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the arm to be positioned in various locations by the
para-scapular muscles such as the rhomboids and
the levator scapulae. The whole process has to be
well coordinated to allow us pain free function of the
shoulder.
Additonally, the nerves which go to the arm and hand
( from our cervical spine) pass just under the shoulder
joint via our “arm-pit” and a pinched nerve in our
neck may lead to pain being felt in our shoulder: a
radicular type pain, that is perceived as coming from
the shoulder but really originates in our neck.
In-coordination of the muscular
mass that controls our shoulder
and arm movements may lead to
the muscles or tendons rubbing on
the undersurface of the acromion
process ( i.e. the hard bone just
under the tip of the shoulder) and
cause impingement syndrome
which is an inflammatory condition
that may lead to pain in certain
arm positions and a nagging pain
that is worse at night. This process
may progress to the stage where
our bodies (some people are more
susceptible to this phenomenon)
lay down calcium deposits in the
irritated tendon that leads to calcific
tendonitis.
The hallmark of this calcific
tendonitis of the shoulder is acute
flare ups of pain for no apparent
reason: “I haven’t done anything
unusual or injured my shoulder
so why is it paining so much?”
Further, chronic impingement may
lead to a wearing out of the tendon
(commonly the supraspinatus
tendon ) and to an actual rotator
cuff tear which may result in a loss
of motion of the arm or prior to
this pain with use of that arm in an
overhead position such as hanging
clothes on the line or putting
objects into a high cupboard.
Some people may be affected by a
painful shoulder and loss of motion
due to “frozen shoulder” which is
a completely different condition
due to a “seizure “ of the joint that
affects females mainly especially in
the 5th decade, diabetics, people
who have had trauma or operations to the arm.
Your Orthopaedic Surgeon will be able to consult with
you, examine your shoulder and review the relevant
investigations to determine exactly what is the cause
of your shoulder pain so that the appropriate treatment
can be applied to relieve the pain and improve the
function of your shoulder.
