Am I Likely To Get Back Pain
Several factors can increase your chances of having upper and middle back pain. Among them:
- Age.Back pain starts for most people in their 30s or 40s, and itâs more common the older you get.
- Being out of shape. The stronger the muscles in your back, shoulder, and abdomen, the lower your chance of injury.
- Weight. If you carry extra pounds, you put more strain on your back.
- Underlying conditions. Diseases such as arthritis and cancer can cause back pain.
- Smoking. Smokerâs cough can strain your back. And if you smoke, you may be slower to heal, which can make your back pain last longer.
Physiotherapy For Shoulder Pain
The number of physiotherapy sessions you may have depends on the cause of your shoulder pain.
If you’re still in pain after your sessions end, go back to the GP. They might prescribe more physiotherapy or suggest another treatment.
Physiotherapy is available through the NHS, but waiting times can be long. You can also pay to get physiotherapy privately.
What Tests Are There
Blood tests arent usually needed for most shoulder problems, but theyre sometimes used to rule out other conditions, including some types of arthritis.
X-rays are good for looking for problems with the bones in your shoulder and minor changes in the joints. However, small changes are quite common and may not be the cause of your trouble.
X-rays can only show bones and other hard substances, but they wont show injuries to soft tissue like muscles.
An ultrasound scan can show swelling, as well as damage and problems with the tendons, muscles or other soft tissues in the shoulder. It uses high-frequency sound waves to examine and build pictures of the inside of the body.
You may be referred for magnetic resonance imaging scans if your doctor suspects a more complex problem with the soft tissue in your shoulder. An MRI uses radio waves to build a picture to show whats happening to the bones and soft tissue, such as the muscles and tendons, inside your shoulder.
Sometimes dye is injected into the shoulder before the MRI to get a clearer picture especially in cases of shoulder dislocation.
Nerve conduction studies can show whether your problems are being caused by the nerves in your arm being pinched or irritated.
They measure the electrical activity in the muscles and nerves. Its common to feel slight pain or discomfort, like a tapping on the skin, but the test doesnt last long.
Some of the specific conditions that affect the shoulder include:
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Some Shoulder Conditions May Become More Common As You Age
You probably don’t think about your shoulders much, until you suddenly experience pain in one of them. Shoulder pain can make a simple act brushing and drying your hair, reaching behind your back to fasten a bra, or grabbing something overhead seem like a monumental task.
As you age, you’re more likely to experience shoulder pain from a variety of common conditions. The pain can come on gradually or abruptly, and it may range from mild to excruciating.
Below are some of the most common conditions you may encounter, and some tips for how to address them.
What to do if your shoulder hurts
If you do experience shoulder pain, it’s not always possible to figure out the cause. Sometimes problems in other parts of the body are actually the source of the pain, which then radiates to your shoulder. This can happen with certain neck problems, including arthritis and disc herniations.
In general, if you are experiencing a lot of pain or know you injured yourself, it’s best to see a doctor right away to have your shoulder condition diagnosed.
But if you have general, mild shoulder pain, try adjusting your activities, taking acetaminophen or an over-the-counter nonsteroidal anti-inflammatory drug, and performing mild stretches to see if the pain improves on its own. However, if the pain is getting worse or doesn’t go away after a few weeks, you should consult your doctor.
Common Causes Of Pain Under The Shoulder Blade
There are many reasons you might be experiencing a nagging ache or soreness under the shoulder blades. It may hurt due to inflammation from injury or overuse. This is often noticeable at onset or gradually after you have been active. It may feel painful due to radiating pain from another body part or structure, such as from the neck, spine, or shoulder. Here are some of the most common causes.
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Signs And Symptoms Of Shoulder Pain
There may be many causes of shoulder pain. They all have their own unique set of symptoms.
People with shoulder pain can experience pain deep in the shoulder joint, in the back or the front of the shoulder and the upper part of the arm. Sometimes the pain in the shoulder can be described as a catching pain. The location and type of pain is likely to relate to the structure causing the pain.
In some conditions there may be reduced movement, and moving the shoulder may cause you to feel pain. A feeling of weakness of the shoulder/upper arm is also common.
Depending on the condition, there may be a sensation of the joint slipping out and back in to the joint socket, or the shoulder can become completely dislodged . Some people may experience sensations of pins and needles and burning pain. This is more likely to be associated with nerves from the neck than the shoulder joint itself.
Lack of movement after a shoulder dislocation is usually due to pain. Complete rotator cuff tears and injury to the axillary nerve both cause weakness in moving the arm away from the body. These problems require close clinical examination.
