Related Subjects:
|Analgesia and Pain management
|Sedation and Analgesia on ITU
|Neuropathic Pain Management
|Codeine
|Dihydrocodeine
|Diamorphine
|Morphine
Examination
Movements
Integrity
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.
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Painful Shoulder syndromes
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