Pain in shoulder from stress

Elite Sports Medicine + Orthopedics: Orthopedics

Can Stress Cause Shoulder Pain?: Elite Sports Medicine + Orthopedics: Orthopedics

Tension and tightness in your shoulders is common symptom of anxiety and stress. It's part of your body's fight or flight stress response or its way of preparing to confront or survive a perceived physical threat. 

Fortunately, shoulder pain from stress responds well to yoga, stretching and other relaxation methods. 

Can Stress Cause Frozen Shoulder? 

Prolonged or increased levels of stress and anxiety can cause inflammation. This, in turn, may result in a stiff or "frozen" shoulder. Tension or stress can cause tightness when it gathers in our shoulders, and when this stress is sustained over a long period, it manifests as stiffness and pain. 

If the cause of your frozen shoulder is anxiety, effective treatments will involve utilizing proven tools and techniques to address the stress in your life.  

How to Ease Shoulder Pain Caused by Stress

Stretching is one of the most effective ways to relieve tightness or tension in your shoulders. A stretch called "thread the needle" can help ease tension in your shoulders, as well as in your neck and back.

To perform this pose:

  1. Get down on your hands and knees and place your palms flat on the floor. Your knees should be under your hips and your wrists under your shoulders. 
  2. With your palm facing upward, slide your right hand over to the left side of your body. It should be in contact with the floor when you do this, and your body will rotate with the movement. Gently slide your left hand forward and sink down until your right shoulder is touching the floor as you look to the left. 
  3. Support your weight using your left hand.
  4. Hold this position for 20 to 30 seconds before returning to the starting position.
  5. Repeat steps one through four on the left side. 
  6. Complete the exercise two to three times on each side.  

Tips for Managing Stress and Anxiety 

Developing stress management skills is one of the best things you can do to manage stress and anxiety — and, in some cases, alleviate shoulder pain. 

Try reducing stress through techniques such as:

  • Progressive muscle relaxation (PMR)
  • Meditation
  • Yoga
  • Breathing exercises
  • Physical activity and exercise

Find Relief for Shoulder Pain From Elite Sports Medicine + Orthopedics 

If your shoulder pain doesn't improve with self-care techniques such as stretching, follow up with a shoulder specialist as soon as possible. 

To schedule an appointment with one of our shoulder doctors at Elite Sports Medicine + Orthopedics, you can book online or call us at one of our Franklin or Nashville locations today. 


Nick Flory Nick is the Marketing Manager for Elite Sports Medicine + Orthopedics. He has been writing and reviewing medical content since 2018.

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How to Relieve Stress-induced Tension in the Neck or Shoulders

Learning how to achieve balance in our lives can be a tricky thing to master. When you’re expected to run the household, manage social activities, and carry a full load at work it can leave you with strong feelings of stress and anxiety. We live in a world where we’re expected to be “on” all the time but the added levels of stress, day after day, can have adverse effects on the body, ultimately leading to muscle tension in our neck and shoulders, among other things.

It’s natural to experience small moments of stress throughout your day, but the problems start to occur when you experience stress on a consistent basis. This might be chronic physical stress from poor posture, standing all day or performing repetitive motions on the job for long periods of time. Or, stress can stem from emotional difficulties like a relationship, financial, or health concerns. When stress is present on a regular basis it begins to show in the form of aches, pains, and irritated nerves. So how does this response to life’s daily challenges end up causing chronic tension in neck and shoulders?

Can stress cause neck pain and tension in the shoulders?

When we experience high levels of anxiety or stress, our body’s natural reaction is to tense up. When this happens consistently over a long period of time, it can lead to muscle tension. This can cause stiffness, tightness, aching, and pain in your neck and shoulders. Stress-related pain in this region is typically the result of emotional or mental anxiety. This can directly affect the muscles and nerves that run through your shoulders, neck, and spine.

Aside from psychological and emotional stress, there are other issues that lead to feeling sore shoulders. These can include overuse, poor posture, long periods of sitting, incorrect or poor sleeping positions, and cases of injury.

Why is my shoulder hurting for no reason?

Wondering to yourself, “why does my neck and shoulder hurt?” If you’re experiencing shoulder pain, but you can’t recall doing anything to trigger a nerve, and you aren’t feeling regular bouts of stress, there may be something internally irritating the shoulder that you’re not aware of. Common conditions include:

  • Rotator cuff tendonitis and bursitis – a swelling of the tissues and tendons that connect the muscles and bones in the shoulder
  • Rotator cuff tear – a tear in the tissues that connect the muscle to the bone and tendons around the shoulder joint
  • Arthritis – inflammation that causes chronic pain and tightness in the shoulder
  • Frozen shoulder – stiffness and chronic pain in the shoulder joint that typically worsens over time
  • Tendon tear – a tear in the tissues connecting the muscle to the bone around the shoulder joint

Stretches for neck and shoulder pain

Massage, yoga, and rotator cuff physical therapy are all great ways to improve proper body mechanics and relieve unwanted neck and shoulder tension. In addition, it is suggested to do a few stretches to see if you can get your shoulders and neck muscles to relax a bit. Here are a few simple, yet effective shoulder and neck stretches you can incorporate throughout your day.

