Shoulder pain

The shoulder is a joint with a large range of motion. To achieve this, nature has designed a joint involving two bones (the humerus and scapula) and a multitude of muscles, ligaments, and tendons whose purpose is to keep the shoulder joint in place and to move it in nearly all directions (360-degree rotation).

This complexity of structure is what makes the shoulder joint so vulnerable to injuries, and the term "shoulder pain" (omalgia) encompasses many causes.

Starting the investigation of shoulder pain first consideration is that the deep muscles that stabilize the joint to function as a lever in various movements are initially involved in various

rotational movements of the upper limb (rotators of the shoulder joint) , followed by the external layer of muscles that provide the strength for the body to use the shoulder joint in daily activities (such as the deltoid, major and minor pectorals, latissimus dorsi, trapezius, etc.). Then, the bones (humerus, scapula, clavicle) that constitute the shoulder joint itself are examined, along with the muscles between the trunk and shoulder that serve to connect the upper limb to the torso.

The cause of shoulder pain is individualized based on each patient's activity, the degree of strain on the joint in daily life, as well as the chronicity, location, and extent of the initial injury.

An injury may remain stagnant or progress if the underlying cause continues to exist. The specialist's goal is to initially identify the area of injury through clinical examination, confirm it with some imaging method, and then propose the appropriate solution to the patient based on their activity profile and daily demands. This means that often, different solutions are suggested for the same problem in different patients and age groups.

The solutions provided for shoulder pain are closely tied to the underlying cause of the pain and the patient's needs. In cases of soft tissue tears, surgical treatment may be recommended for an athlete (due to higher demands on the musculoskeletal system in their profession), while analgesic conservative treatment may be suggested for an elderly person .

Surgical treatment is usually performed using the minimally invasive method known as shoulder arthroscopy. With the use of specialized tools, we can intervene on anatomical injuries, such as repairing ligament and tendon tears, through very small incisions.

In cases where the pain is caused by degeneration of the bones in the joint or osteoarthritis (an anatomical injury), there are surgical techniques available, including the option of replacing the joint with an artificial one, which can yield good functional results.

Conservative treatment, when chosen , is based on pharmacological pain relief, anti-inflammatory medication, and physical therapy. All of these aim to maintain the range of motion of the shoulder without pain, allowing the patient to meet the demands of daily life.

In conservative (non-surgical) treatment, as well as as an adjunct after surgical treatment, the Neural Therapy technique can also be included, often with significant results, for the functional management of shoulder pain beyond the usual practices when they are no longer effective, or in combination with them for optimal outcome.