Shoulder Pain
The shoulder joint is a synovial ball and socket joint (glenohumeral joint) in which the head of the humerus fits into the socket of the scapula. It is the most mobile joint of the human body and is surrounded by multiple soft tissue structures that can be damaged. Shoulder pain can arise from damage within the:
Shoulder Joint
Due to osteoarthritis, rheumatoid arthritis, trauma, infection, inflammation.
Bursa
- Subacromial-subdeltoid bursa (between the joint capsule and deltoid muscle)
- Subacromial bursa (between the joint capsule and the acromion)
- Subcoracoid bursa (between the joint capsule and the coracoid process of the scapula)
- Coracobrachial bursa (between the subscapularis muscle and the tendon of the coracobrachialis muscle)
- Subscapular bursa (between the joint capsule and the tendon of the subscapularis muscle)
Rotator Cuff Muscles
The shoulder joint lacks strong ligaments and is a muscle-dependant joint. The main stabilizers of the shoulder include the tendons of the rotator cuff muscles (supraspinatus, infraspinatus, subscapularis, teres minor) and the tendon of the long head of the biceps brachii. Injury to any of these structures (ie strain, sprain, tear) can cause pain.
The nerves supplying the shoulder joint arise in the brachial plexus. The main nerves include the suprascapular nerve, axillary nerve and the lateral pectoral nerve. The suprascapular nerve provides sensory innervation to the acromioclavicular joint and the glenohumeral joint (shoulder joint). This nerve is often targeted and a suprascapular nerve block with rhizotomy may provide significant relief of shoulder pain. The suprascapular nerve also provides motor innervation to the supraspinatus and infraspinatus muscles.
Steroid injections into the affected bursa may provide significant relief if the majority of pain is secondary to bursal inflammation (bursitis).
Helpful Resources:
- Musculoskeletal Australia: Shoulder pain information
- RACGP: Shoulder pain information
- Educational video: Bursitis
- Musculoskeletal Australia: Managing your pain
- The Pain Toolkit
DisclaimerThe above information is for general education only and is not intended as a substitute for your own independant health advice. At Western Pain clinic we comprehensively assess each patients pain condition and provide advice using the latest evidence-based treatments. If you would like to find out more information about shoulder pain, please discuss this with our doctor during your consultation.