  • Neck muscle exercises – Lower your chin to your chest for 15 seconds and gently let the weight of your head create a stretch through your upper back. Next, gently drop your head towards the right for 15 seconds, then to the left side for 15 seconds.
  • Shoulder to ear – Sit with a straight spine and gently tilt your head towards your left shoulder. You can go a little deeper into this stretch by gently pulling your head down slightly farther with your right hand, until you feel a gentle pull. Hold this position for 30 seconds and repeat on the other side.
  • Shoulder rolls – While sitting or standing, maintain good posture and roll your shoulders up, back, then down. Repeat this circular motion 10 times. Then do the opposite and roll your shoulders up, forward, then down. Repeat 10 times.
  • Shoulder raises – While standing or sitting, put your arms down by your side, straighten your back. Then slowly lift your shoulders up toward your ears. Hold for a few seconds, then slowly lower your shoulders back down. Repeat this action 5 times.
  • Cross arm stretch – Bring your right arm across your chest and bring your left hand up to support it by slightly pushing your right arm into your chest to get a deeper, yet gentle stretch. Hold for 30 seconds and repeat on the opposite side.
  • Forward bend – Stand up straight with your feet slightly wider than hip distance apart. Interlace your hands behind your back. You should feel a gentle pull in your chest. With a slight bend in the knees fold forward, hinging at the hips, and bring your arms up towards the ceiling. Make sure there is no discomfort or neck tension by allowing your head to hang down freely. Continue to hold this stretch for 60 seconds.
  • Meditation – Giving yourself a mental break can help relax your shoulder and neck muscles. Sit quietly with your eyes closed for 5-10 minutes. Try listening to a guided meditation or just simply allow your mind to be still. It may take some practice, but try working your way up to meditating for 10-20 minutes each day to help reduce chronic stress levels.
  • Move your body – Cardio and aerobic exercises can engage the muscles in your neck and shoulders which will increase the blood supply, stretch the muscles, and release toxins.

Healthy habits to help reduce stress

While we’ll never be able to eliminate stress from our lives completely, there are healthy habits, along with shoulder prehab exercises, that we can incorporate on a daily basis to help reduce levels of emotional stress.

  • Eat a healthy and well-balanced diet
  • Aim for 30 minutes of moderate exercise at least 5 days per week
  • Reduce caffeine, alcohol, and sugar intake
  • Get enough sleep each night
  • Avoid cigarettes and drugs
  • Think positively and surround yourself with positive people

Can physical therapy help with stress related neck pain and shoulder tension?

It is important to seek out a physical therapist to relieve your shoulder and neck tension or it could lead to bigger problems down the road. If left untreated, your persistent neck pain can lead to tension headaches and migraines.

There’s a multitude of evidence to support the effectiveness of physical therapy when it comes to reducing shoulder pain.  Physical therapy treatment options for shoulder pain include manual therapy, joint mobilization, therapeutic exercises, stretching, therapeutic ultrasound, laser therapy, and modalities such as electrical stimulation/TENS, heat or ice.

Physical therapy can be a safe and effective option for pain relief and managing the effects of severe stress. If your stress-induced shoulder and neck pain lasts for more than a few weeks, give us a call or request an appointment to discuss potential treatment options.

Article by: 
Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA

Ivy Rehab 

Holly is a practicing physical therapist, partner and Director of Clinical Services at Ivy Rehab Network with more than 40 years of experience in sports management with young athletes, and is board certified as a geriatric clinical specialist and certified exercise expert for aging adults. Deuer is certified as an aquatic and oncology rehabilitation specialist and serves as adjunct faculty at Central Michigan University and Grand Valley State University.

The medical information contained herein is provided as an information resource only, and does not substitute professional medical advice or consultation with healthcare professionals. This information is not intended to be patient education, does not create any patient-provider relationship, and should not be used as a substitute for professional diagnosis, treatment or medical advice. Please consult with your healthcare provider before making any healthcare decisions or for guidance about a specific medical condition. If you think you have a medical emergency, call your doctor or 911 immediately. IvyRehab Network, Inc. disclaims any and all responsibility, and shall have no liability, for any damages, loss, injury or liability whatsoever suffered as a result of your reliance on the information contained herein.

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Arthrosis, tendon rupture or inflammation?

  1. Pain in the shoulder after traumatic injuries:
    Contusion, sprain, injury of the acromioclavicular joint, dislocation, fracture
  2. Painful inflammation in the shoulder:
    Calcification of the forearm, bursitis, frozen shoulder (periarteritis glenohumeralis), rheumatism, arthritis
  3. Degenerative changes in the shoulder joint:
    Osteoarthritis, impingement syndrome of the shoulder, rupture of the biceps of the shoulder (biceps), stenosis of the cervical spine,
  4. Non-specific pain of the shoulder joint: Stress, poor posture, scapula, cervical spine

Shoulder pain is often caused by sudden injuries: A fall or blow can damage tendons and soft tissues. As a rule, not only one structure is injured. In most cases, patients are diagnosed with sprains or ruptures of the tendons, bursae, joint capsule, and muscles surrounding the shoulder joint. In addition, such shocks can lead to damage to bone structures: A fracture of the head of the humerus or a rupture of the acromioclavicular joint can have long-term consequences and cause arthrosis of the shoulder joint. To prevent contractures and soreness that occurs after injuries, conscientious targeted treatment is necessary.

The shoulder is a complex structure consisting of a ligamentous apparatus, tendons and a joint capsule. An injured shoulder can lead to overstretching and even rupture of these connective tissue structures. Each deformation of the shoulder joint can lead to serious consequences, the recovery period is delayed. Inflammation, subcutaneous hemorrhage, painful swelling are sources of stabbing pain in the shoulder and mobility restrictions. © Sebastian Kaulitzki / photo

In addition to traumatic deformities, pain in the shoulder joint appears due to metabolic disorders: Calcification of the forearm and deposits of calcium salts in the supraspinatus tendon or inflammation of the joint capsule (frozen shoulder syndrome) can lead to severe pain and discomfort in the shoulder even without external influence . Due to the frequent repetition of stressful situations, metabolic problems can not always be distinguished from an overload of the shoulder joint. Activities such as raising your arms above your head while working or playing sports can cause inflammation of the bursa (bursitis) of the shoulder or inflammation of the tendon sheath. As with other joints, wear and tear on the articular cartilage (arthrosis) can cause chronic pain and contracture of the shoulder joint. For each source of pain in the shoulder, there is a conservative treatment. In difficult cases, surgical treatment is recommended. Experienced orthopedic specialists of the Gelenk Klinik clinic in Germany will conduct a qualified examination, after which they will offer the patient treatment depending on the diagnosis.

