Shoulder pain is among the three commonest musculoskeletal complaints. Behind the same symptom sit entirely different conditions with entirely different treatments, which is why precise diagnosis matters so much here.
Telling them apart
Pain on raising the arm above shoulder height, weakness, and night pain when lying on the affected side point to a rotator cuff tear. Progressive loss of movement in every direction, including passively, means frozen shoulder. Sudden, severe pain arising without injury suggests calcific tendonitis. A sense that the shoulder is about to slip out in certain positions means instability.
Age as a guide
Under thirty, the problem is usually instability. Between forty and sixty, frozen shoulder and calcific tendonitis dominate, with a clear female predominance. Over fifty, rotator cuff tears become the leading cause. Beyond sixty, arthritis and fractures after a fall are added to the list.
Conservative treatment first
The large majority of shoulder conditions improve with targeted physiotherapy, activity modification and selective injections. Surgery has clear indications: a traumatic tear in a younger patient, recurrent dislocation, or failure of at least three months of properly delivered conservative care.
Conditions of the shoulder
- Rotator cuff tears
- Frozen shoulder
- Calcific tendonitis
- Traumatic shoulder instability
- Shoulder fractures
- Shoulder arthritis
See also shoulder surgery: arthroscopy and shoulder replacement.
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