Shoulder Pain: Common Causes and Cures

Of the aches and pains that inevitably cloud the senior years, those affecting the shoulder can be the most frustrating. In this article, we will discuss how to know if your pain is really coming from the shoulder, the most common causes of shoulder pain in seniors, and some of the ways shoulder pain can be successfully treated.

The common shoulder problems that we discuss in this article usually cause sharp or aching pains that are felt in the areas directly around the shoulder joint. Typical symptoms include pain at night, pain raising the arm, pain reaching around the back, weakness in lifting with the arm extended, and difficulty with arm exercises or throwing. Warning signs of a condition that can mimic a shoulder problem (particularly a neck problem) include pain located around the shoulder blade muscles (the muscles between the shoulder joint and the neck), pain shooting through the whole arm, burning pain, and hand weakness or numbness.

The structure of the shoulder is very complicated, and pain and dysfunction can result when any of the major parts wears out or sustains an injury. The tendons of the shoulder (rotator cuff and biceps) are the most common cause of shoulder pain. A shoulder specialist can usually tell if shoulder pain is related to tendons using of a combination of reported symptoms, characteristic physical exam findings, and x-rays that show minimal bony changes. If a significant tendon problem is suspected (i.e. a rotator cuff tear), MRI is most commonly used to confirm the diagnosis.

Caption: Two types of total shoulder replacement, anatomic (A) and reverse (B), can provide excellent pain relief in cases of severe shoulder osteoarthritis.

The other major cause of shoulder pain in seniors is osteoarthritis. In this condition, the specialized cartilage surface of the ball and socket of the shoulder has become diseased. This results in pain, grinding, and stiffness. Shoulder osteoarthritis usually can be seen on x-rays without any other special imaging test.

Shoulder tendon disease and osteoarthritis (along with other problems such as frozen shoulder and traumatic injuries) thankfully can be treated without surgery in most cases, particularly when disease is mild. Often, simple measures such modifying activities, physical therapy exercises, and over the counter medications for a few weeks will allow symptom resolution. An anti-inflammatory injection can often be added if problems persist.

As a general rule, surgery is reserved for patients whose severe symptoms persist following nonsurgical treatments. However, in certain situations, surgery is the best course of action as the first treatment. For rotator cuff and biceps surgery, minimally invasive arthroscopic techniques are now the standard of care. For arthritis, shoulder replacement can dramatically improve pain and function by providing smooth surfaces for joint motion. A shoulder specialist can be very helpful in making the correct diagnosis and guiding your treatment, particularly when surgery is under consideration.

Dr. Robert Hartzler is a board certified orthopaedic surgeon with TSAOG Orthopaedics. He is fellowship trained and specializes in treating conditions of the shoulder and elbow and has new patient appointments available at five locations in San Antonio, TX and New Braunfels, TX. To schedule an appointment with Dr. Hartzler, please call (210) 281-9595.

Submitted By: Dr. Robert Hartzler, TSAOG Orthopaedics

Phone Number: (210) 281-9595