Pain in the shoulder after injury: Damage to the shoulder joint

Most often, athletes complain about pain in the shoulder after injuries and heavy loads: Overstretching, deformities and falls cause traumatic pain in the shoulder.

Contusion of the shoulder joint (shoulder contusion)

Contusion in the shoulder area occurs after a fall, blows and collisions, resulting in compression of the soft tissues, muscles and tendons of the shoulder joint. The causes of a shoulder bruise are usually obvious, as the person consciously experienced the injury.

After a shoulder injury, the situation can become more complicated due to pre-existing tendon defects (eg rotator cuff and biceps tendon). A blow to the shoulder joint can lead to degenerative partial ruptures of previously damaged tendons.

A bruised shoulder joint causes severe pain almost immediately. This fact is the cause of repeated subcutaneous hemorrhage and the appearance of hematomas. An important aspect of the examination is the timely exclusion or confirmation of degenerative changes in the tendons and bones using imaging techniques such as x-rays, ultrasound and magnetic resonance imaging.

How is a shoulder injury treated?

  • Immobilizing bandage, fixing bandage
  • NSAIDs - non-steroidal anti-inflammatory drugs (eg Ibuprofen)
  • Physiotherapy and especially biological regulation therapy based on cellular technologies

Shoulder contusion symptoms disappear without consequences within a few days or a maximum of two weeks. If the complaints continue longer than usual, an additional examination for the presence of structural mutations in the shoulder area is necessary. Treatment of this injury is carried out with the help of immobilization, special fixing bandages and load relief.

Sprain of the shoulder joint - the cause of stabbing pain in the shoulder

Sprain in the shoulder is a phenomenon in which, for various reasons, the length of the ligaments becomes more than normal. Very often, this pathology appears as a result of excessive loads or after strength sports training, and sometimes it happens after a fall on an outstretched arm. Sprain of the shoulder joint is a rather painful injury that limits the mobility of the shoulder, after which it is necessary to keep the arm in a gentle position and not overload. In the most difficult cases, patients are also diagnosed with inflammation of the soft tissues of the shoulder joint, accompanied by subcutaneous hemorrhage (hematoma).

As a rule, the causes of a shoulder sprain are obvious, as patients experience the injury while fully conscious and immediately feel typical pain. In order to exclude structural damage to muscles, tendons and bone structures, in addition to the clinical examination, an imaging study using ultrasound, X-ray and MRI is recommended.

This disease is dangerous due to the rapid transition from a simple sprain to such serious pathologies of the shoulder, such as torn rotator cuff and tendon of the biceps muscle, as well as SLAP - shoulder joint syndrome (damage to the upper part of the articular lip of the scapula).

How is a shoulder sprain treated?

  • Immobilization with fixation bandages
  • Physical rest

The healing process of this disease is quite fast and simple: Pain in the shoulder disappears after 2-4 weeks. If the shoulder hurts for longer than the indicated period, the highly qualified orthopedists of the Gelenk Klinik in Freiburg will carry out additional diagnostics for possible structural deformities and prescribe the appropriate treatment.

Periosteal bruise ("Bone Bruise")

Bone Bruise is a compression or bruise of the periosteum of the shoulder joint with damage to the cartilage surface and accumulation of excess fluid (edema) in the underlying bony structures.

The pain in the shoulder caused by this disease lasts a very long time and passes rather slowly. Often, the Bone Bruise of the humerus appears in combination with a sprain of the shoulder joint or a bruise of the shoulder. Quite often, after traumatic situations, only superficial damage to soft tissues is assumed. The recovery process of patients suffering from this disease can last several months. The typical Bone Bruise fluid buildup can only be identified with an MRI diagnostic imaging study. .

How is a bruised bone treated?

  • Sparing position, joint immobilization
  • NSAIDs - non-steroidal pain relievers (Ibuprofen, Diclofenac)
  • For associated injuries: shoulder arthroscopy

Bone Bruise periosteal contusion treatment will be most effective if you are patient, stop playing sports for a while and limit physical activity. Surgical treatment after a bruised bone with the help of arthroscopy of the shoulder joint is necessary only with concomitant damage to the tendons or cartilage. Non-steroidal pain relievers can help relieve shoulder pain after a bone injury.

Dislocation of the shoulder: Stitches and immobility of the arm

X-ray of the shoulder joint after dislocation. In case of violation of congruence in the shoulder, the head of the humerus pops out of the joint capsule, after which it changes its position and is far from the acromion. The current situation leads to soft tissue damage: There is a rupture of the cartilaginous articular lip of the glenoid cavity of the shoulder. Numbness in the arm as well as shooting pains are the consequences. The dislocation should be corrected by the doctor as soon as possible. Then it is necessary to carry out a detailed diagnosis of the articular structures in order to exclude degenerative changes in the tendons, ligaments and cartilage tissue. © Gelenk Clinic

When the shoulder is dislocated, the head of the humerus slips out of the socket. As a rule, this is caused by external factors or accidents. This injury is often accompanied by damage to the articular lip (labrum) or capsular-ligamentous apparatus.

After a dislocation of the shoulder joint, the arm and shoulder lose their original function. Until the patient turns to a specialist who corrects the dislocation, the arm will remain motionless and hurt badly.

Sharp, intense pain typical of shoulder dislocation, as well as immobility in the arm, contribute to a quick diagnosis. More difficult is the diagnosis of concomitant injuries in the shoulder: For example, rupture of the articular lip and capsular-ligamentous apparatus.

The most accurate way to recognize a dislocation is with the help of X-ray examination. Ultrasound and CT help to establish accompanying traumatic disorders of the articular lip and other soft tissues.

How is a dislocated shoulder treated?

  • Dislocation reduction
  • Pain treatment
  • Physiotherapy
  • Surgical Reposition
  • Arthroscopy of the shoulder joint in case of detachment of the articular lip and capsular-ligamentous apparatus

Displacement of the head of the humerus is treated with a simple reduction of the dislocation. Doctors recommend doing this procedure immediately after the injury, namely after a few minutes. The situation becomes more complicated with additional soft tissue injuries: Treatment of such complications is possible only with shoulder arthroscopy.

