2023-10-28 10:49:30
Shoulder pain is a frequent reason for consultation in general medicine, indicates the High Authority of Health (HAS) (source 1). The main cause of shoulder pain is shoulder pathology. the rotator cuff (see below), a lesion which concerns approximately two out of three shoulder pains in the general population, reports HAS. But when faced with a painful shoulder, apart from muscular pathologies, other diagnoses can be mentioned: other mechanical pathology (osteoarthritis), rheumatic… We take stock.
What causes a painful shoulder?
The tearing of a muscle corresponds to damage to the fibers that compose it. “You should know that the contracture or the tear from the shoulder is a rarer cause of shoulder pain. We’re talking more about damage to the fibers of the shoulder,” says Dr. Jean-Marc Sène, sports doctor.
The pain can thus come from a inflammation of the tendons or tendinopathy : “when you have shoulder pain, it is more often the tendons (the endings of the muscle which are inserted on the bone) as the muscles which are involved. The tendons can be inflamed or even damaged, and be the cause of the pain: we then speak of tendinopathy,” he explains.
But it can also have other origins and come from:
- From a inflammation of the bursa or bursitis : “between the bone and the tendons, there are small unscrewing structures called bursae – we can compare them to a sliding sheet, or interposition, which allows the tendon not to rub directly on the bone. When this slip sheet ignites, it causes what is called a bursitis »;
- From a inflammation of the joint capsule or capsulitis: “the shoulder joint is surrounded by a small bag called a joint capsule and this bag which surrounds the joint can sometimes also become inflamed”;
- From a shoulder instability (ligamentous cause)“in other words these are the shoulder ligaments which do not hold together well”;
- Of the’arthrosis(joint cause) : “there may be arthropathies in the shoulder”.
Tendinopathy or rotator cuff tear
The rotator cuff refers to a group of four tendons (teres minor, subspinatus, supraspinatus, subscapularis) which cover the head of the humerus (the bone which constitutes the skeleton of the arm between the shoulder and the elbow) . There rotator cuff tendinopathy is a degenerative or traumatic lesion of the tendons while a rotator cuff tear is a total or partial disinsertion of these tendons at the level of the humerus.
How do you know if you have a shoulder muscle injury?
The symptoms are:
- A pain : “this is a mechanical pain which will increase when mobilizing the shoulder. When you want to raise your arm, turn or open your shoulder, you feel a sharp pain,” says Dr. Sène;
- We also note a decrease in amplitude : “it is more difficult to raise your arm, you have less range of movement. We see it in particular when it is impossible to take off or put on one’s t-shirt normally”;
- Pain can be radiated and go down the arm, or up towards the neck;
- And sometimes, particularly in the case of a ligament injury, “there may be play in the joint, a bit as if the shoulder was going to dislocate (shoulder instability),” concludes the doctor.
What to do if you have shoulder pain?
In the event of shoulder pain (especially after trauma, such as pulling or pushing, etc.), the first reflexes to take are:
- To immediately stop the current activityif you are practicing a sporting activity or physical effort;
- To temporarily immobilize the shouldermore very little timenot more than one or two days;
- To consult your doctor quickly in order to find the origin of the pain.
In order to choose the right treatment, it is necessary to identify the source of the painwhich first passes through the clinical examination with a doctor specializing in the musculoskeletal system (rheumatologist, orthopedist, sports doctor, etc.) or with your doctor.
In case of doubt or to confirm his/her hypothesis, he/she may possibly prescribe a complementary exam (ultrasound, magnetic resonance imaging or MRI, etc.). Once the lesion diagnosis is made, he/she directs the treatment.
How to treat a shoulder muscle injury?
The treatment will be adapted to the cause of the pain, but in general many shoulder lesions heal by observing some reposthen exercises rehabilitation with the physiotherapist.
Tendons, inflamed muscles: how to calm the pain?
In case of tendinopathy (but also bursitis or osteoarthritis), the cold will relieve pain and congestion, in particular thanks to the application of ice. For example, you can place an ice pack wrapped in a cloth on the painful area. It is also possible to take painkillers if the pain is severe.
It is not recommended to apply heat or massage the shoulder.
How long does the lesion(s) last?
“From one week after the muscle tear, muscle damage is gradually repaired, and new connective tissue is put in place. This phase can last up to 70 days. Muscle remodeling corresponds to the healing proper, which sometimes extends over several months », Indicates Health Insurance (source 2).
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