Painful shoulder syndrome is an umbrella term for various inflammatory and degenerative diseases of the shoulder joint. The structures around the joint, i.e. tendons, tendon insertions, bursa and muscle insertions are affected by signs of wear in particular. Medicine summarises the abnormal changes related to the shoulder joint under the term periarthritis humeroscapularis. Depending on which structures are affected and the symptoms, a differentiation is made between various clinical pictures such as a rotator cuff tear, impingement syndrome or what is known as frozen shoulder.
The function and stabilisation of the shoulder joint is guaranteed by a complex interplay of different structures. Muscles, muscle tendons and ligaments play an important role in this regard. The rotator cuff is a group of muscles with their tendons that are particularly important for the function of the shoulder joint. As a result of wear and tear, mild strain or trauma can cause a tear (rupture) in the rotator cuff.
Another manifestation of painful shoulder syndrome is impingement syndrome. In the process, there is wear and tear and calcifications through to constriction of the tendons which run under the scapular. The supraspinatus tendon, which forms a part of the rotator cuff, is affected in particular. The degenerative changes in the shoulder joint usually manifest around the age of fifty and increase as a person ages. Overexerting the shoulder during sport often causes the symptoms to become acute.
Pathological changes in the shoulder joint cause movement and position-related pain in the shoulder and upper arm. Pain typically occurs when the arms are lifted sideways to an angle of between 60 and 120 degrees. Medicine calls this phenomenon “painful arc”. Depending on the extent of the signs of wear and tear and inflammatory changes, pain during the night, muscle tension and pain in the neck can occur. If the shoulder needs to be rested due to the symptoms and can no longer be moved, the shoulder joint can stiffen. This is then known as “frozen shoulder”. Such a development in the shoulder inflammation must definitely be avoided.
Different examinations are carried out to diagnose degenerative and inflammatory changes in the shoulder joint. They include manual examination of the shoulder joint as well as x-ray imaging. The changes to the tendons and muscles can often only be detected with computed tomography or with an MRI examination.
The treatment depends on the causes of the changes and the symptoms. As a general rule: The earlier that degenerative changes in the shoulder joint are treated, the better the chances of recovery are. In the majority of cases, the symptoms are firstly addressed with conservative treatment. They include analgesics, anti-inflammatory medication and targeted physiotherapeutic exercises. In the majority of cases, the symptoms can be satisfactorily treated within a few months. Surgery becomes an option if the conservative treatment measures do not produce the desired results. If there are significant tears in the rotator cuff or tendons are completely torn through, surgery is recommended above all else. The procedures are usually performed arthroscopically. Find out more about these operations in the Arthroscopic surgery section.
Frozen Shoulder
Frozen shoulder and shoulder stiffness cause the joint lining and capsule to become inflamed. In the process, the capsule initially thickens and then shrinks back later. If the patient has no other issues with their shoulder, the cause of this stiffness usually remains unclear. It begins with pain and difficulty lifting and rotating the arm outwards. It can take up to several years for the patient to progress through the inflammatory, stiffening and thawing phases.
Treatment
In the first phase, the inflammation in the joint must be treated with anti-inflammatory medication (cortisone, if necessary). In the second phase, the stiffening phase, the movement should be improved with special exercises so that the stiffness can release in the third phase – the thawing phase.
Tip
Patience and positive thinking are required: The healing process takes between 1.5 years and 3 years; those affected are spared any long-term damage. A frozen shoulder usually heals completely.
Frozen Shoulder
Frozen shoulder and shoulder stiffness cause the joint lining and capsule to become inflamed. In the process, the capsule initially thickens and then shrinks back later. If the patient has no other issues with their shoulder, the cause of this stiffness usually remains unclear. It begins with pain and difficulty lifting and rotating the arm outwards. It can take up to several years for the patient to progress through the inflammatory, stiffening and thawing phases.
Treatment
In the first phase, the inflammation in the joint must be treated with anti-inflammatory medication (cortisone, if necessary). In the second phase, the stiffening phase, the movement should be improved with special exercises so that the stiffness can release in the third phase – the thawing phase.
Tip
Patience and positive thinking are required: The healing process takes between 1.5 years and 3 years; those affected are spared any long-term damage. A frozen shoulder usually heals completely.
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