Torn ligaments of the acromioclavicular joint of the shoulder: Stitches in the shoulder, night pain and numbness

When the acromioclavicular joint is ruptured, ligaments, bones, and articular surfaces are damaged. The degree of violations is measured depending on the amount of deformation of the bone structures. An outdated Tossi classification of the severity of an acromioclavicular joint injury underlies this image. Currently, injuries are classified according to the five-stage Rockwood scheme. Mobility disorders, stabbing pains of the shoulder joint, as well as restrictions in movement are the result of this disease. With this ailment, the patient cannot lie on his shoulder, as he feels severe pain. In medical terminology, several degrees of damage to the acromioclavicular joint are mentioned, for the treatment of which fixing bandages are most often used. In rare cases, clinics perform surgical reconstruction of the ligaments. © Alila Medical Media / fotolia

In medical terminology, the shoulder joint is also called the acromioclavicular joint, which connects the acromion to the sternal end of the clavicle (Clavicula). Acromioclavicular ligament tears are often caused by falls while skiing and cycling. As a rule, the victim falls from a height directly onto the shoulder so that most of the impact falls on the shoulder. A characteristic phenomenon of such a bruise is severe pain in the shoulder joint, limited mobility in the shoulder, as well as hematomas. During the examination, an experienced specialist immediately notices the protrusion of the clavicle of the shoulder joint and prescribes the appropriate treatment for the patient.

After a clear visual diagnosis, doctors perform an X-ray of the shoulder joint, which finally confirms the diagnosis. Sometimes x-rays are taken under stress. To obtain information about changes in the functionality of the shoulder joint, weights are fixed on the injured arm.

How is an acromioclavicular ligament tear treated?

  • Joint immobilization with fixation bandages
  • Surgical treatment (refixation of the acromioclavicular joint)
  • Tendon transplantation

In case of a torn ligament of the acromioclavicular joint, our medical center mainly offers conservative treatment with stabilizing bandages. Surgical treatment is carried out only in severe cases, for example, if the patient's arms and shoulders are subjected to heavy loads every day. With the help of special fixators and screws, the surgeon reconnects the separated fragments. Also, the performance of the shoulder helps to restore the methods of tendon transplantation.

Immobility of the joints in the shoulder and stabbing pains as a result of a fracture of the head of the humerus

Fracture of the head of the humerus is a fairly common occurrence. As a rule, this type of fracture occurs after falls, bumps or accidents. Especially often this injury occurs if a person falls on an outstretched arm, for example, while riding, skiing or after falling from a bicycle. . With the help of X-ray examination, the category of the fracture and the position of the separated fragments are established. Computed tomography (CT) provides a three-dimensional image of the shoulder joint and can recognize more severe fractures.

How is a humerus fracture treated?

  • Immobilization of the shoulder joint
  • Reconstruction and fixation for displaced fractures
  • In complex cases - shoulder replacement

If the bone fragments remain in a stable position and do not move relative to each other after an injury, surgical treatment is not necessary. In this case, a more effective and gentle way is to immobilize the shoulder joint with a shoulder bandage for several weeks. In case of a fracture of the humerus with displacement or damage to the articular surfaces, surgical treatment is required, during which the surgeon stabilizes the bone fragments with the help of special plates and screws. Thus, the separated fragments heal in the desired position, after which a smooth articular surface is formed. In addition to the complete restoration of the functions of the shoulder joint, every experienced doctor tries to do everything possible to avoid arthrosis of the shoulder joint (omarthrosis).

Injury or rupture of the joint capsule of the shoulder (HAGL injury or avulsion of the humeroglenoid ligaments from the humerus)

Due to the high mobility of the shoulder joint, the joint capsule is separated from a very important function. It not only participates in the metabolism of articular cartilage, but also contributes to the stabilization of the shoulder with the help of glenohumeral ligaments. Stretching or bruising can lead to injuries and even ruptures of these ligaments.

This pathology is often accompanied by other deformities in the shoulder: Sometimes patients have a dislocation of the shoulder joint.

Treatment of HAGL injuries in the shoulder

  • Immobilization and sparing position
  • Surgical treatment: Shoulder arthroscopy

First, the treatment of the rupture of the joint capsule, that is, the separation of the glenoid ligaments from the humerus, is carried out by immobilizing the shoulder joint. In addition, it is necessary to reduce physical activity and, if possible, keep the joint in a sparing position. If the injuries are more serious and conservative treatment does not bring the desired results, surgical treatment is required, namely arthroscopy of the shoulder joint.

Pain in the shoulder after physical exertion and inflammation

In physically active people, professional athletes, as well as workers, inflammatory processes of the shoulder joint due to overload and unilateral overexertion are observed more often than others. First of all, raising the arm above the head, as painters or fitters do, for example, causes severe pain due to excessive tension in the shoulder, soft tissues and tendons. Degenerative changes in older patients also cause inflammation of the soft tissues and tendons.

Calcification of the forearm: stabbing pain due to deposits of calcium salts in the supraspinatus tendon

X-ray of the shoulder joint: Visualization of calcium deposits in the supraspinatus tendon (in the red circle). In forearm calcification, these deposits, as well as the associated degenerative lesions and rotator cuff inflammation, result in pain and limited range of motion in the shoulder. © Gelenk Clinic

Metabolic disorders can cause rotator cuff calcification and forearm calcification (Tendinosis calcarea) to form calcium deposits in the supraspinatus tendon. In some cases, this fact may remain painless. However, most often the deposits of calcium salts cause shooting pains and impair the mobility of the shoulder joint. As a rule, calcium deposits that cause pain in the shoulder resolve within about three years. Problems when raising the arm above the head, as well as severe pain symptoms at night, limit the patient's movements. In this case, you should immediately consult a doctor and begin treatment of the disease.

Accurate diagnosis of calcification of the forearm is possible using X-ray. If the patient does not feel discomfort in the shoulder, surgery is not necessary. In this case, the disease can be treated conservatively.

