What causes acromioclavicular joint hypertrophy


Shoulder pain

Shoulder pain is very common. Some causes of shoulder pain resolve within a few weeks without treatment, other than simple pain relief medication. However, some causes of shoulder pain can last for a long time and your doctor will need to arrange further examinations and treatment. You should see your doctor if the pain is severe, or if there is an injury, or if there is no improvement after a few weeks.

Shoulder pain

  • What are the possible causes of shoulder pain?
  • How do I know what's causing my shoulder pain?
  • When should I see a doctor about my shoulder pain?
  • What can i do to relieve shoulder pain?
  • What are the treatments for shoulder pain?
  • What is the result (prognosis)?
  • The shoulder joint

What are the possible causes of shoulder pain?

See also the separate leaflet on joint pain. Shoulder pain is a common problem with a number of different causes, including (starting with the four most common):

  • Frozen shoulder. This is sometimes called adhesive capsulitis of the shoulder. It is a condition in which one shoulder becomes painful and stiff. Symptoms usually appear without treatment, but this can take 2-3 years.
  • Rotator cuff disorders. The rotator cuff is a group of muscles and tendons that surround the shoulder joint and help keep it stable. Rotator cuff disease is one of the most common causes of shoulder pain. Most people can be treated successfully and make full recovery.
  • Pain comes from a neck problem. See the separate leaflets called Neck Pain and Cervical Spine.
  • Acromioclavicular joint disorders - some conditions (such as a shoulder injury or osteoarthritis) can affect the acromioclavicular joint, the joint on the shoulder (see the illustration at the end of this leaflet). Problems with this joint are usually due to wear and tear and injury to the joint.
  • Osteoarthritis (wear and tear) in the shoulder joint.
  • Septic arthritis. This is an infection in the joint. Symptoms include pain and tenderness over a joint, pain when moving the joint, and feeling unwell. Septic arthritis is uncommon but needs urgent hospital treatment.
  • Arthritis, which affects a number of other joints as well as the shoulder - e.g. B. Rheumatoid arthritis.
  • Polymyalgia rheumatica. This is a condition that causes pain, stiffness, and tenderness in large muscles, typically around the shoulders, upper arms, and hips.
  • Injury (trauma):
    • A broken bone (fracture), e.g. B. a fracture of the upper arm bone (humerus) or a broken collarbone (collarbone).
    • A soft tissue injury, e.g. B. an injury to a ligament, tendon, or muscle around the shoulder joint. This can be caused in a number of different ways, e.g. B. a sports injury, a traffic accident or shoulder strain after heavy lifting or carrying.
    • Shoulder dislocation.This means that the ball of the joint has moved out of the socket. See separate leaflet called Joint Dislocations.
  • Shoulder instability The shoulder is unstable because the joint does not hold the bones tightly together. The humerus often pops out of position.
  • Pain Recommendations This means a pain caused by a problem elsewhere in the body, but felt by the nerve pathways in the shoulder. The neck is the most common source of pain. (See the links above for more information). Occasionally, shoulder pain can occur if the source is the heart or diaphragm (the muscle that separates the chest area from the stomach area). A problem in the abdominal area can cause irritation to the membrane, which can sometimes be felt in the shoulder. Usually there is pain in the abdominal area as well. When the problem starts in the chest area, chest pain and shoulder pain usually occur.

What causes shoulder pain?

How do I know what's causing my shoulder pain?

As you can see above, there are many possible causes of shoulder pain. Hence, you may need to see a doctor to help you resolve it. Some general guidelines that can help are as follows. Remember, however, that there are always exceptions to every rule!

  • Shoulder pain usually - but not always - comes from a shoulder problem. It is more likely due to the shoulder itself if it hurts more when you move your shoulder, when you touch the shoulder, or when you see something wrong with the shoulder. For example, if the shape on the other side looks different or is hot or red. If your shoulder hurts when you raise your arm, it is likely due to a problem with the shoulder joint itself, such as a shoulder joint. B. a frozen shoulder, a rotator cuff problem, or a shoulder injury.
  • If you've had pain after a fall or injury, it is likely that the trauma was causing the pain; a bone, joint, ligament, muscle, or tendon is likely damaged, which can be minor or large.
  • Shoulder pain is very common and can affect any age. Some causes of shoulder pain, such as osteoarthritis, shoulder and rotator cuff disorders, mainly affect middle-aged and elderly people. Shoulder pain from sports injuries is more common in younger age groups. Sports that can lead to shoulder injuries include repetitive throwing or bowling, or contact sports such as rugby. Shoulder instability and acromioclavicular joint disorders often affect people who exercise regularly.
  • If you have pain in other joints such as your shoulder, this is more of a general problem.
  • If you have pain and stiffness in both shoulders, which is worse in the morning, you may have rheumatic polymyalgia.
  • Some clues that suggest shoulder pain is caused by a problem other than the shoulder itself include:
    • If there is a blister-like rash that is painful, it may be shingles.
    • If the shoulder pain is coming from the neck, you likely have some neck pain and / or stiffness as well.
    • If the pain is in your left shoulder and there is pain in your chest, it may be from your heart. Usually with angina or heart attack, other symptoms occur or instead of shoulder pain. For details, see the separate leaflets called Angina and Heart Attack (Myocardial Infarction).
    • If everything Your joints are painful, and if you feel hot for one minute and cold the next, you may develop a high temperature (fever) from an infection - such as a cold, flu, chest infection, or kidney infection.
    • If you have abdominal pain and pain at the tip of your shoulder blade, it could be from your abdomen or your liver or gallbladder
    • If you have chest pain or feeling out of breath, or have a persistent cough with shoulder pain, it may be due to a lung problem rather than your shoulder.

