The shoulder is a very complex part of the body, and when one component is not working properly, the result is pain and dysfunction. At Boston Orthopaedic & Spine, our team of board-certified, fellowship-trained experts understands this complex joint, and they have the training and expertise to return you to your active life.

Shoulder Anatomy

The shoulder is made up of three bones: the scapula (shoulder blade), the humerus (upper arm bone) and the clavicle (collarbone). Connecting these are ligaments and tendons.

• The part of the scapula that makes up the roof of the shoulder is called the acromion.
• The joint where the acromion and the clavicle join together is known as the acromioclavicular (AC) joint.
• The true shoulder joint is called the glenohumeral joint and consists humeral head and the glenoid. It is a ball and socket joint.
• The rotator cuff muscles and their tendons play an important role in the correct functioning of this joint. They are responsible for the motion, stability, and power of the humerus. 4 tendons join to make up the rotator cuff.
• The labrum surrounds the glenoid and deepens the socket. It aids in stability.

Common causes of shoulder pain and injury treated at Boston Orthopaedic & Spine

Arthritis

Arthritis, or osteoarthritis, is loss of cartilage within a joint. While there are many other types of arthritis, including rheumatoid, psoriatic, septic, post-traumatic, and lupus, wear and tear osteoarthritis remains by far the most common. Arthritis symptoms can include swelling, tenderness, sharp pain, stiffness, and sometimes fever and chills.

Bursitis

Bursitis is painful inflammation of the bursae, the fluid-filled sacs that reduce friction between bones, tendons, and muscles. Bursitis in the shoulder is commonly caused by an injury, infection or other condition. Pain may be accompanied by swelling, tenderness or loss of movement. Treatment is rest, ice, activity modifications, injections, and in some cases, surgery.

Dislocated shoulder

A dislocated shoulder occurs when the upper arm bone (humerus) is forced out of its natural position inside the shoulder socket. Symptoms include severe pain, swelling, bruising, and a visible deformity of the shoulder.

A dislocation is a serious injury that requires medical attention. A physician will put the arm bone back into the socket either manually or surgically. The joint will be immobilized in a sling, and medication may be prescribed to help manage the pain. In the early stages after a dislocation, physical therapy is helpful to restore the shoulder stability. If instability persists, surgery is often indicated.

Rotator cuff tear

A rotator cuff tear is an injury to any of the four rotator cuff tendons in the shoulder. Tears are caused by repetitive motion or sudden injury.

Symptoms include pain, weakness in the shoulder, and difficulty raising the arm overhead. Treatment for a rotator cuff tear depends on the severity of the damage, and may include rest, ice, over-the-counter pain medication, physical therapy or surgery.

Fractures

A fracture is a break in a bone. Broken bone symptoms include pain (intensified when the area is moved or pressure is applied), swelling, bruising, and loss of function. Fractures may also cause the area around the bone to appear distorted or deformed, especially in open fractures where the bone protrudes from the skin.

Frozen shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition in which the capsule of tissue surrounding the shoulder joint becomes thicker or tighter, restricting movement. Symptoms typically develop in several stages, and resolve within one or two years.

Common symptoms include pain, stiffness, and restricted range of motion. Treatment options include over-the-counter pain medication, physical therapy, or injections. Most cases of frozen shoulder go away within 18 months, but for some patients, surgery may be necessary.

Shoulder impingement

Impingement is caused by irritation of the tendons and bursa on the bones of the shoulder. It is often caused by repetitive overhead activities or throwing sports.

Symptoms include generalized aching of the shoulder and pain when raising the arm out from the side or in front of the body. Impingement may also cause a sharp pain when trying to reach into your back pocket, or difficulty sleeping due to pain. Treatment for shoulder impingement includes rest, ice, and physical therapy. In some cases, surgery may be necessary to restore functionality.

Shoulder separation

A shoulder separation is an injury to the ligament that connects the shoulder blade (scapula) and the collarbone (clavicle). This injury can vary in severity from a strain to a complete dislocation of the acromioclavicular (AC) joint. We often see athletes in sports like football, hockey, and skiing who may experience an AC joint injury as a result of falling or being hit on the shoulder.

Symptoms include pain, tenderness, swelling, and bruising. Signs of a severe separation are a popping sensation when the loose joint shifts, and a noticeable bump on the shoulder where the collarbone has moved out of place. Treatment for shoulder separation depends on the severity of the injury, but includes anti-inflammatory medications and immobilization of the shoulder with a sling. For more severe separations, surgery may be recommended.

SLAP tear

A SLAP tear is an injury to the ring of cartilage that surrounds the shoulder socket, called the labrum. The acronym SLAP stands for superior labrum, anterior to posterior, and means that the top of the labrum is torn from back to front.

This injury is common among athletes, and often occurs when falling on the outstretched arm or the shoulder. SLAP tears can also happen as a result of repeated overhead motions or sudden heavy lifting. Symptoms include aching pain, weakness, and popping or clicking in the shoulder. Treatment for SLAP tears includes over-the-counter anti-inflammatory medicine, physical therapy, and in some cases, surgery.

Tendonitis

Tendonitis is inflammation of the tendons, the tissue that connects muscle to bone. Tendonitis is caused by overuse (repetitive motion) or sudden injury. Tendonitis symptoms include pain in the tendon area, swelling, and loss of motion.

Biceps tendonitis is inflammation of the tendons that connect the biceps muscle to the top of the shoulder. It may be caused by overuse, wear and tear from aging, or injuries to the shoulder. Sports activities like golf, tennis, and swimming can cause biceps tendonitis, as well as work activities that require frequent overhead motions.

Symptoms of bicep tendonitis include aching pain that increases with use of the arm and shoulder It may also cause weakness when bending at the elbow or twisting the arm. Treatment includes rest, over-the-counter anti-inflammatory medicine, and physical therapy. In some cases, surgery may be necessary for patients who are not improving with non-surgical treatments.