  • Shock wave therapy
  • Biological regulation therapy based on cellular technologies
  • Rare: Surgery (arthroscopy) to remove calcium deposits
  • Successful treatment of the symptoms of calcification of the shoulder joint is often carried out conservatively. Extracorporeal shock wave therapy can accelerate the process of disintegration of the above named pathology. Calcification of the forearm is based on a metabolic disorder, which leads to necrosis of tenocytes (tendon cells) and their replacement with calcium deposits. Biological regulatory therapy based on cellular technologies contributes to the activation of metabolism and the rapid resorption of calc deposits. Surgical treatment of this disease is carried out only in cases where conservative treatment has failed.

    Bursitis (inflammation of the bursae): Swelling and stabbing pain in the shoulder

    Shoulder bursitis is a painful inflammation of the bursae. Mucous bags (lat. bursa = bag) are fluid-filled connective tissues that act as a shock absorber and serve as a lubricant between overstressed tendons and muscles. Synovial bags are located between the soft tissues of the body and bones, namely, at the site of movement of the tendon through a nearby muscle or bone. Thus, the friction process is eliminated or softened. Most often, bursitis affects the mucous bag of the shoulder under the acromion, since this process of the clavicle is most susceptible to stress. Rheumatism and other inflammatory processes can also cause bursa deformity. Sometimes bursitis leads to swelling and overheating of the shoulder joint. Since the synovial bags are located deep in the shoulder joint, there are no external symptoms of the disease at all. With bursitis, the patient has noticeable impaired mobility of the shoulder, especially the process of raising the arm above the head.

    Treatment of shoulder bursitis

    • Cryotherapy
    • Biological regulatory treatment based on cellular technologies
    • NSAIDs - non-steroidal anti-inflammatory drugs
    • Shoulder Arthroscopy

    Acute and painful inflammation of the shoulder is relieved by cooling compresses. At the same time, the patient is advised to take into account the doctor's instructions and reduce the load on the shoulder. Treatment of inflammatory processes in the mucous bag of the shoulder joint can be carried out using non-steroidal anti-inflammatory drugs. In addition, there are pills that help get rid of pain. Surgical treatment, namely arthroscopy of the inflamed synovial bursa, is performed in rare cases. As a rule, the tissues of the mucous bag of the shoulder joint are restored within a short time again.

    Frozen Shoulder Syndrome (Adhesive Capsulitis)

    Adhesive Capsulitis (Frozen Shoulder Syndrome) causes limited mobility of the shoulder joint by shortening the joint capsule. At first, the clinical picture of the disease progresses rather slowly. Over the course of several weeks or months, it becomes increasingly difficult for the patient to move his arm. After that, sharp stabbing pains begin at night, which interfere with sleep. Habitual sports and daily movements are getting harder and harder. The cause of this pathology can be both bruises and shoulder blows, after which the patient is strongly recommended to give up training for a long time and keep the shoulder in a sparing position. Metabolic disorders, such as diabetes, also contribute to the appearance of frozen shoulder syndrome. It is worth noting that this disease sometimes goes away on its own. Despite this, with the duration of pain and limited mobility for more than three years, you need to see a doctor and urgently start treatment for the disease.

    Frozen shoulder treatment

    • Physiotherapy
    • Medical pain relief treatment
    • Biological regulatory treatment based on cellular technologies
    • Pain relief tablets
    • Surgical mobilization of the shoulder joint under anesthesia
    • Surgical splitting of the joint capsule of the shoulder

    In most cases, this syndrome is treated with physiotherapy (eg cold compresses). Particularly successful is biological regulatory treatment based on cellular technologies. Reactivation of the metabolism of the shoulder joint significantly reduces the duration of the feeling of numbness in the shoulder.

    Medication also helps to overcome the disease. The so-called gradual cortisone pain relief shortens the duration of pain and numbness in the shoulder.

    Non-steroidal anti-inflammatory drugs alleviate the symptoms of the disease, but do not shorten the duration of the syndrome. If conservative treatment fails, the orthopedic specialists at the Gelenk Klinik Freiburg perform surgical mobilization of the shoulder joint under anesthesia. At the same time, the surgeon can perform arthroscopic treatment of the shoulder.

    Rheumatoid arthritis: painful inflammation of the shoulder joint and disorder of the tendon structure

    Shoulder rheumatism begins with dull and dull pain in the shoulder. At a progressive stage, rheumatoid arthritis destroys the cartilaginous surface of the shoulder joint and leads to arthrosis. This disease also affects the rotator cuff of the shoulder joint. Rheumatism has many causes that have not yet been fully explored to date.

    Treatment of rheumatism or arthritis of the shoulder joint

    • Antirheumatic drugs
    • Radiosynovectomy (anti-inflammatory x-ray irradiation)
    • Arthroscopic removal of the inflamed synovium of the joint
    • Shoulder arthroplasty

    In case of rheumatic inflammation of the shoulder joint, regular monitoring of pathology and pain is in the foreground. As a rule, various antirheumatic drugs help control the disease. Due to inflammation and destruction of the articular structures, surgical treatment may also be required. In our medical center, the patient is offered several techniques, for example, arthroscopic removal of inflamed synovial membranes and mucous bags or shoulder joint arthroplasty.

    Wear and tear of the shoulder joint: Osteoarthritis and degenerative tendon ruptures

    In addition to excessive physical activity, the age factor is definitely the cause of pain in the shoulder: The older the patient, the more often he has wear of the bone structures, cartilage and tendons of the rotator cuff. At the same time, the wear of the shoulder joint, which is complex in structure, can be treated with the help of physiotherapy procedures. Since many muscles and tendons can be involved in one movement, the disease can also spread to neighboring structures of the shoulder, which can also lose their original functions. In this case, physical therapy can help. Therefore, conservative treatment of degenerative changes in the shoulder is the most successful.

