Tenderness top of shoulder – Causes, Diagnosis & Treatment

Causes:

• Rotator Cuff Tendinitis/Tears: Inflammation or tears of the rotator cuff tendons, which surround the shoulder joint, are a frequent cause of tenderness, especially with overhead activity or reaching.
• Bursitis: Inflammation of the bursae (fluid-filled sacs) in the shoulder, such as subacromial bursitis, can cause localized tenderness, pain, and swelling.
• Muscle Strain/Tear: Strains or tears in the muscles of the shoulder or surrounding areas (like the deltoid, trapezius, or neck muscles) can cause tenderness and pain.
• Shoulder Impingement: Occurs when tendons in the shoulder are compressed by bone, leading to pain and tenderness, especially with overhead movements.
• Osteoarthritis: Degenerative joint disease can affect the shoulder joint, causing pain, stiffness, and tenderness.
• Cervical Radiculopathy (Neck Problems): Nerve irritation or compression in the neck can sometimes cause referred pain that is felt in the top of the shoulder.
• Fractures: Fractures of the clavicle (collarbone) or humerus (upper arm bone) can cause significant pain, tenderness, and swelling.
• AC Joint Injury: Injury to the acromioclavicular (AC) joint, where the clavicle meets the shoulder blade, can cause pain and tenderness at the top of the shoulder.

Diagnosis:

• Physical Exam: Careful examination of the shoulder, noting the location of tenderness, range of motion, strength, and any other abnormalities. Specific tests to assess the rotator cuff and other structures.
• Patient History: Gathering information about the onset of symptoms, any injuries, repetitive activities, other medical conditions, and medications.
• Imaging:
  • X-rays: To rule out fractures or arthritis.
  • MRI: May be used to visualize soft tissues like ligaments, tendons, and muscles, especially if a rotator cuff tear or other soft tissue injury is suspected.
  • Ultrasound: Can also be used to evaluate soft tissues.

Treatment:

• RICE (Rest, Ice, Compression, Elevation): Often the initial treatment for shoulder injuries and inflammation.
• Pain Relief: Over-the-counter or prescription pain medication.
• Physical Therapy: Exercises to improve strength, flexibility, and range of motion.
• Injections: Corticosteroid injections may be used to reduce inflammation in some cases, such as for bursitis or tendinitis.
• Surgery: May be necessary for some injuries, such as rotator cuff tears, fractures, or other conditions that do not improve with conservative treatment.
• Treatment of Underlying Cause: If the tenderness is due to an underlying medical condition, treatment will be directed at that condition.

Important Considerations:

• Seek immediate medical attention if you have severe shoulder pain, deformity, or are unable to move your arm. This could indicate a fracture or dislocation.
• Consult a healthcare professional for persistent or unexplained shoulder tenderness. Do not attempt to self-treat without consulting a doctor. Early diagnosis is essential for effective treatment and to prevent complications.