USF-COM Department of Family Medicine

Patient Education Information on...

Shoulder Pain

Jordan Messler, Class of 1999

Facts you should know
Common Causes

Bursitis

Rotator Cuff Injury

Arthritis

Trauma

Referred Pain

Frozen Shoulder

Questions your docotor may ask
Treatment
Prevention
Exercises
Websites for more information

Index of Patient Education Topics

FACTOIDS

Shoulder is a ball and socket joint, the most mobile joint in the body
Injury most commonly due to local inflammatory changes in the joint

Call your health care provider if…

Pain is felt as pressure or heaviness behind the breast bone then travels to the shoulder
Fever, swelling, redness, or instability exists in the joint
Pain due to an injury
Pain lasts for more than one week

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COMMON CAUSES

Bursitis

Local inflammation
Usually from humeral head compression
If prolonged impingement, cuff ruptures, eventual atrophy

Rotator cuff injury

Rotator cuff: muscles, ligaments, tendons that hold shoulder together
Common sports-related injury
Often due to trauma, or overuse (repetitive) injury
Classically with pain when extremity used in overhead position

Arthritis

Various causes
Infection, overuse, disease processes

Trauma

See your doctor

Referred Pain

May be cardiac, if pain also in chest go see your doctor
May be a sign of other disease processes, if concerned see your doctor

Frozen shoulder (adhesive capsulitis)

More commonly seen in women > 40 years old
Limited range of motion on one side

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QUESTIONS YOUR DOCTOR MAY ASK

Any pain in other joints?
Any associated weakness?
Does the pain radiate?
What other symptoms are present?
Do you have localized tenderness?

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TREATMENT

Home Care: RIMS

RIMS = Rest, Ice, Maintain Mobility, Strengthen
When you feel shoulder pain, apply ice for 30 minutes, then let the shoulder rewarm for 15 minutes. Continue for several hours. Be careful not to freeze skin; try placing a wet paper towel between skin and ice. Then rest the shoulder for two days. After the rest period, work the shoulder with some of the exercises listed below. Light weight lifting, full range of motion exercises are recommended

At the office:

NSAIDS, anti-inflammatory drugs, may be given
Corticosteroid injection may be given
Instructions for rehabilitation, possibly physical therapy
Surgery may be an option, as a last resort

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PREVENTION

May be secondary to poor technique if sports related, check your form
Decrease heavy lifting
Be sure to stretch, see exercises at end
Do not take aspirin or NSAIDS before exercise, they may mask the pain

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EXERCISES

1. Pendulums

Warm-up. While standing, lean over so that you are facing the floor. Let your sore arm dangle straight down. Draw circles in the air with your dangling arm. Start with small circles, then draw bigger ones, for about one minute.

2. Climb the Wall

Stand with your side next to a wall and have your fingertips touching the wall. Now slowly "walk" your fingers up the wall until you feel the shoulders muscle stretch, but no pain. Hold the position at the top for 10 seconds. Repeat three times.

3. Across the Chest

While standing or sitting, use the arm that is not sore to hold the bent elbow of the arm that is sore. Pull that arm gently across your chest until you feel a good stretch of the muscles in your shoulder. Repeat three times

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Websites for more information on Shoulder Pain

The Virtual Hospital: Iowa Health Book: Orthopaedics: Patient Guide to Shoulder Surgeries and Injuries (http://www.vh.org/Patients/IHB/Ortho/Shoulder/Shoulder.html)
The Physician and Sportsmedicine: Recovering From Shoulder Pain (http://www.physsportsmed.com/issues/feb_96/loosli.htm)
The Physician and Sportsmedicine: Rotator Cuff Injury (http://www.physsportsmed.com/issues/1997/06jun/wolin.htm)