    Arthrosis of the shoulder joint (omarthrosis): Wear and tear of the joints in the shoulder

    Osteoarthritis of the shoulder joint is characterized by gradual wear of the articular cartilage. The bones of the shoulder no longer slide on the watery cartilage surface, but collide with each other. Bone spurs (osteophytes) form on the surfaces of the joints, which make them rough and accelerate the process of wear of the articular cartilage. © Viewmedica

    Arthrosis of the shoulder joint (omarthrosis) is a condition of the shoulder after wear and tear of cartilage surfaces. Doctors note several causes of shoulder omarthrosis: Excessive exercise, violation of the biomechanics of the shoulder joint due to violations of the structure of the tendons, genetic weakness of the articular cartilage, inflammation, damage to the articular surface due to fractures, and much more. At first, cartilage deformities appear due to dull and deep pain. Arthrosis calls for very discomfort in the shoulder, especially in the morning after waking up and starting to walk. As the disease progresses, the patient is unable to move the arm as before.

    As in cases of damage to other joints, an x-ray examination can confirm the diagnosis of "Osteoarthritis of the shoulder joint": The degree of narrowing of the joint space determines the stage of wear of the articular surface.

    Treatment of arthrosis of the shoulder joint

    • NSAIDs - non-steroidal anti-inflammatory drugs
    • Physiotherapy (shoulder centering)
    • Biological regulatory treatment based on cellular technologies
    • Autologous cartilage cell transplantation
    • Nutrition counseling
    • Endoprosthetics (arthroplasty)

    Shoulder osteoarthritis is treated with several techniques, which are also used to stabilize other joints. In other words, the treatment of this disease involves not only drug relief of pain and improvement of the functionality of the joint with physiotherapy, but also surgical joint-preserving treatment. The latter includes transplantation of cartilage cells using both autologous and laboratory-derived cartilage cells. In case of complete wear of the shoulder joint, the only way out is arthroplasty. This surgical method relieves the patient of pain and restores mobility in the shoulder. It should be noted that shoulder arthroplasty is performed much less frequently than, for example, lower limb arthroplasty).

    Impingement syndrome: Narrowing, degeneration and rupture of the rotator cuff

    A rotator cuff tear is an injury to the tendon of the supraspinatus muscle, which runs under the acromion and wraps around the head of the humerus from above. As a rule, only part of the wide tendon is damaged, which, despite severe pain, partially preserves the function of the rotator cuff. © Viewmedica

    The definition "impinge" (English: to impinge = pinch or hit) describes the unintentional collision of two bone structures. During impingement syndrome of the shoulder joint, the head of the humerus collides with the bone structures of the acromial process of the clavicle. In this case, there is constant compression of the tendons passing through this subacromial cavity (the area under the acromion). So, this pathology affects the tendon of the supraspinatus muscle, covering the head of the humerus from above and the long tendon of the biceps. This fact leads to degenerative wear of the rotator cuff tendons. Even after the most minor injury, such as a fall on the elbow, the weakened tendon can rupture completely and lose its original function.

    In older patients, supraspinatus rupture is caused by degenerative wear of the shoulder joint, and in younger patients by traumatic effects.

    If the supraspinatus tendon stops working partially or completely, the head of the humerus advances towards the acromion. X-ray examination determines its exact position. The condition of the rotator cuff is shown by ultrasound.

    Shoulder joint impingement syndrome is characterized by Painful Arc - an angle from 60 to 120 ° in which the arm is abducted in relation to the longitudinal axis of the body. © Gelenk Clinic

    Conservative treatment of impingement syndrome of the shoulder joint

    • Pause between loads, immobilization of the shoulder joint
    • Changing the manner of acting: Avoid situations that require raising your arm above your head
    • NSAIDs - non-steroidal anti-inflammatory drugs
    • Physiotherapy and exercise therapy
    • Physiotherapy (cooling, ultrasound)
    • Injection treatment with cortisone and local anesthetics (local anesthesia)
    • X-ray irradiation and treatment of chronic inflammation of the supraspinatus brachii
    • Shock wave therapy, especially for calcification of the forearm

    Surgical treatment of impingement syndrome of the shoulder joint

    • Acromioplasty: Expansion of the subacromial tunnel by removing bone
    • Interrupted sutures on the rotator cuff
    • InSpace™ Biodegradable Implant for Supraspinatus Tendon Restoration by Centering the Shoulder Joint.

    In the advanced stage of rotator cuff degeneration, arthroscopic treatment no longer helps. In this case, it is possible to center the head of the humerus by implanting a biodegradable balloon for a period of one to two years. An InSpace™ implant is placed under the acromion during arthroscopic shoulder surgery. During the procedure, the balloon implant is filled with saline solution to keep it flexible and stable.

    The biodegradable InSpace™ implant can replace a damaged rotator cuff and act as a retainer to help center the humeral head. After that, the pain in the shoulder goes away, and other muscles of the rotator cuff can take over some of the functions of the supraspinatus tendon. © Orthospace ltd, Israel, Exactech, Germany

    Destruction, painful inflammation and rupture of the biceps tendon

    The biceps is a muscle located on the front side of the shoulder, which is responsible for the flexion of the arm. The biceps muscle of the shoulder joint is formed by a long and a short head. The first begins with the articular tubercle (protrusion) on the shoulder blade. The short head passes through the inner region of the humerus and, together with the long head, creates a thick biceps tendon that enters the radius of the forearm. The proximal part of the biceps brachii connects to the upper edge of the glenoid cavity. This part - the tendon of the long head of the biceps of the shoulder - is subject to traumatic injuries and inflammatory processes. Another, from a medical point of view, almost imperceptible part of the bicep fuses with the coracoid of the scapula (the coracoid process of the scapula).

    Excessive loads and constant tension of the shoulder joint cause painful inflammation, destruction of shoulder structures and even rupture of the biceps of the shoulder. . Inflammation of the tendon of the long head of the biceps brachii muscle becomes more likely with impingement syndrome of the shoulder joint, that is, with narrowing of the space under the acromial process of the clavicle.

