Monday, 15 August 2016

The causes of shoulder pain

There are several reasons may lead to shoulder pain, namely:

bad situation poor posture.

frozen shoulder frozen shoulder. It is a painful medical condition, which reduces the joint on the natural movement ability, and may lead to prevent movement of the joint completely sometimes.

rotator cuff disorders rotator cuff disorders. Rotator cuff is a group of muscles and tendons surrounding the shoulder hinge, helping the firmness and stability.

  precarious or no shoulder shoulder instability stability. Shoulder be in this situation is fixed, and may be a major area of his abnormally (hyper hypermobility) movement.

acromioclavicular joint disorders acromioclavicular joint disorders. A group of health conditions, from which osteoarthritis (joint) osteoarthritis, which affects the acromioclavicular joint acromioclavicular joint roughness, which is detailed at the top of the shoulder.

osteoarthritis (joint) osteoarthritis, which affects the shoulder joint roughness.

  bone fractures broken (fractured) bone, such as broken humerus humerus or clavicle collarbone.

It may not result in shoulder pain in some cases there is a problem in the shoulder joint, but may be due to a problem in another area, such as the neck neck that may feel the pain caused by it in the shoulder and upper back.

Frozen shoulder

Frozen shoulder frozen shoulder, which is defined by inflammation adhesive capsulitis adhesive capsulitis, too, are a constant and painful stiffness in the shoulder joint, moving the lead to make the shoulder joint fully within the normal scope very difficult.

Frozen shoulder injury appears when a thickening and swelling in the tight elastic fabric Ocean hinge shoulder. This leads to a narrowing of the movement into the humerus in the shoulder joint, making a cruel and painful movement.

 The person may find it difficult to do everyday duties, Kartdae clothes or taking a shower or driving a car or sleep comfortably, where some people are unable to move for Ktefhm completely.

Can be symptoms of frozen shoulder vary widely, but they tend to worsen gradually and slowly, where he develops a sense of it in three stages over several months or years usually.

 Frozen shoulder symptoms

The constant pain and stiffness in the shoulder joint presentations to major shoulder injury frigid.

This is what makes it difficult and painful to do by moving the shoulder joint natural motion within the entire area is possible
.

These symptoms vary the intensity of light that lead to a slight difference in the performance of daily duties, severe symptoms that may lead to a complete prevention of the movement of the shoulder.

Should see a doctor when suspected frozen shoulder, or when feeling constant pain in the shoulder limiting his movement.

 Stages of infection frozen shoulder

Worsen the symptoms of frozen shoulder gradually over several months or years usually.

It occurs in three separate stages, but may be difficult to distinguish between those stages in some cases. These symptoms may also vary greatly from one person to another as well
.

 - The first stage

This phase is called phase "start freezing or freezing stiffness" Often where he begins feeling the pain of the shoulder, and increase the intensity too much when you move your hand to deal with things.

Exacerbated the pain during the night or when you lie on the affected side often. This phase may last from 2-9 months.


- The second phase

This phase is called phase "occurrence of freezing frozen" often, where you may grow stiff shoulder, but the pain does not usually worsens, it may even decrease.

Shoulder atrophied muscles may start a little bit, because of the lack of use. And continue this stage of typically 4-12 months.

- third level

This phase is called phase "softening thawing", where it becomes possible to move the shoulder a little bit and gradually during this period. The pain starts to decline, although they may return despite a drop in sometimes stiffness.

The person may not be able to restore his ability to move his shoulder completely, but it will be able to perform many of the duties. These could phase of 6 months to continue for several years.
 Risk factors frozen shoulder

Most frozen shoulder cases occur in people over the age of 40 years.

It is still the cause of frozen shoulder is perfectly understandable, but there are a number of risk factors that increase the likelihood of injury. They include the following
:

surgery or shoulder injury shoulder injury or surgery. Install the arm and shoulder for a long period of time; for example, during the period of recovery from injury or surgery in the arm.

  diabetes mellitus diabetes. A person with diabetes are more susceptible to frozen shoulder, but the cause of it is still incomprehensible.

• Other medical conditions, such as heart disease, pulmonary and overactive thyroid hyperthyroidism and Dupuytren's contracture Dupuytren's contracture.

 Rotator cuff disorders

Rotator cuff rotator cuff - as already mentioned - is a group of muscles and tendons surrounding the shoulder hinge. Muscle tendons and tendons are solid rubber ropes, connects muscle to bone.
It keeps rotator cuff on the joint in the correct position, and allow him to move, controlled manner.