Video: Cervical Herniated Disc
A cervical herniated disc occurs when the inner portion of a disc in the cervical spineor neckruptures through the outer wall of the disc.Watch Now
A herniated disc in the cervical spine occurs when a discs outer layer tears and the inner layer starts to leak outward. A disc herniation can cause pain and may inflame a nearby nerve root that radiates pain down into the shoulder, arm, and/or hand. A disc herniation in the lower cervical spine is more likely to radiate pain into or near the shoulder blade area.1 While less common, its also possible for a disc herniation in the thoracic spine to cause pain near the shoulder blade.
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How Does The Shoulder Work
Your shoulders each have two joints, making them the most flexible parts of your body.
The main shoulder joint the glenohumeral is a ball-and-socket joint. Its called this because the top of the upper arm bone the humerus is shaped like a ball. This ball fits into the shoulder blade bone, which acts as the socket, giving your shoulder a wide range of movement.
But, the shoulder socket is very small, compared to other ball-and-socket joints, such as the hip. Its held together and controlled by a covering of muscles, which are secured to the bones by strong cords called tendons.
These muscles and tendons form a capsule around the joint and support its movements, but can make it more likely to dislocate than other joints.
Inside the capsule is the synovium, which produces fluid that lubricates the joint and keeps the cartilage healthy. The cartilage helps protect your bones from any impact and sits between the bones of your shoulder joints to stop them rubbing together.
Above the main shoulder joint theres a smaller joint where the top of the shoulder blade the acromion meets the collar bone.
This is known as the acromioclavicular joint. It helps the larger joint below to move through its full range, particularly when youre raising your arm, lifting or throwing.
Shoulder Pain And Scoliosis
One of the early warning signs that scoliosis is present is an asymmetry of the shoulders: one can appear to sit higher than the other. Especially when bending forward, it becomes more noticeable if one shoulder blade is protruding more on one side than the other.
So does the postural effect that the shoulders experience produce pain, or does scoliosis just make them look different, but not necessarily feel different?
There are a lot of uneven forces at work with scoliosis, so when a patient is struggling with shoulder pain, its most likely going to be the shoulder that isnt subject to the postural shift. For example, if a patients curvature bends to the left, its going to be the right shoulder thats most likely to feel the affects, and vice versa.
This is because the normal shoulder is trying to compensate for the uneven force of the tendons and muscles working to move the spine back into a healthy alignment.
If left untreated and to progress, scoliosis can start to affect both shoulders as the body tries harder to adjust to the unhealthy spinal curvature.
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What Are The Symptoms Of Neck Pain
If your neck hurts, you may notice other symptoms including:
- Pain that gets worse when you hold your head a certain way while working on a computer, driving, or doing other tasks
- Muscle tightness or spasms
- Do you have numbness or weakness in your arms or hands?
- Does moving your neck in a certain way make things better or worse?
- Does coughing or sneezing make the pain worse?
Youre Short Of Breath
Rarely, upper back pain may be due to a punctured lung, which can be caused by an injury. While it is less likely to be the cause of your discomfort, a punctured lung is something you need to know the signs of so you can take the right action. If the pain is accompanied by shortness of breath or severe pain taking a deep breath, seek urgent medical care, advises Dr. Chang.
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Physical Activity To Strengthen Back Muscles
Weak shoulder blade muscles can induce pain. Therefore, you need to include physical activity that can strengthen the different areas in your back. You can perform pull-ups, pushups, and sit-ups to strengthen the weak muscles in the abdomen and back region. So, try to include the exercise in your daily routine to get relief from the pain.
Relieving The Pain Under Your Shoulder Blade
Pain under your shoulder blade can be a sharp or burning pain near the spine, or more of a deep aching sensation that spreads across the shoulder or upper back. When shoulder blade pain persists, it can affect quality of life and limit arm and back movements. Here are 5 ideas that may help ease your pain.
If pain underneath the shoulder blade develops without any signs of an emergency, most people can safely try to alleviate the pain on their own using self-care treatments. ReadEarly Treatments for Upper Back Pain
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Herniated Or Bulging Discs
Degenerative disc disease in the cervical spine or thoracic spine can irritate or press on your nerves or spine. This can lead to pain between your shoulders.
Other symptoms of a herniated disc include:
- Pain in one or both arms
Sometimes pain caused by disc disease in the neck is positional, meaning it can get better or worse when you flex or extend your neck.
Symptoms Of Upper Back Pain
Symptoms can vary from person to person and depend on whats causing the pain. The pain can be mild or more severe. You might have sharp pain in one particular spot or a general achiness that comes and goes. Back pain that doesnt have a clear or known cause is called non-specific back pain.
If your back pain is significantly affecting your daily activities or stopping you from getting a good nights sleep, see your physiotherapist or GP.
