Healthy Life: Shoulder Pain – Causes and Symptoms (542)

Healthy Life: Shoulder Pain – Causes and Symptoms

蘇鎮邦 (Christopher So)：
舒整物理治療師 (Manipulative Physiotherapist) 人類工程師 (Ergonomist)

Frozen shoulder is one of the most common shoulder problems especially for people around 50 years of age. Mostly, it is an accumulation of minor injuries over the years which have reached breaking point and it is brought on by trivial incidents. People between the age of 45 -55 are likely to develop frozen shoulder. In my opinion, at this age range people still cannot accept that their bodies have aged and are not as tough as they were. They persist in doing as much as they were around 25 – 35. The body is not able to sustain the same kind of pressure. When the joint has degenerated, what was normal pressure on the joint before becomes abnormal for an ‘abnormal’ joint.

On account of the trivial incident, most patients cannot remember when they hurt their shoulders and what caused it. Moreover, the symptoms start to become more obvious after 1-2 weeks or even 1-2 months. These symptoms are tolerable at the start. That is why many patients come for treatment after a few months. When these symptoms start to affect their daily activities: e.g. hanging up clothing, combing hair, putting on clothing especially tight overalls or bra, scratching and drying their back, and sleeping on the painful shoulder which wakes them up. They worry and come for treatment. A few common causes of frozen shoulders are: reaching out to pick things up when the leverage will make the object much heavier than one thought, reaching back to the back of the car to get things, above head movement like putting hand luggage into the cabin on a plane, and many awkward unnatural movements of the shoulder in confined space.

The common symptoms are pain on the front and side of the shoulder. Pain at the back of the shoulder may be caused by Teres Majors’ tendon, however, one should clear the cause from cervical spine (C5) or neck. Rotator cuff is the four tendons that are commonly involved in this condition, because they blend into the capsule of the shoulder. Inflammation of these tendons will extend to the capsule which might scar and shrink to cause the frozen condition. The long head of biceps is generally involved because it is highly strained in any reaching activities. The supraspinatus tendon is commonly involved and full thickness tear usually results. Subacromial bursitis increases the chance of impingement on the tendons and related soft tissues. Referred pain down the arm is common.