Can cause different types of rotator cuff disorder emergence of different symptoms, the general characteristics are:

• Pain is aggravated when doing activities which will be higher than shoulder level arm level, for example, when the hair layoffs.

  feeling pain when you move your arm in an arc away from the body.

feeling pain in the front and side of the shoulder.

feeling pain during the night.

The following explanation of the different types of rotator cuff disorders, and the reasons for their occurrence:


Tendinitis and bursitis

 Tendonitis tendinitis is an inflammation (or swelling swelling) affects the gut muscle tendon. And bursitis bursitis is an inflammation of the bursa bursa, which is a small sack filled with fluid, and there are over joints and the tendons and bones normally.

Resulting folliculitis and Uttar rotator cuff for irritability and confusion caused by the occurrence of a shoulder injury or overuse of the shoulder usually.

 For example, it can infect these cases, the person who requires him to do things to raise the top, or the athlete who competes in sports chucking, Carmi javelin or discus.

Any kind of injury in the shoulder joint and may lead to inflammation in the tendons or bursa, which means the area that can move with the joint between the tendons and muscles shortages.

If jammed tendons or muscle or surrounding tissue between the shoulder blades, any repetitive movement will Ahejeha.

 Inflammation of the tendons and bursa is happening at the same time often. And it called the situation in which the trap tendons and bursae between the bones "impact syndrome impingement syndrome" often.

When repeated scratching tendon bones of the shoulder, it becomes weak gradually, has been torn apart in some cases.


Disruptions

Result in injury to the muscle or tendon rupture to feel severe pain, and may lead to a weakening of the arm and shoulder. And you can feel some people crackling or popping when moving them to the shoulder.

 The rupture of tendons of the most common cases in people over the age of 40 years. While the resulting disruptions that affect younger people often are not all accidents. The disruptions that afflict older people for older Vtndjem syndrome crash often.

Estimates indicate that about 50% of people over the age of 60 years, suffering from partial ruptures or college in the rotator cuff, because these tendons become weaker with advancing age person.

 Rotator cuff syndrome

The term "syndrome rotator cuff rotator cuff syndrome" to describe any kind of damage that may affect the tendons in the rotator cuff, which include the full ruptures complete tears.

Precarious or shoulder instability

Shoulder joint consists of a detailed hollow with the ball. Where the summit will be the upper arm bone (humerus) is a ball, which enters a cavity adapted to the scapula.

Shoulder instability occurs when the spherical part of the shoulder joint is not moving properly within the cavity. The degree of injury can range from feeling plunge slipping shoulder, a dislocated shoulder full, and that the ball completely out of the cavity.

Symptoms of shoulder precarious vague may be sometimes. It describes people with Ptqkul or lack of shoulder symptoms, their symptoms as resembling "arm dormant dead arm" Often, such stability:

  Prods tingling.

• weakness weakness.

Alakhaddrar (numbness) numbness.

fatigue shoulder shoulder fatigue.

• Feeling Btqtqh clicking or closing, locking or popping Balfrqah.

When this happens shoulder dislocation (the ball out of the cavity), symptoms can be as follows:


severe pain.

  a clear change in the status of the arm.

• Feeling muscle contractions painful.

limited movement of the shoulder.

Types of precarious or shoulder instability

There are two types of precarious shoulder, namely:

complacent traumatic, where the shoulder is forced to get out of the place the impact of a sudden hit.

Allarda atraumatic. Shoulder out of his place gradually over time.

The resulting precarious shoulder complacent about the occurrence of an accident often.
While the resulting precarious shoulder Allarda repetitive arm movements, such as throwing or swimming.

Shoulder precarious happens when people who have not attained 35 years of habit.

Acromioclavicular disorders clavicular

 Acromioclavicular joint acromioclavicular joint is the joint located at the top of the shoulder (not the detailed ball and socket). Acromioclavicular joint disorders include potential clavicular happen the following cases:

osteoarthritis (joint) osteoarthritis roughness. A condition in which the joints become painful and stiff, and is the most common reason for the occurrence of disorders acromioclavicular joint.

rupture or stretch acromioclavicular joint ligaments. Ligaments ligaments are harsh tapes of connective tissue that connects the Azemin in the joint.

 Symptoms include joint disorders acromioclavicular the following:

pain in the joint.

determine the movement of the joint.

feeling the pain at the top of the shoulder.

It may be happening dislocation of the acromioclavicular joint and clear through the change in the status of the shoulder.

The risk of disorders acromioclavicular joint factors

The detailed acromioclavicular disorders are more common in men aged between 20-50 years.

And increased risk of this condition in people who practice extreme sports friction, Kalrgbe rugby.