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Urgent Advice: Ask For An Urgent Gp Appointment Or Get Help From Nhs 111 If:
- you have sudden or very bad shoulder pain
- you cannot move your arm
- your arm or shoulder has changed shape or is badly swollen
- you have pins and needles that do not go away
- there’s no feeling in your arm or shoulder
- your arm or shoulder is hot or cold to touch
- the pain started after an injury or accident, like a fall
- you develop severe pain in both shoulders
- you feel feverish or unwell
These can be signs of something serious, like a broken or dislocated bone, or a torn ligament or tendon.
You could also go to your nearest urgent treatment centre.
Shoulder Tendinitis Or Bursitis
Tendons are strong fibers that attach muscles to your bone. Bursa are fluid-filled sacs that prevent friction at joints.
Inflammation of the tendons and the bursa are common causes of shoulder pain, but pain can occur anywhere that inflammation occurs.
The tendons and bursa around your rotator cuff are especially prone to inflammation that causes pain and stiffness around your shoulder.
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Visit A Health Care Provider
If the above treatments dont effectively reduce the pain under your shoulder blade, visit a physiatrist, chiropractor, or physical therapist. These health care providers will evaluate you for the source of the pain and can individually tailor plans that will help strengthen and stretch your upper back, neck, and core muscles. They might also provide manual manipulation, using hand maneuvers to loosen stiff muscles or misaligned joints.
You may need to take a trial and error approach with these tips. Try a combination of these treatment ideas to see what reduces the pain under your shoulder blade.
Inflammation Of The Shoulder Capsule
The synovial membrane of the shoulder may become inflamed this is called ‘synovitis’. Synovitis may occur as a result of another condition or it may happen as a result of an injury, or the cause may be unknown.
Frozen shoulder is a condition that occurs when the shoulder capsule thickens and becomes inflamed and tight. There may also be less synovial fluid to lubricate the joint. As a result, the shoulder becomes difficult to move.
Frozen shoulder may occur as a result of another condition if the shoulder has been immobilised . Sometimes the cause of shoulder pain may not be known.
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What Exercises Should I Do
The following exercises may help you. Ask your doctor if you should do other exercises, too. You can also try these rotator cuff exercises.
Range of motion
Stand up and lean over so youre facing the floor. Let your sore arm dangle straight down. Draw circles in the air with your sore arm. Start with small circles, and then draw bigger ones. Repeat these exercises 5 to 10 times during the day. If you have pain, stop. You can try again later.
Having good shoulder posture can help prevent shoulder pain. Many people with shoulder pain often lift up or hunch their shoulder forward. Work on improving your posture if you find yourself slumping or hunching. Throughout the day, focus on bringing your shoulder or shoulder blade down and holding there. Another exercise is to stand against the wall with the back of your head, shoulders, legs, and heels touching the wall. Notice if your painful shoulder blade doesnt touch the wall completely. Keep trying that position throughout the day.
Upper extremity strengthening
As your pain goes away, try adding a general upper body weight-lifting program using weight machines or free weights. Lie on your right side with your left arm at your side. With a weight in your left hand and your forearm across your tummy, raise your forearm.
Keep your elbow near your side.
When To Contact A Medical Professional
Sudden left shoulder pain can sometimes be a sign of a heart attack. Call 911 or your local emergency number if you have sudden pressure or crushing pain in your shoulder, especially if the pain runs from your chest to the left jaw, arm or neck, or occurs with shortness of breath, dizziness, or sweating.
Go to the hospital emergency room if you have just had a severe injury and your shoulder is very painful, swollen, bruised, or bleeding.
- Shoulder pain with a fever, swelling, or redness
- Problems moving the shoulder
- Pain for more than 2 to 4 weeks, even after home treatment
- Swelling of the shoulder
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Important Anatomy Of The Shoulder
As you can hopefully appreciate in the image below, the shoulder itself is more than just a single, isolated joint. Its surrounded by a number of muscles that span large anatomical areas. Its also influenced by a number of bony structures.
If we take a muscle like the Trapezius, you can see that it not only influences the shoulder, but also anchors to the upper back, the neck, and also the base of the skull. This muscle alone ties together a number of areas to the shoulder making them important considerations when trying to understand why shoulder pain occurs.
Beyond this, we can see that the shoulder obviously attaches to the top of the very mobile scapula. The scapula sits on top of the upper back allowing the shoulder to slide and glide in whichever direction we need.
However, when we introduce restricted upper back tissue into the equation, things have the potential to go awry.
Clinically, upper back joint stiffness in both the spinal and rib joints is a highly underrated feature in many shoulder complaints.
In short, if your upper back has a handbrake on the shoulder could be the structure that suffers over time.
So if youre struggling to shake a shoulder injury, or you just want your shoulders to function better again, its important to go looking around to see what you can find. Or, better still, have your favorite Physical Therapists do it for you!