    Pain in the bicep becomes especially noticeable when extending the arm up: Activities that require raising the arm above the head, such as assembly work, ceiling painting, and freestyle swimming, accelerate the degeneration process.

    Thus, other diseases of the shoulder joint can spread to the biceps brachii.

    A fall on the elbow injures the biceps under the acromion. With a partial or complete rupture of the long biceps tendon, patients feel severe pain and cannot move their arm as before. A total rupture leads to subsidence of the muscle belly - a protrusion between the place of attachment of the tendon and the elbow bend. Pre-existing injuries increase the likelihood of a ruptured biceps brachii.

    Multifactorial causes tears or injuries in the shoulder to occur at any age. In younger patients, rupture of the tendon of the biceps muscle of the shoulder occurs after traumatic injuries and overload. In elderly patients, this ailment appears against the background of degenerative defects that previously existed.

    Conservative and surgical treatment of degenerative changes and ruptures of the tendon of the biceps brachii

    • Analgesic and anti-inflammatory drugs
    • Physiotherapy (cold treatment))
    • Biological regulatory treatment based on cellular technologies
    • Therapeutic gymnastics
    • Reduced stress and gentle position of the shoulder joint
    • Biceps tenotomy (truncation of the tendon of the long head of the biceps brachii)
    • Surgical refixation of the tendon of the long head of the biceps

    Inflammation or partial tearing of the biceps brachii causes prolonged complaints. The latter require some time to decide on the method of therapy. In this case, doctors need to decide whether conservative treatment is appropriate and whether it can restore the previous functions of the muscle. Another option may be surgical treatment with fixation of the biceps to restore its performance. Pain, as well as loss of strength, indicate the need for surgery. Since after surgery the patient will need a long rehabilitation, doctors need to weigh the pros and cons well.

    When the biceps brachii is torn, doctors resort to a technique called biceps tenotomy. If necessary, tenodesis of the biceps brachii is performed.

    Non-specific shoulder pain: Stressful situations, posture, scapula, cervical spine

    Neuralgic pain often radiates from the cervical spine to the shoulder. Pain in the neck and shoulder may appear due to stressful circumstances or after dysfunction of the cervical spine. Diseases such as herniated and degenerated intervertebral discs, as well as stenosis (narrowing) of the spinal canal contribute to the narrowing of the spinal nerves. © blackday / fotolia

    The shoulder joint is directly involved in the work of the muscles of the trunk, back of the chest, as well as the occipital muscles. Therefore, injuries in this area negatively affect the health of the shoulder. Very often, the symptoms that we perceive as pain in the shoulder do not appear in the region of the shoulder itself, but in other structures of the shoulder joint. These traumatic injuries cause narrowing and tension of muscle structures, as well as pinching of nerves. That is why this pain radiates to the shoulder..

    Tension and stiffness of the muscles

    Most often, pain in the shoulder joint is due to tension and stiffness of the muscles of the shoulder and neck. In medicine, there are several causes of these injuries. Stress, for example, leads to muscle stiffness. Due to the lack of mobility and sedentary work, the muscles in certain areas of the shoulder joint are shortened: The back is rounded, the shoulder blade is extended, and the trunk bends forward. In addition, the sternal muscles shorten and the space under the acromion narrows, which leads to degeneration and inflammation of the tendons of the shoulder joint.

    How is shoulder pain due to stiffness and muscle contraction treated?

    Physiotherapy and special exercises aimed at restoring the neck muscles, as well as the muscles of the shoulder, back and chest, help to get rid of pain caused by incorrect posture and lack of movement.

    Shoulder pain: Herniated disc and spinal stenosis

    Shoulder pain is not always due to dysfunction of the shoulder joint: Nerve narrowing after a herniated disc or spinal stenosis in the cervical spine also affects the condition of the shoulder and causes constriction and loss of strength in the muscles. Sometimes it is quite difficult to determine the cause of shoulder pain. Therefore, specialized clinics recommend neurosurgical differential diagnosis, during which a clinical imaging examination of the cervical spine is performed. Magnetic resonance imaging (MRI) helps diagnose a herniated disc.

    How is a pinched nerve in the cervical spine treated?

    • Physiotherapy and massage
    • Nucleotomy (hernia removal)
    • Surgical treatment (arthrodesis of the cervical spine)
    • Endoprosthetics

    A herniated disc of the cervical spine, that is, a protrusion of a shock-absorbing intervertebral disc from the spinal canal or spinal cord stenosis, is treated with physiotherapy. If this treatment is unsuccessful, doctors perform surgical treatment, namely the surgical release of the nerves. During this operation, an experienced surgeon removes a hernia from the spinal canal. This technique helps to remove the narrowing at the exit point of the nerve from the spinal cord. In the last stages of the disease, only arthroplasty can help.

    Painful disorders of scapular mobility (scapular dyskinesia, "thrower's shoulder")

    Pain in the shoulder joint is sometimes due to scapular mobility disorders, namely scapular dyskinesia. The lack of intensity of the movements of the scapula has many reasons. So, this disease can appear due to impingement syndrome, rotator cuff injuries, or due to instability of the shoulder joint. In addition, there are common factors that lead to scapular dyskinesia: If the patient's torso is strongly tilted forward, the scapula stretches upward. The contraction of the sternum muscles (deltoid muscle) contributes to the chronicity of this fact. For this reason, the differential diagnosis of scapular dyskinesia is not an easy procedure. It is important to know that the shoulder blade plays a critical role in the transfer of energy between the arm and the torso.

    How is scapular dyskinesia treated?

    At the first suspicion of scapular dyskinesia, a differential examination of shoulder pain should be performed. In this case, it is necessary to examine everything: Muscles, tendons, neuralgia, bone structures, as well as the interaction of the muscles of the trunk, shoulder joint and neck. In most cases, physiotherapeutic treatment or biological regulation treatment based on cellular technologies is carried out.

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    Deceptive symptoms

    The body reacts to most disturbances and failures with pain and other unpleasant sensations. The first reaction to them is unambiguous - the sore spot indicates the disease itself.