Also it increases the risk of disorders acromioclavicular joint in people who were exposed to the fall of the Ktefhm, for example, during a skiing accident on the snow.

 Diagnosis of shoulder pain

The doctor can diagnose the cause of shoulder pain by discussing the symptoms with the patient and examination of the shoulder. There may be a need to conduct tests in some cases.

The doctor needs to know the exact position of the pain, as well as to know the following information:

a person of any recent injuries.

All the things that mitigate or aggravate the severity of the pain.

worsening of pain during the night.

• Does the pain be gradual or sudden.

the impact of pain in the course of daily life, such as feeling it during work or during exercise.

suffering from any other symptoms.

Clinical examination

Being a doctor examined clinically Mntefh shoulder, through carrying out the following steps:

make a comparison between the shoulders.

investigate the existence of any redness or swelling or bruising.

investigate the existence of dislocation of the shoulder joint, where the status of the shoulder is normal when there is injury.

palpate joints and bones of the shoulder to see if it causes any pain.

 Arm movements

The doctor of the person may be asked to do certain movements in the arm, such as placing your hands on the back of the neck and guidance elbows to the sides. And it helps the performance of this type of movements that cause pain for the doctor to determine the underlying cause of the feeling of pain.

Surveys

Your doctor may refer the person to the hospital for tests, when there is a need to make any graphic tests, so as to get more details about the shoulder, or when you need to perform blood tests also.

  X ray

There may be a need for an X-ray image, or a study to examine the inner part of the shoulder joint and to exclude the presence of other problems, where X-rays are used to detect problems in the bones.

Magnetic resonance imaging

Using MRI A magnetic resonance imaging (MRI) scan, magnetic fields and strong radial waves to produce detailed pictures of the body, which is particularly useful for imaging soft tissue, Kaloothar and ligaments.

Ultrasound

Using ultrasound ultrasound scan high-frequency sound waves to form a picture of the internal parts of the body, and can be used to diagnose problems that affect the joints, ligaments and tendons.

Blood tests

Can be a sample of a blood test to rule out cases of infection may cause pain in the shoulder or similar symptoms, such as:

rheumatoid muscle pain polymyalgia rheumatica. A case where the infected tissue inflammation of joints, leading to the emergence of some of the symptoms, such as stiffness and muscle pain


tumors cancerous tumour.

diabetes mellitus diabetes. A condition caused by a large rise in blood sugar, which increases a person's risk of frozen shoulder.

Persons exposed to infection shoulder pain

The unrest in the shoulder are common to some extent, where it gets about 30% of adults at some point.

The incidence of frozen shoulder and rotator cuff disorders are more common in people in middle age and in the elderly. While younger people are more susceptible to Ptqkul shoulder and acromioclavicular joint disorders, especially men who have:

sports that include repetitive movements of the shoulder, such as a bowling alley where the arm above the shoulder or flinging lifted.

sports require physically friction, such as rugby, in which a person may become infected or fall on his shoulder.

Treatment of shoulder pain

There are several types of treatment for shoulder pain, according to the cause of pain, and symptoms that suffers from an infected person.

May help to use compresses packs hot or cold and analgesics to relieve pain, treat minor injuries in the home.

But, it should see a doctor if the pain caused by injury, particularly severe, or when no improvement after several weeks.

The doctor converts the patient to receive the orthopedic surgeon orthopedic surgeon or a rheumatologist rheumatologist at the injury, including the following:

  frozen shoulder.

rotator cuff disorder.

acromioclavicular joint disorder.

torn rotator cuff.

precarious shoulder at less than 30-year-old person.

Treatment Options

 Home treatment options for shoulder pain include:
Avoid doing activities that aggravate symptoms.

• Use ice packs.

use of pain relievers.

• Use anti-inflammatories.


Physical therapy.

expansion filming hinge (water expansion) arthrographic distension (hydrodilatation).

surgery (in some cases).

In addition to pain, the patient may have a lack of strength or shoulder movement. In this case, you may use a combination of different treatments.

Avoid doing activities that aggravate symptoms

The doctor may suggest a person to avoid certain activities or movements could lead to a worsening of symptoms, depending on the activities or movements that cause a person feeling the pain of the shoulder.

For example, it should be in the early painful injury phase shoulder frozen, the doctor person advised that to avoid doing activities that require lifting the arms above the head and tensile strength; however, it should continue to use the shoulder in other activities, because keeping it steady may lead to a worsening of symptoms .

 It can be a person who is suffering from precarious shoulder to avoid carrying out any movements are advised is likely to aggravate the injury, such as throwing with the lifting arm overarm throwing or pressure couch bench pressing.

