1 | 2 | 3

What most people call the shoulder is really several joints that combine with tendons and muscles to allow a wide range of motion to the arm - from scratching your back to throwing the perfect pitch. Mobility has its price, however. It may lead to increasing problems with instability or impingement of soft tissue resulting in pain. You may feel pain only when the shoulder is moved, or all of the time. The pain may be temporary and disappear in a short time, or it may continue and require medical diagnosis and treatment.

This brochure explains some of the common causes of and treatments for shoulder pain, and how you can prevent it. Your orthopaedist (orthopaedic surgeon), a specialist in musculoskeletal conditions, can give you more detailed information.

What causes shoulder pain?
Most shoulder problems involve the soft tissues - muscles, ligaments, and tendons - rather than bones. And most of these problems fall into three major categories:

• tendinitis/bursitis
• injury/instability
• arthritis
• Other much more rare causes of shoulder pain are tumors, infection, and nerve-related problems.

Tendinitis
A tendon is a cord which connects muscle to bone or other tissue. Most tendinitis is a result of the wearing process that takes place over a period of years, much like the wearing process on the sole of a shoe which eventually splits from overuse. Generally tendinitis is one of several types:

• acute tendinitis following some overuse problem such as excessive ball throwing and other sports- or work-related activities.
• chronic tendinitis resulting from degenerative disease or repetitive wear and tear due to age.
• the splitting and tearing of tendons which may result from acute injury or degenerative changes in the tendons due to advancing age. Rotator cuff injuries are among the most common of these disorders. The rotator cuff is the arrangement of muscles and their tendons which provides shoulder motion and stability.
• Sometimes, excessive use of the shoulder leads to inflammation and swelling of a bursa, a condition known as bursitis. Bursas are fluid-filled sacs located around the joints which lessen the friction caused by movement of the shoulder. Bursitis often occurs in association with rotator cuff tendinitis. Sometimes the many tissues in the shoulder become inflamed and painful, limiting the use of the shoulder. The joint may stiffen as a result, a condition called a "frozen shoulder." Fortunately, with appropriate care, this condition will resolve itself.

1 | 2 | 3