A proper diagnosis of shoulder pain is essential to determine the root cause of the problem and the proper method of treatment. Because many shoulder conditions are caused by specific activities, a detailed medical history is an invaluable tool. A physical examination should also include screening for physical abnormalities—swelling, shoulder pain deformity, muscle weakness, and tender areas—and observing the range of shoulder motion—how far and in which directions the arm can be moved.
This is when a Prolotherapist and his ability to reproduce pain by touching is invaluable. If you can put your finger on the exact spot that is causing the pain, then there is a high probability that you are a candidate for shoulder Prolotherapy since most shoulder problems involve the soft tissues—muscles, ligaments, and tendons—rather than the bones. These soft tissue injuries are precisely the kinds of injury that respond so effectively to Prolotherapy.
The shoulder is really a combination of several joints, combined in such a way by an intricate arrangement of muscles and tendons, that provides the arm a wide range of motion, flexibility and stability.
The rotator cuff is a group of four shoulder muscles that surround the top of the upper arm bone, the humerus, and holds it in the shoulder joint. These muscles are responsible for moving the arm in various directions, and unlike the massive deltoid muscle of the upper arm, are smaller and generally more vulnerable to injury. The four muscles and tendons of the rotator cuff are the supraspinatus, infraspinatus, teres minor, and subscapularis. It is the supraspinatus that is most commonly inflamed or torn.
The supraspinatus, and the rest of the shoulder, because they are built and expected to allow a remarkable array of motion, frequently are subjected to injuries, causing problems of instability or impingement of soft tissue and in pain. The pain may be constant, or may occur only when the shoulder is moved. In any case, any shoulder pain that persists more than a few days should be diagnosed and treated as necessary.
SHOULDER INFLAMMATION- BURSITIS
In the shoulder this is often an inflammation of the tendons as a result of the wearing process that takes place over a period of time. It can also occur from an unusual, awkward movement or fall.
Sometimes, excessive use or injury of the shoulder leads to inflammation and swelling of a bursa, a condition known as bursitis. Bursas are fluid filled sacs located around the body and joints. They lessen the friction caused by movement of the shoulder. Bursitis often occurs in association with rotator cuff tendinitis. Symptoms of shoulder bursitis include mild to severe pain, limiting the use of the shoulder. In extreme cases the joint stiffens into a condition known as “frozen shoulder,” also referred to by doctors as adhesive capsulatis.
SHOULDER IMPINGEMENT SYNDROME
Shoulder impingement syndrome involves one or a combination of problems: inflammation of the bursa located just over the rotator cuff, inflammation of the rotator cuff tendons, (tendinitis), or calcium deposits in tendons—called calcified tendonitis, (caused by wear and tear or injury.) The main problem is usually that the acromium or a bone spur puts pressure on the supraspinatus tendon.
CHRONIC SHOULDER INSTABILITY SYNDROME
Chronic shoulder instability syndrome results from trauma caused by subluxations, dislocations, from less detectable micro-trauma caused by repetitive strain on the tissues, or from congenitally loose shoulder joints. Recurrent pain or tenderness in the shoulder joint and weakness in the arm are two of the more common symptoms, but severe examples include patients whose shoulders pop in and out of joint. Frequent shoulder dislocations stretch the brachial plexus, the nerves that run from the neck down the arm. This process can cause permanent nerve damage, pain, and loss of use of the arm.