We should also tip the person who suffered sprains acromioclavicular joint that avoids doing activities that do include moving the arm in front of the body (such as swinging in the game of golf, or weight lifting).

 You must be maintained on the use of shoulder strap through simple tasks as much as possible, but we should avoid doing lifting weights and practicing violent sports for a period ranging between 8-12 weeks. There may be a need for the use of a supporting strap (scarf sling) to support the arm for a period of at least one week after the injury, too. The osteoarthritis (joint) osteoarthritis roughness of the most common joint disorders acromioclavicular reason.

Compresses the snow

Can, in the event of a shoulder injury during the exercise, as the application of snow on the place of the injury to reduce pain and inflammation.

Compress the ice should be applied for between 10-30 minutes. Packaging can be ice bag moist towel to avoid direct contact with the skin, which may result in occurrence of skin burns excessive cold.

 pain killers

It may be the use of painkillers, such as paracetamol or codeine codeine, enough to relieve pain if it lightly. However, the drug should be used according to the dosage instructions on the medication tray, making sure the appropriateness of the medication to the injured, and not to use a larger dose than the dose required.

If shoulder pain more severe, your doctor may recommend the use of a anti-inflammatory drugs non-steroidal non-steroidal anti-inflammatory drug (NSAID), Kalaabobrovin or diclofenac or naproxen.

 In addition to relieving pain, non-steroidal anti-inflammatory drugs may help to relieve swelling in the shoulder-winning portfolio, where Tkout greater effectiveness when used regularly, rather than be used only when symptoms are severe.

Corticosteroids tablets

Corticosteroids corticosteroids are medications containing steroids (which is one of the types of hormones). And hormones strong chemicals that possess a wide range of effects in the body, including relieving pain and swelling.

 Disks can be used steroid corticosteroid tablets in the treatment of frozen shoulder. Some evidence suggests that these discs may help to ease the pain for a short period of time not exceeding a few weeks, but it is not clear whether the use of corticosteroid tablets better than other treatment options, such as injectable steroid corticosteroid injections.

Injected corticosteroids

It may not be the use of oral pain relievers enough to relieve shoulder pain when it is very severe.

Can help injected corticosteroids in and around the shoulder joint to relieve pain, increase the field of shoulder movement for several more weeks, but it is not these injections can heal completely this case, the symptoms may reappear gradually.

 Some researchers believe that it should delay use of injected corticosteroids as long as possible, where a few of the available evidence indicates that this is an effective treatment. However, it may help to relieve pain, allowing the use and rehabilitation physical therapy more effectively.

Warnings

The person who injection of corticosteroid side effects at the injection site may suffer, including:

temporary pain temporary pain.

• Lighten lightening the skin color of skin.

thinning of the skin thinning of skin.

 It may cause a lot of use of corticosteroid injections for shoulder damage. Therefore, you can use this type of treatment is limited to three times during the year for a maximum of one shoulder.
Injection Alheiarunat

Alheiarunat Hyaluronate another drug that can be injected into the shoulder to treat shoulder pain. One study found that injection of this drug was useful for pain relief.

But, do not advisable to use this drug in the treatment of osteoarthritis (joint) osteoarthritis roughness, because the benefit of using Alheiarunat were few when compared to the best benefit of the use of corticosteroid injections. Therefore, you may not be used Alheiarunat in the treatment of shoulder pain.
 the physical treatment

Physical Therapy Physiotherapy uses a number of different physical methods to achieve healing.

These treatments are divided into two sections:

sporting quality of the shoulder exercises; for example, you can train a person Ptqkul shoulder to conduct exercises to strengthen the shoulder.

Massage, where using a specialist physical therapy hands shoulder treatment.

Shoulder Exercises

It should maintain the person who is suffering from shoulder pain on his shoulder carried lightly, and slide gently; it could lead to the non-use of the shoulder muscle atrophy and the worsening state of stiffness. Therefore, we should continue to use the shoulder as normally as possible.

If a severe shoulder stiffness, the exercise may be painful. Therefore, the doctor or specialist physical therapy patient training to perform calisthenics do not cause additional damage to the shoulder.

The patient may be trained to perform calisthenics to perform at home, or they may be completed to make these exercises under the supervision of a doctor or a specialist physical therapy. You can also use manual therapy Manual therapy, where the health care provider by moving the arm instead of a person. And used in manual therapy especially to move the joints and soft tissues in the shoulder ways.

It has been found, when reviewing a number of studies, that the benefit of using physical therapy for a long period equivalent to the benefit of surgery for those suffering from the impact impingement syndrome syndrome.

