Pain over shoulder could arise from disease affecting shoulder joint or muscles, ligaments, fascia, nerves around shoulder joint.
1. Frozen shoulder or Periarthritis shoulder: As the name suggests, shoulder movement gets progressively restricted in multiple planes of movement. It occurs mainly due to injury or fall on the shoulder, causing swelling/inflammation of soft tissues or muscles around the shoulder joint. When swelling subsides gradually, fibrosis or thickening of soft tissue occurs in and around the shoulder joint, causing limitation of shoulder movements. Other causes of frozen shoulder are Diabetes, degenerative tears of rotator cuff muscles, post-breast or chest surgery, prolonged immobilization after fracture or trauma.
2. Rotator cuff tear or injury: Muscles around shoulder joint which helps in moving arm at shoulder joint are known as rotator cuff muscles. Any injury or overuse/repetitive stress of these muscles can produce pain in the shoulder, during specific activities. Injury can cause muscle swelling known as Tendonitis or collection of inflammatory fluid in the outer layer of muscles known as Tenosynovitis, partial tear & complete tear of rotator cuff muscles.
3. Other causes:
a. Acromioclavicular AC joint strain.
b. Bicipital tendonitis.
c. Shoulder osteoarthritis.
d. Bursitis.
4. Referred pain to shoulder:
- Cervical spine or neck pain.
- Neck muscle spasm.
- Brachial plexus injury.
- Scapular fracture.
- Tumours.
Diagnosis is by clinical examination. Xray to rule out bony abnormalities, fracture, deformities.
Ultrasound guided examination of shoulder joints helps in identifying most of the causes of shoulder pain. Also US guided pain relief procedures can be done for complete relief of pain, followed by shoulder rehabilitation plan.