Pain in the shoulder and elbow areas can be the result of a condition such as arthritis or bursitis, but more commonly comes from an injury that can range from a simple strain to a tear in the tendons.
A shoulder is what is known as a ball-and-socket joint. This is because the upper arm has a rounded shape that fits into a hollow socket in the shoulder blade. The joints within the shoulder are very flexible, in fact, more flexible than any other joint in the body.
The elbow is a hinge joint connecting the forearm to the upper part of the arm. A hinge joint allows for flexibility in the lower part of the arm.
The shoulder and elbow are held together with ligaments, tendons and various soft tissues. Ligaments connect bones to other bones, where tendons connect bones to muscles. A thin layer of cartilage covers these areas and eases any friction during movement. If there is damage, from disease or injury, you may experience pain, numbness or a weakened range of motion. Because the shoulder and elbow are so heavily utilized, they are commonly prone to injury or disorder.
There are a number of disorders, preexisting or new, that can lead to shoulder pain including:
Arthritis - Also known as osteoarthritis, this condition is caused by cartilage degeneration or a loss of cartilage, the flexible covering between bones, that causes friction between the bones and leads to pain in the joints.
Bursitis - A painful condition caused by inflammation of the small, fluid-filled sacs, called bursae, that protect and lubricate the bones, tendons and muscles around the shoulder and elbow.
Cubital Tunnel Syndrome - Similar to the more well-known wrist condition, carpal tunnel syndrome, cubital tunnel syndrome is caused by pressure on the shoulder or elbow from long periods use, leaning or being put in an awkward position.
Frozen Elbow - There is still some uncertainty of the causes but frozen elbow is pain and limited movement caused by the gradual degeneration of the elbow and can lead to scar tissue in the elbow joint.
Frozen Shoulder - Also known as adhesive capsulitis, frozen shoulder is a condition that can cause pain and stiffness in the shoulder. It is often the result of thickening or scarring of the capsule (lining or tissue surrounding the shoulder joint).
Shoulder or Elbow Arthrosis - Damage to the shoulder or elbow joint causing damage to cartilage causing rubbing between bones and pain or loss of movement.
It is very important to work with your doctor to correctly classify a shoulder or elbow injury so effective treatment can be administered. Common shoulder and elbow injuries include:
Tennis Elbow (Lateral Epicondylitis) - Inflammation in the tendons that connect the forearm muscles, caused by tension, heavy use or trauma. Manifests as swelling and pain in the elbow, worsened by movement of the palm.
Golfer’s Elbow - Inflammation of the elbow joint where the bone is attached to the tendon. Golfer’s elbow is caused by repeated movements and can cause limited mobility, swelling and pain.
Tendonitis - Inflammation and irritation of the shoulder or elbow tendon from overuse or injury and causes impingement (pinching) of tendons and nerves. Over time the pinching can lead to heightened pain and pain in other areas of the body.
Rotator Cuff Injury - The rotator cuff is a collection of muscles and tendons surrounding the shoulder joint, keeping the upper arm bone firmly in the socket of the elbow. If these tendons are sprained or torn it can lead to sharp pain, and if left untreated will lead to further damage to the shoulder joint.
Shoulder or Elbow Dislocation - An injury that causes the bone to become dislodged and moved out of place from the joint. Dislocation causes damage to the surrounding tendons, muscles and nerves.
Shoulder or Elbow Joint Overload - Pain and inflammation caused by activities like swimming, baseball or tennis. This is caused by microtrauma or wear of the joints and can cause sharp pain, especially at night.
SLAP tears - Superior labrum anterior to posterior (SLAP) tears are a type of injury where the labrum, a ring of cartilage that surrounds the shoulder socket, is damaged where it attaches to the biceps tendon. They can cause pain, weakness and instability in the shoulder.
Most shoulder and elbow pain can be cured with R.I.C.E. method (Rest, Ice, Compression and Elevation). This coupled with over-the-counter anti-inflammatory medications like NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can help to relieve swelling and reduce pain.
Using a splint, brace or sling helps a particular area of the body to rest until the pain subsides. These shouldn’t, however, be used indefinitely as they can lead to lowered flexibility and reduce muscle mass.
If the pain is not residing with conservative treatment your doctor may recommend physical therapy or other treatments, such as injections, that can assist in healing.
Surgery may be required if all other treatments have been exhausted and there are still pain or immobility problems. Orthopedic surgery includes arthroscopic procedures, which use small incisions and a camera for minimally invasive joint repairs, and open surgery, which involves larger incisions for more complex bone and joint corrections. Common surgical procedures for the treatment of shoulder and elbow injuries include:
Elbow or shoulder arthroscopy – A surgical procedure that is done with small incisions and a special camera to allow surgeons to remove loose or damaged cartilage, bone fragments or bone spurs to relieve pain and restore mobility.
Rotator Cuff Surgery – A common shoulder procedure that is performed arthroscopically, through small incisions to the shoulder area. Surgeons drill tiny holes in bine to anchor a “patch” (usually using a piece of a tendon) to fix instability caused by a tear in the rotator cuff tendons.
Shoulder or Elbow Replacement – Full or partial shoulder or elbow replacement may be necessary if the joint is damaged beyond arthroscopic repair.
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