Conditions Causing Shoulder Pain
Here we will have a look at some different presentations of shoulder pain in regards to location and see what may be causing this discomfort.
Anterolateral Shoulder Pain
A patient presenting with anterolateral shoulder pain could be suffering from any of the following intrinsic disorders: 
- Shoulder impingement syndrome: The patient will generally complain of pain over the side/top of the shoulder more so with overhead actions involving end range abduction and flexion, it occurs when tendons or bursa are impacted by bones or other joint structures during normal or abnormal movement of that shoulder. It can lead to inflammation of rotator cuff tendons in the area as well as the bursa in the area, if left untreated further damage can begin to occur such as rotator cuff tendinopathy or tear as discussed below.
- Rotator cuff (RC) tendinopathy/ tear: Is basically defined as RC tendon pathology that originates within the RC tendons, usually as a consequence of overuse or overload (including compression). Overuse injuries can occur after repetitive forceful use of the RC muscles leading to damage and weakness, Overload injuries (generally tears), occur when the shoulder is taken past its anatomical/physiological range of motion again leading to damage (often more severe) and weakness, they may require surgical repair if damage is severe enough.
- Subacromial bursitis: this occurs when there is inflammation of the bursa in between the supraspinatus muscle and the rotator cuff tendons, it may be caused by trauma, irritation via tendons/other structures at the shoulder or it could be primarily a visceral cause. This inflammation usually causes pain along the front and side of the shoulder as well as some weakness.
- Acromioclavicular conditions: The AC joint is an articulation between the clavicle (collarbone) and an articulation on the shoulder blade. Pain originating from the AC joint may be due to trauma or could be secondary to altered shoulder movement patterns and even degeneration of the joint. This pain usually has a distinct presentation with patients generally pointing directly to the end of the clavicle, any movement of the scapula/ shoulder blade will more than likely exacerbate the pain
- Labral tears: The labrum is a piece of cartilage found in the socket of the shoulder joint, and tear or damage to this labrum will likely lead to pain around the anterolateral aspect of the shoulder and may have popping or clicking associated with it.
- Adhesive capsulitis: Frozen Shoulder occurs when the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, greatly restricting motion and causing chronic pain. Pain is usually constant, worse at night, and with cold weather. Certain movements or bumps can provoke episodes of tremendous pain and cramping. The condition is thought to be caused by injury or trauma to the area and may have an autoimmune component.
It is important to note that patients who present with poorly localised shoulder pain but have a normal shoulder examination need to be assessed for visceral pathology. Although uncommon, elbow conditions may also produce a referral pattern that is poorly localised. Immediate, appropriate diagnosis and treatment in patients with anterolateral shoulder pain is essential to ensure a speedy recovery. Once the condition is chronic, healing slows significantly resulting in markedly increased recovery times. Do not hesitate to contact us here at Synergy Healthcare if you are suffering from any type of shoulder pain!
