Shoulder pain due to numerous causes

Seek medical attention if there is significant pain in the shoulder following an acute injury.
Seek medical attention if there is significant pain in the shoulder following an acute injury.PHOTO: ISTOCKPHOTO

Q Some time ago, I woke up with a lot of pain in my right shoulder. I could not lift my arm. The pain was horrible. I also could not brush my teeth, shave or comb my hair.

After going to a traditional Chinese medicine (TCM) practitioner for acupuncture and tuina treatments, I felt better.

But the pain returned the next morning. I then went to a general practitioner, who prescribed painkillers and anti-inflammatory pills. Since then, I have gone to see my doctor twice and my TCM practitioner thrice, but the pain, although reduced, is still there. I still feel very uncomfortable. Is there a cure for this?

A The shoulder is the most mobile joint in the body and consists of several joints, combined with tendons, muscles and ligaments.

The pain in this area can be due to numerous causes. It may originate from the joint itself or from the surrounding muscles, ligaments or tendons.

Most shoulder problems fall into one of these categories - tendon inflammation or tear, arthritis, frozen shoulder, instability or fracture.

Less common causes include an infection, tumour or pain that is caused by a neck problem. Occasionally, it can be the result of heart or gall bladder disease.

If the pain is mild or improving, it may be safe to continue observing it for a few days to see if the pain resolves over time. However, if there is significant pain in the shoulder following an acute injury, you must seek medical attention.

The inability to lift the arm, accompanied by shoulder pain, suggests an inflammation or tear of the rotator cuff, the group of muscles and tendons that surrounds the shoulder joint.

When this happens, it is advisable to see an orthopaedic doctor for further evaluation.

Advanced imaging studies such as an MRI (magnetic resonance imaging) scan may be recommended to help identify the problem. Further treatment will depend on the specific diagnosis.

Dr Dennis Ng
Associate consultant, division of shoulder & elbow surgery, University Orthopaedics, Hand & Reconstructive Surgery, National University Hospital.

A version of this article appeared in the print edition of The Straits Times on January 10, 2017, with the headline 'Shoulder pain due to numerous causes'. Print Edition | Subscribe