Tags
deltoid, Generalized DJD, glenohumerl joint, infraspinatus, pmr, radiculopathy, rotator cuff, shoulder, subacromial, subdeltoid, supraspinatus, tendonitis
Shoulder is a complicated joint as it involves three bones and four articulations. It is also not a usual place for arthritis and therefore cause of shoulder pain requires prompt investigation.
Shoulder pain can be either inflammatory or it could be structural. Shoulder inflammation often causes pain at night and is better with activity during the day. These include:
– Polymyalgia Rheumatica
– Rheumatoid Arthritis
– Seronegative Arthritis
Structural shoulder problems on the other hand cause pain mostly during the day and also at night. These include:
– Bursitis
– Tendonitis
– Rotator Cuff tear
– Shoulder impingement
– Frozen shoulder
– Osteoarthritis
– Scapulothoracic syndrome
– Neck pain radiating into the shoulder
Evaluation usually involves
– physical examination
– X-rays
– MRI exam
– Local injection with Marcaine to determine the cause of pain in selected cases
Treatment depends on the specific cause and can range from exercise to medication and at time surgery.
– Polymyalgia Rheumatica: Diagnosed by a short trial of steroids. It is treated by Methotrexate or long term low dose prednisone with gradual taper.
– Rheumatoid Arthritis: Diagnosed by a short trial of steroids as well. It is treated by Methotrexate as well as other drugs listed.
– Seronegative Arthritis. These may not respond to steroids. They would usually do respond to NSAIDs.
Structural shoulder problems on the other hand cause pain mostly during the day and also at night. These include:
– Bursitis
– Tendonitis
– Rotator Cuff tear
– Shoulder impingement
– Frozen shoulder
– Osteoarthritis
– Scapulothoracic syndrome
– Neck pain radiating into the shoulder
