Shoulder and Arm Conditions
What are shoulder and arm conditions?
Most people think of the shoulder as one joint. However, there are actually three bones that make up two joints within the shoulder complex. The main shoulder joint is a ball and socket joint, similar to the hip. The top of the upper arm bone (humerus) ends in a ball. This ball fits into a socket on the shoulder blade (scapula). The third bone, the collarbone (clavicle), forms the other shoulder joint with the shoulder blade in the back. Shoulder and arm conditions affect any of the many components of the shoulder joint and upper arm.
The shoulder complex also contains cartilage, ligaments, tendons and muscles. These components work together to make the shoulder the most flexible joint in the body. It has the greatest range of motion of any of the joints. When you have an arm or shoulder problem, it can interfere with the shoulder’s movements, cause pain, and make daily tasks challenging.
Common arm and shoulder injuries and conditions:
Biceps tendon injury is trauma to one of the tendons that attaches the biceps muscle to bones. A tendon attaches the top of the muscle to the shoulder. Another tendon connects the bottom of the muscle to the elbow.
Fractures and dislocations including broken arm (of the humerus bone), dislocated shoulder, and shoulder fracture—all of which require emergency medical treatment
Frozen shoulder occurs when the capsule of cartilage surrounding the main shoulder joint thickens and tightens. This makes it impossible to move the shoulder, even when someone assists you.
Shoulder arthritis causes pain and inflammation in the shoulder joint. Osteoarthritis is the most common form of arthritis affecting the shoulder. It results from degeneration, or wear and tear, on the joint over time.
Shoulder bursitis is inflammation and irritation of a bursa in the shoulder. Bursae are fluid-filled sacs that allow tendons, ligaments and muscles to glide over bones in a joint. The shoulder has a large bursa at the top of the upper arm bone. It is a common site for bursitis.
Shoulder impingement syndrome develops from rotator cuff tendinitis or shoulder bursitis. Swelling from an acute or chronic injury causes pressure, which compresses the rotator cuff and the nerves and blood vessels supplying it. Bursitis can cause similar compression.
Shoulder separation occurs when the collarbone and shoulder blade disconnect. This ligament sprain can range from mild to severe. Seek immediate medical treatment if you suspect shoulder separation.
Torn rotator cuff is a tear of one of the tendons in the rotator cuff—the group of muscles and tendons inside the shoulder.
Triceps tendon injury is trauma to the tendons that attach the triceps muscle to bones. Like the biceps muscle, tendons connect to the shoulder at the top and the elbow at the bottom.
Seek prompt medical care for shoulder or arm problems or symptoms that do not respond to at-home treatment, such as resting the arm or applying ice for swelling. An experienced doctor will be able to determine the seriousness of the problem and how best to treat it. Seek immediate medical care (call 911) if you have severe shoulder or arm pain or signs of a broken or dislocated shoulder.
What are the symptoms of shoulder and arm conditions?
The symptoms of a shoulder or arm condition will vary depending on the specific problem. Pain is a symptom common to many conditions. Shoulder and arm pain can range from mild tenderness to severe, debilitating pain. The location of the pain can also vary. You may notice it at the front of the shoulder, behind the shoulder, or in the upper arm. The pain can be dull, sharp or achy.
You may find some activities worsen the pain, such as raising your arm overhead or laying on it. But also pay attention to what makes it feel better. All of this information can help your doctor pinpoint the cause of the pain.
Other common symptoms of shoulder and arm problems include:
Decreased ability to bend or extend the elbow or move the shoulder
Difficulty raising the arm
Hearing a crackling, creaking or popping sound when moving the arm, elbow or shoulder
Inability to move the shoulder
Instability of the shoulder
Swelling and warmth
Serious symptoms that might indicate a life-threatening condition
A broken arm or broken or dislocated shoulder can lead to serious complications. Seek immediate medical care (call 911 for help) if you, or someone you are with, have symptoms including:
Abnormal appearance of the shoulder or arm, such as the arm hanging oddly or an abnormal bump or bulge
Difficulty or inability to move the arm or shoulder
Hearing a snapping or grinding sound during the injury
Loss of feeling in the arm or hand
Open wound or bone protruding through the skin
Severe swelling or bruising
Bone protruding through the skin
Deep wound or trauma with open skin
What causes shoulder and arm conditions?
Many arm and shoulder conditions are injuries. Fractures, dislocations, separations, and other injuries usually involve major trauma, such as the force from a fall or direct blow to the area. Tendinitis, bursitis, and other chronic injuries are typically the result of repetitive motions that constantly irritate the tissues. These are repetitive strain injuries. For some shoulder conditions, such as frozen shoulder, doctors do not fully understand the cause.
If you need specialized care for an acute injury or serious condition affecting your arm or shoulder, see an orthopedic surgeon. Also, if you have received primary care for an existing shoulder or arm condition and you need or want additional treatment, consider an orthopedic surgeon’s expertise.
What are the risk factors for shoulder and arm conditions?
The risk factors for shoulder and arm conditions can vary with the underlying cause. Aging is a frequent risk factor for many of them. The risk of developing arthritis increases with age. Tendon problems also become more common with age because tendons slowly weaken and become less flexible. Older people are also more likely to have osteoporosis, which thins the bones and makes them more prone to breaking.
Other risk factors include:
Being in a motor vehicle accident
Participating in activities with repetitive stresses, such as racquet sports
Playing contact sports
Some people are at risk for shoulder problems due to their anatomy. Their shoulder ligaments may be looser than normal, making dislocations and other injuries more likely to occur.
Reducing your risk of shoulder and arm conditions
You may be able to lower your risk of a shoulder or arm injury by:
Balancing strength training with stretching and flexibility exercises
Following your treatment or prevention plan for osteoporosis and other chronic conditions
Resting your arm and shoulder after heavy use
Strengthening the muscles that support your shoulder joint
Strengthening your bones with weight-bearing exercise, calcium, and vitamin D
Taking care to avoid falls
If you have shoulder or arm symptoms that are not getting better, see your doctor soon. Early diagnosis and treatment can improve your symptoms and get you back to an active life.
How are shoulder and arm conditions treated?
The treatment your doctor recommends will depend on your specific problem and its cause. General treatment goals include pain relief, correcting physical problems and defects, and restoring pain-free mobility and function. Often, treatment starts with nonsurgical approaches, such as rest, ice, and anti-inflammatory medicines. Exercises to strengthen the shoulder and restore flexibility can help. A physical therapist can teach you how to do this.
Your doctor may also recommend corticosteroid shots into the shoulder in some cases. Surgery may be necessary if these treatments do not resolve the problem. Upper arm surgeries include tendon repair procedures and internal fixation for a broken arm. Shoulder surgeries include shoulder replacement, impingement surgery, rotator cuff surgery, and diagnostic or therapeutic shoulder arthroscopy.
What are the potential complications of shoulder and arm conditions?
With some shoulder and arm conditions, it is possible to develop complications. This is especially true for injuries, both acute and chronic. Without proper treatment and adequate recovery, injuries can fail to heal or may heal incompletely or improperly. This can lead to chronic pain, weakness and instability in the shoulder. Following your treatment and recovery plan is the best way to prevent complications. A physical therapist can show you how to protect your shoulder and avoid future problems.