When should I see a doctor about my shoulder pain?

It is not possible to have rules that apply to every situation - it depends on how bad you are feeling and how much pain you are in. In general:

See a doctor immediately if:

  • The pain follows an injury or trauma and is severe (severe) or you cannot move your shoulder at all.
  • When your shoulder feels hot or is red.
  • If you have chest pain, breathlessness, or generally feel very unwell (call 999/112/911).

See a doctor as soon as possible if:

  • The pain affects both shoulders and is worse in the morning.
  • The pain does not improve with simple pain relievers.
  • The pain affects your daily activities.
  • You have other symptoms, as well as your shoulder pain, such as:
    • stomach pain
    • A persistent cough
    • Night sweats
    • Weight loss
    • A blistering rash
  • You have a high temperature (fever) that does not respond to simple measures such as acetaminophen or when there is no obvious simple cause.
  • You have a history of cancer and have persistent pain in the bone area of ​​your shoulder.
  • You have pain in more than one joint.
  • There is a swelling of the shoulder.

What can i do to relieve shoulder pain?

Initial treatment for some of the most common shoulder problems involves taking simple pain relief medications such as ibuprofen or acetaminophen. Ice packs can also be used to relieve or relieve pain. You should avoid activities that may cause more shoulder pain, such as heavy lifting and carrying. If these measures don't work, see a doctor.

What are the treatments for shoulder pain?

This, of course, depends on the cause of the pain. You should see a doctor if your shoulder pain is severe, doesn't get better within a few weeks, or has been caused by an injury. Further treatments may be needed depending on the cause of your shoulder pain.

Treatments can include physical therapy and / or a steroid injection into your shoulder.

In some cases, you may need to be referred to a bone and joint specialist (orthopedic surgeon or rheumatologist specialist) to see if further treatment is needed, such as: B. surgery to treat the cause of your shoulder pain. However, most causes of shoulder pain do not require surgery.

In some cases, surgery may be required. Most often this is done through a "keyhole" procedure - an arthroscopy. During an arthroscopy, parts of the shoulder joint can be examined to find out what is causing the problem. Damaged tissues can be repaired or removed.

Decompression is a surgical option for shoulder (subacromial) pain. Decompressing means removing bone spores and soft tissue through a thin telescope inserted through the keyhole incision. However, the results of a recent large study show that little pain is of benefit with this particular surgery and this should be discussed with you during the joint treatment decision process.

Occasionally, shoulder joints can be replaced by an artificial joint, especially if they are worn out (osteoarthritis).

If the pain is believed to be due to inflammation, such as: For example, if you have rheumatoid arthritis or rheumatoid polymyalgia, drugs will be used to treat you. You may be under the care of a rheumatologist. For more information about treatment options, please refer to the relevant information sheets for these conditions.

There is currently no evidence that acupuncture is helpful for shoulder pain.

What is the result (prognosis)?

The outcome depends on the underlying cause. Shoulder pain can only last a few weeks, last a few years, or be a lifelong problem. However, if the cause of your shoulder pain is identified and treated early on, it can often help alleviate or greatly reduce the pain in the shoulder.

The shoulder joint

There are three bones in the shoulder area - the clavicle (collarbone), the shoulder blade (shoulder blade) and the humerus (humerus). The shoulder blade is a triangular bone that has two important parts: the acromion and the glenoid. The three bones in the shoulder area are part of two main joints:

  • The acromioclavicular joint between the acromion of the shoulder blade and the collarbone.
  • The glenohumeral joint between the scapula glenoid and the humerus.

There are also a number of muscles, ligaments, and tendons around the shoulder. Ligaments are fibers that connect bones together at one joint. Tendons are fibers that connect muscles to bones.

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Further literature and references

  • Shoulder pain; NICE CKS, April 2017 (UK access only)

  • Artus M, Holt TA, Rees J; The Sore Shoulder: An Update on Assessment, Treatment, and Referral. Br J Gen Pract. 2014, Sep64 (626): e593-5. doi: 10.3399 / bjgp14X681577.

  • Bart DJ, Rees JL, Cook JA, et al; Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicenter, pragmatic, parallel, placebo-controlled, randomized, three-group surgical study. Lancet. 2018 Jan 27391 (10118): 329-338. doi: 10.1016 / S0140-6736 (17) 32457-1. Epub 2017 November 20th

  • Brun S.; Shoulder Injuries - Management in General Practice. Aust Fam doctor. 2012 Apr41 (4): 188-94.

  • Green S, Buchbinder R, Hetrick S; Acupuncture for shoulder pain. Cochrane Database Syst Rev. 2005 April 18 (2): CD005319.

  • Green S, Buchbinder R, Hetrick S; Physiotherapeutic interventions for shoulder pain. Cochrane Database Syst Rev. 2003 (2): CD004258.

  • Page MJ, Green S., Kramer S., et al; Manual therapy and exercise for adhesive capsulitis (frozen shoulder) Cochrane Database Syst Rev. 2014 Aug 268: CD011275. doi: 10.1002 / 14651858.CD011275.

  • Shoulder disorders; Wheeless' Textbook of Orthopedics

  • Buchbinder R, Green S, Youd JM; Corticosteroid injections for shoulder pain. Cochrane Database Syst Rev. 2003 (1): CD004016.

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