 The doctor may suggest the use of expansion Beltsoar hinge in the treatment of frozen shoulder, where he injects a special liquid can be clearly seen in the X-ray images X-rays within the shoulder joint at the beginning of the procedure. Under continuous X-ray guidance, injected a mixture of liquid saline brine with a corticosteroid and a local anesthetic into the shoulder joint. It takes to do this procedure is usually 15 minutes, being under the influence of a local anesthetic, and the injured person may return to his home in the same day. Resorting to physical therapy may be necessary after that to help recover a good portion of the field of shoulder movement.

Frozen shoulder surgery

The patient may be referred to a surgeon when other treatments have failed to measure frozen shoulder. There are two possible surgical procedures Nscherhaa are as follows:

Maneuver or manual processing

This method of moving the injured shoulder during the period of undergoing general anesthesia, where they are moving and gently stretch the shoulder during anesthesia.

You should then apply physical therapy to maintain shoulder movement normally. You can resort to the use of the manual method manipulation if the patient found it difficult to cope with shoulder pain, with the inability to move.

   Edit portfolio Ptnzir detailed

There is an alternative to the manual method of procedure, the liberation of the portfolio Ptnzir detailed arthroscopic capsular release, and is one of the types of laparoscopic surgery, where the surgeon begins the surgery after he make a long incision less than 1 cm. And enter through a special probe opens whereby shoulder portfolio shrinking, and eradicate any tapes of scar tissue scar tissue. We must do this leads to an improvement of symptoms dramatically.

  Similarly to what happened after you apply the manual method, it should be applied to physical therapy after surgery to help restore full movement of the shoulder joint.

Torn rotator cuff surgery

Can resort to surgery to repair a torn rotator cuff if a major disruption or if other treatment options have failed after use for a period of 3-6 months. It is likely to lead the surgery early to heal the situation faster, despite the fact that current research does not assert the usefulness of surgery early.

It can, through the implementation of this procedure, a small amount of scraping the bones of the shoulder. You can eradicate the tendons and bursae (bags filled with fluid and there over the joints between the tendons and bones) are also affected. This is what creates the largest intra-articular space allows freedom of movement of the rotator cuff.

 Can the surgery in one of the following methods:

Open surgery, open surgery. Being a large incision in the shoulder.

open surgery mini-mini-open surgery. Being a small incision in the shoulder.

surgery Ptnzir detailed arthroscopic surgery. It is one of the types of laparoscopic surgery in which the camera is used to view the inside of the shoulder joint.

  Anecdotal evidence suggests the return of persons who have had a small surgery to open their month of the return of persons who underwent open surgery before.

As is the case after a frozen shoulder surgery, it should be used in physical therapy after surgery to help restore joint movement of the shoulder completely.

 Shoulder surgery precarious (shoulder instability)

If a person is suffering from severe or recurrent shoulder dislocation, it may be necessary to undergo surgery to prevent this from happening again, and to prevent damage to the nerves and tissue surrounding it. You can determine the type of surgical procedure according to the type precarious shoulder suffered by the victim as follows:

tighten the laces Alemtemtth or re-connected when torn.

tighten the shoulder sutures stitches portfolio.

 Surgery can be performed precarious shoulder either way laparoscopic or open. It is necessary to install the shoulder for several weeks after surgery, using a special scarf. You should use physical therapy to strengthen the shoulder muscles. Complete healing of the situation and may take several months.

 Replace (or bridge) scapuloclavicular infected osteoarthritis

The Knuckle Joint replacement therapy to replace the treatment, also known as bridging joint arthroplasty, the most common treatment for the treatment of osteoarthritis (roughness detailed) in the shoulder, where the surgeon during the joint heal the process of removal of the affected joint and replace it with a hinge artificial (alternative) is made of plastic and metal materials in particular. The artificial joint can use for up to 20 years, only to be replaced may be necessary in the end.

 Shoulder ousted

Should immediately go to the nearest Department of accidents and emergencies when a dislocated shoulder.

The health care providers at the hospital to re-highest football arm bone (humerus) to the joint cavity. This procedure is called to respond reduction.

After doing to respond, it is necessary to make the arm using the ribbon for a few weeks, and can be used to dilute medications for pain, too.

Healing usually requires the application of a run of physical therapy containing the exercise to restore strength to the shoulder muscles.

 When should you see a doctor

You should see a doctor when the pain caused by a severe injury, or when it is not showing signs of improvement after two weeks after the occurrence of the injury.

Shoulder pain may be long-term problems, where the percentage of people who continue to suffer from symptoms after 18 months of treatment on their use to 50%. Proper diagnosis will ensure that the person get the right treatment.

   


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