The shoulder is the most flexible joint in the human body and the rotator cuff gives it a wide range of motion. Such motion increases the risk of issues in the shoulder. In fact, shoulder pain affects 18 to 26 percent of adults at any point in time, making it one of the most common physical complaints. Shoulder pain not only can impact your daily activities when moving and lifting your arms, but can cause major disruptions in sleep. Laying down can cause the rotator cuff to stretch and pull, leading to significantly worsened shoulder pain at night.
On the bright side, shoulder specialists can typically restore your range of motion, relieve your pain, and get you back to your regular daily activities. No matter the level of pain you are experiencing in your shoulder, it is important to know the cause and receive the proper diagnosis from medical professionals.
The two most common shoulder problems are rotator cuff tears and impingement syndrome, which have similar symptoms, but might require different treatment plans. In the case of acute and large rotator cuff tears, surgery may be required to repair the tear, which is why seeking medical expertise is advised.
Common Causes of Shoulder Pain
Rotator cuff tears and shoulder impingement syndrome both occur in the narrow space between the bones of the shoulder and affect the small rotator cuff muscles. Irritation in this area may lead to a pinching condition, called shoulder impingement syndrome, or damage to the tendons, known as a rotator cuff tear.
Since these injuries affect similar muscles, they have the potential to cause the other and to coexist. Aside from rotator cuff tear and shoulder impingement syndrome, shoulder pain causes include:
- Bone spurs in the shoulder area
- Arthritis in the shoulder joint
- Pinched nerves in the neck
- Frozen shoulder syndrome
- Cartilage tear
- Bursitis, the inflammation or irritation of a bursa sac
- Shoulder separation
- Broken shoulder bone
- Shoulder dislocation
- Overuse injury
Symptoms of Rotator Cuff Tear
The rotator cuff is made up of a group of four muscles and their tendons that stabilize the joint and give the shoulder its wide range of motion. Swelling, damage, or bone changes around the rotator cuff can cause shoulder pain. Symptoms may be present, but in many cases, the patient experiences no symptoms at all. When rotator cuff tear symptoms do occur, they include:
- Pain when lifting your arm above your head, moving your arm forward, or reaching behind your back
- Dull ache deep in the shoulder
- Arm weakness
- Interrupted sleep
Causes of Rotator Cuff Injuries
Rotator cuff injuries are most often caused by progressive wear and tear of the tendon tissues over time, which is why they are more common in people older than 60. Aside from age, other risk factors include occupations that require repetitive overhead arm motions, sports activities that include repetitive arm motions, such as tennis, baseball, softball and weightlifting, and family histories since certain families are more prone to rotator cuff tears. The main causes of rotator cuff tears include:
- Severe traumatic injuries
- Degenerative changes
- Repetitive traumas
Symptoms of Shoulder Impingement Syndrome
Shoulder impingement syndrome is thought to be the cause of 44 to 65 percent of all shoulder pain complaints. When the tendons and bursa are inflamed and swollen due to shoulder impingement syndrome, the patient will feel pinching that usually worsens when the arms are moved.
Symptoms of shoulder impingement syndrome include:
- Pain when your arms are extended above your head, lifting and lowering your arm from being raised, or reaching behind your back
- Pain that moves from the front of your shoulder to the side of your arm
- Pain and tenderness in the front of your shoulder
- Interrupted sleep
- Shoulder and/or arm stiffness and weaknes
Causes of Shoulder Impingement Syndrome
Shoulder impingement syndrome, also known as swimmers’ shoulder, is a condition that causes pain in the shoulder due to a tendon or bursa rubbing against the shoulder blade. This usually occurs because the sub acromial space gets smaller due to poor posture or a bone spur growing in the space, or the structures running through the space get larger because tendons and bursae become inflamed and swollen. The inflammation and swelling related to shoulder impingement syndrome are usually the result of a minor injury; repetitive motions, common in certain sports activities and occupations; or a rotator cuff injury, which is why the two usually coincide.
Most types of rotator cuff tears and impingement will respond well to non-surgical treatment, which is similar for both conditions. As mentioned earlier, surgery may be required to repair acute and large rotator cuff tears.
If left untreated, rotator cuff injuries may lead to permanent loss of motion or weakness of the shoulder joint. There are also a small percentage of impingement syndrome patients who may be candidates for surgery if their symptoms do not improve after six months of physical therapy.
Get Treatment from the Shoulder Experts
Seeking treatment from an orthopaedic specialist can restore your range of motion, relieve your pain, and get you back to your regular daily activities.
If you are experiencing shoulder pain, participating in sports that require repetitive movement of the arms, or are over the age of 60, we recommend that you prioritize your orthopaedic health and see one of Spectrum Orthopaedics’ talented shoulder specialists. Call to request an appointment today!