Cause Details Rotator cuff tear The rotator cuff can become compressed in the subacromial space when arm elevated. Can be worsened by osteophytes or muscle or ligamentous issues such as calcification. Seen in Elderly, trauma, marked nocturnal pain, weakness of resisted abduction. Pain when lying on the affected shoulder is key. The painful arc with active abduction from 90 to 120 degrees. Impingement can lead to a frozen shoulder, rupture long head of biceps or rupture of local tendons. Manage with NSAIDs, analgesia and steroid injection and surgery may be considered to remove osteophytes. Adhesive capsulitis/Frozen shoulder Nocturnal Shoulder pain occurs when the patient has not been lying on the shoulder. Fibrosis and retraction of the lower glenohumeral joint capsule. Seen in those aged 50+. Associated with diabetes and glycosylation of collagen. May also be seen post-MI, Stroke. Thyroid disease and TB and lung cancer. Initial inflammatory phase with nocturnal pain and restricted movements for up to 9 months then pain settles but shoulder remains stiff and then there is recovery with improved mobility. Analgesia. The joint injection may help. Arthroscopy may be considered. Oral steroids have short term benefit. Inflammatory arthopathy Swelling of the shoulder and pain, anterior bulge due to subacromial bursa Glenohumeral OA Morning stiffness and pain on use and chronic symptoms. Changes seen on X-Ray.
|MEDICAL DISCLAIMER:The contents are under continuing development and improvements and despite all efforts may contain errors of omission or fact. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice by healthcare workers or laypeople. It is for educational purposes only. Please adhere to your local protocols. Use the BNF for drug information. If you are unwell please seek urgent healthcare advice. If you do not accept this then please do not use the website. Makindo Ltd|
Painful Shoulder syndromes
| About | Anaesthetics and Critical Care | Anatomy | Basic Science | Biochemistry | Cardiology | Cases | Clinical Cases | Crib | Dentistry | Dermatology | Differentials | Drugs | ENT | Electrocardiogram | Embryology | Emergency Medicine | Endocrinology | Ethics | Foundation Doctors | Gastroenterology | General Information | General Practice | Genetics | Geriatric Medicine | Guidelines | Haematology | Hepatology | Immunology | Infectious Disease | Infectious Diseases | Infographic | Investigations | Lists | Microbiology | Miscellaneous | Nephrology | Neuroanatomy | Neurology | Nutrition | OSCE | Obstetrics Gynaecology | Oncology | Ophthalmology | Oral Medicine | Paediatrics | Palliative | Pathology | Pharmacology | Physiology | Procedures | Psychiatry | Radiology | Research | Respiratory | Resuscitation | Rheumatology | Statistics | Stroke | Surgery | Surgical | Toxicology | Trauma and Orthopaedics | Twitter | Urology | Version Jan 2023