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The causes of the painful shoulder are multiple.
We can systematize them in two ways: structural or functional and intra-articular or extra-articular.
Starting at the end, we can locate pain around the shoulder from problems that occur within the joint between the humerus and shoulder blades, such as cartilage lesions surrounding the humeral head and the glenoid cavity in the shoulder blade; capsule injuries and ligaments surrounding it; lesions of the long portion of the biceps (LBP) that has an initially intraarticular course; Best Orthopaedic Surgeon in Dwarka, Delhi or inflammation/rupture of the set of tendons that cause the shoulder to move (rotator cuff — supraspinatus, infraspinatus, subscapularis).
The most common pathologies, extra-articular to the glenohumeral joint, are inflammation of the subacromial pouch, which covers the rotator cuff (bursitis); the narrowing of the space where these tendons move (conflict syndrome); the inflammation or arthrosis of the joint that exists between the collarbone and the tip of the shoulder blade (acromion).
There are also diseases whose pain is referred to as the shoulder but which do not originate in the shoulder. This may be the case with diseases of the cervical spine, inflammation of the set of nerves that emerge from the cervical spine; Some pathologies originating in the lungs and even the heart, Best Orthopaedic Surgeon in Janakpuri, Delhi such as acute myocardial infarction, may give localized pain in the shoulder.
But all these situations have a structural translation of the cause of pain. However, certain circumstances give pain but have no associated structural changes. These are the case of functional changes, Best Orthopaedic Surgeon in Janakpuri where pain arises from an imbalance in the harmony of functioning of anatomical structures. These are more difficult to diagnose and in which complementary diagnostic tests give us little information, being the fundamental medical examination for the diagnosis.
The rotator cuff is made up of four tendons that lie on the joint capsule which surrounds the shoulder joint. These tendons are called: Sub-scapular (front), supraspinous (top) and infraspinatus and small round at the back. By acting on their muscles, the tendons act together to control shoulder movement (see article on conflict syndrome).
By external (trauma) and/or internal actions these tendons undergo changes in their structure and quality. Thus a fall can lead to a rupture of one of these tendons, but also the process of tendon ageing coupled with daily exertion can wear out the tendon that causes a rupture. Also a worn, though not ruptured tendon on the occasion of a low energy trauma can rupture more easily. Although these situations lead to breakages, they have different characteristics and as such should be viewed in different ways.
In the consultation, we tried to find out if there were any complaints on the shoulder, whether or not you hear any trauma and what is the intensity, if the onset of the complaints was immediate, what intensity and type of pain you have and your inability to perform movements with the shoulder. . During medical observation we look for signs of muscle atrophy and decreased strength so that we can appreciate what we will find in the complementary exams.
Radiography shows bone changes and gives indirect signs of tendon injury and is, therefore, an important examination. Ultrasound is the only exam that can show the action of the moving tendons, however, its quality is very dependent on who does it and does not give information about the quality of the tendon and muscle. Computed Axial Tomography (CT) has very little interest in this pathology. Magnetic resonance imaging may show the size of the tear, its location, the quality of the tendon and muscle, being the most important examination in a suspected rotator cuff tear.
In analyzing the situation consultation with your doctor is critical. Together with the complementary exams, the doctor will be able to give you the various types of treatment and advise which one is most likely to lessen/end your pain and improve your function in a lasting way.
When the pain is very severe, for example preventing you from sleeping at night, your doctor may indicate that you have an infiltration. In addition to lessening your pain, it also helps you to understand if your difficulty with shoulder movement is largely due to the pain or mainly due to tendon rupture.
In ruptures that occur in diseased tendons and in tears of part of the tendon thickness or complete but small (less than 1cm), physical therapy may be a good solution. The goals are, at an early stage, to lessen pain and then to optimize the functioning of all muscles and tendons of the shoulder girdle, to explore the possibility of mechanically balancing your shoulder and allowing it a quality life. for more information visit here- Best Orthopaedic Surgeon in Dwarka,
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