Causes of Shoulder Pain?
The shoulder joint is the joint with the widest range of motion in our body. It is a joint made up of the scapula (scapula), clavicle (collarbone), and humerus (shoulder) head bone. In order for the shoulder joint to perform its normal movements, these three joints must work in harmony.
Shoulder impingement syndrome, which is one of the most common causes of shoulder pain, is the injury of the tendon of the muscle that allows the arm to be lifted up due to deterioration in joint function, as a result of compression between the shoulder bones. As a result of this injury, pain occurs in the shoulder region, usually radiating to the upper arm, with arm movements. Sometimes, if the injury is severe, it may cause the tendon to rupture and cause serious limitation in shoulder joint movements.
Causes such as lifting the shoulder with a weight to 90 degrees and above, working by reaching up, sleeping in the shoulder joint at 90 degrees and upwards, compelling traumas cause more compression of the shoulder muscles. . As a result of these, the person may complain of pain that gradually increases over time or shoulder pain that occurs after a sudden movement, as well as restriction of movement. He/she may complain of shoulder pain, especially during arm back, overcoat movement or reaching up, and shoulder movements may be limited gradually. It can result in quite serious limitation of motion of the shoulder joint, which we refer to as “frozen shoulder”.
The diagnosis of shoulder impingement is made by examining the patient with special test movements and by MRI of the shoulder. With the MRI examination, the reason for the compression of the tendon of the muscle, the degree of injury and whether there is a tear, and the degree of the tear, if any, can be determined.
Treatment
In treatment, first of all, 2-4 weeks of physical therapy and exercise should be applied.
Injection into the nerve going to the shoulder muscles in pain that does not respond to physical therapy provides serious reductions in the patient’s pain. The general application is to numb the fibers that transmit pain by applying heat to the nerve (Radiofrequency thermocoagulation, RFT). Applying the procedure under ultrasonography will increase the chance of success. With this procedure called suprascapular RFT application, 80-85% of patients reduce pain and improve shoulder joint movements.
Suprascapular Nerve Block with USG
Another application that can be performed for the shoulder joint is steroid + local anesthetic application (3in1 block) to the 3 joint forming the shoulder joint under imaging. . This procedure is highly successful in reducing pain, especially in patients with inflammation in the joint.
In patients who do not heal with these treatment methods or whose complaints recur in a short time and who have serious tears in the tendon of the shoulder muscle, the congestion is removed by applying surgical methods.