    Commentary for Domashny Ochag magazine was given by Evgeny Avetisov, general practitioner, medical director of the European Medical Center.

    "The right shoulder hurt, which means it blew out or turned awkwardly." Do you know that a diseased liver can give an alarm in this way? And pain in the liver, quite possibly, causes renal colic. By the way, liver diseases are often manifested by the so-called chronic fatigue syndrome, and the liver itself, as an organ devoid of nerve endings, suffers “silently”.

    Or, for example, cardiac arrhythmia, as well as depression, indigestion, insomnia, excessive sweating, hair loss, impaired nail growth, skin changes can be caused by a violation of the thyroid gland. With this disease, in general, a very difficult situation, because the thyroid gland affects all metabolic processes, it can affect any organ. This is the reason for such a variety of manifestations in the form of a wide variety of symptoms that can mask or mimic many diseases.

    We asked the expert about some symptoms that can mislead us (but not attentive doctors!)

    Symptom: Chest pain

    At first glance: heart problems.

    In fact: very often heart problems cause pain not in the chest at all, but, for example, in the left shoulder, in the left elbow, in the left hand, on the left side of the neck, etc. And real chest pains can be the result of intercostal neuralgia. Or lung disease - if a sharp pain in the chest is accompanied by shortness of breath, this may be a sign of pneumothorax, when a sudden rupture of the lung occurs for no apparent reason. A person can live without being aware of the peculiarities of the structure of his lungs, and suddenly - after active sports or a strong attack of coughing - there is a sharp pain in the chest, coughing, shortness of breath - a feeling of lack of air. One lung stops functioning.

    Acute chest pain can be caused by Tietze's syndrome, an inflammation of the junction of the ribs with the sternum. Such an indisposition is quite common, it is not dangerous to health, although it is accompanied by painful sensations, in this case, the diagnosis is usually made easily.

    Pain in the middle of the sternum sometimes indicates problems with the esophagus - its inflammation, damage to a sharp bone, for example, fish, as well as a hernia of the esophageal opening of the diaphragm.

    Symptom: Lower back pain

    The most obvious: sciatica ("lumbago").

    In fact: may be a sign of kidney disease, such as pyelonephritis, a gynecological disease in women, most often such pain is caused by problems with the spine or muscle spasms. There is even such a special diagnosis - pain in the lower back.

    Symptom: Upper abdominal pain

    The most obvious: diseases of the stomach (gastritis), especially if the pain is associated with eating, the symptoms of a duodenal ulcer appear in a similar way.

    In fact: such pain can be a sign of a heart attack, if the process develops in certain parts of the heart, the pain is “redirected” to the stomach area. It can also be a sign of gallbladder disease, rarely inflammation of the pancreas (pancreatitis) or intestines. And yet - a manifestation of radiculitis or lower lobe pneumonia. To make a diagnosis, the doctor needs to take into account other additional manifestations.

    Symptom: Shoulder pain

    The most obvious: a disease of the shoulder itself - damage to the joint, ligaments due to overload or injury.

    Actually: shoulder pain is caused by damage to the cervical spine. It can also be a sign of heart or lung disease. By the way, pain in the cervical spine sometimes mimics a heart attack - they can cause severe pain in the heart.

    Changes in the cervical region helps to accurately diagnose MRI.

    If we talk about the right shoulder, it is rare, but it happens - when the pain indicates a problem with the gallbladder, which radiates to the right shoulder joint. And the pain in the left shoulder is a possible irradiation of the pain of the stomach or lungs.

    Symptom: Headache

    The most obvious: increased blood pressure, vascular problems, migraine.

    In fact: in 90% of cases, causal relationships are also violated here. Pressure rises with any discomfort - a headache, especially severe, especially if a person is alarmed; it rises because the head hurts, and not vice versa! You need to know that a headache due to high blood pressure occurs only when the numbers are very high. With a pressure of 140/90, there may not be a headache.

    Much more often headache occurs due to problems with the upper spine, neuralgia of the occipital nerve is associated with its exit to the first vertebrae. Very often it gives headaches, especially in the back of the head, temples.

    Inflammation of the sinuses - sinusitis, frontal sinusitis - are also likely culprits of headache, which is localized in the forehead, eye sockets and cheekbones. Headache can be caused by a viral infectious disease, for example, herpes lesions of the nerves: occipital, trigeminal.

    Vision problems also provoke a headache - people with myopia and astigmatism, especially pronounced, often experience severe pain in the forehead and temples when they are forced to read a lot, work at a computer, due to visual overload.

    Headache may be associated with anemia (lack of hemoglobin), but this is rare.

    As for the increase in intracranial pressure, this diagnosis is made quite often in our country: in order to make it, in fact, you need to insert a probe or do a spinal puncture.

    Symptom: Joint pain

    The most obvious: inflammation of the joints (arthrosis).

    In fact: on the one hand, indeed, pain is often caused by degeneration of the articular cartilage. As well as an inflammatory process that develops right in the joint.

    But it can also be a sign of reactive changes when the infection develops elsewhere, such as in the urogenital organs or in the gastrointestinal tract. Due to the work of the immune system, this inflammation does not manifest itself in the intestines (there is no diarrhea or disorders), and the pain is “transferred” to the joints. In this case, it is simply pointless to treat only the joints - this will only help relieve symptoms for a while, and then the process resumes.

    Joint pain is sometimes caused by chlamydial infection, salmonella, shigella - different pathogens that "dig in" in different places, without even causing the classic symptoms of their disease - shigellosis or salmonellosis.

    Psychotherapist's commentary

    Natalia Rivkina, Head of the Psychotherapy Clinic of the European Medical Center:

    Heart stone

    Feelings of physical discomfort, which, as it seems to a person, are caused by a somatic disease, in fact, can be caused by neurotic conditions or mental stress. The likely cause is depression. One of the symptoms of moderate to severe depression is retrosternal pain, a feeling of heaviness in the region of the heart.

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