of the clavicle. In the majority of cases, a fracture in the shoulder area is treated surgically, in order to immediately restore the functionality of the upper limb.

Similar to a fracture, a shoulder dislocation also has a traumatic etiology and is manifested as a result of the head of the humerus exiting the articular surface of the scapula. The most common forms of shoulder dislocation are acromioclavicular dislocation and humeral head dislocation, which occur after a fall on the shoulder.
The main priority in the case of shoulder dislocation is immediate reduction , and then an appropriate treatment plan should be chosen depending on whether the dislocation occurred for the first time or has recurred.

Other conditions causing shoulder pain

Conditions that can cause shoulder pain include calcific tendinitis of the shoulder, in which calcium deposits are found in the tendons of the rotator cuff. It is not clear exactly what causes these deposits to form, but the condition causes sudden, severe shoulder pain that often starts in the morning.

It is more common in middle-aged and older adults and in those with diabetes mellitus. The method of treatment is shaped by the severity of the symptoms.

Similarly, congenital bursitis of the shoulder or frozen shoulder can also be a cause of severe shoulder pain. This condition involves the occurrence of inflammation and the development of scar tissue and adhesions within the joint. Frozen shoulder can be either idiopathic or secondary, depending on whether the causes are clear or not.

In the idiopathic form of frozen shoulder, the exact cause cannot be determined, whereas in the secondary form of the condition, the cause is an injury to the shoulder, the presence of calcific tendinitis or subacromial friction syndrome, or immobilisation of the joint following shoulder surgery. Frozen shoulder is also common in people suffering from diabetes mellitus.

Dr. Panagiotis N. Kormas, Orthopaedic Surgeon, treats any condition that is responsible for the onset of shoulder pain. His goal is to relieve and eliminate the pain and regain the range of motion of the shoulder.

Each patient is treated on a fully individualized basis, while in case surgical treatment is indicated, the most modern minimally invasive techniques, such as shoulder arthroscopy, are applied, aiming at the treatment of pain and the rapid return of the patient to daily activities.