Shoulder Inflammation

An inflammation in the shoulder primarily causes severe pain to the patient. Especially whenever he moves his shoulder and loads it. If the bursa is inflamed, the elevation, i.e. the arm movement away from the body, is particularly difficult because it is associated with severe pain. In addition, there may be a slight swelling in the area of ​​the shoulder joint.

If the inflammation of the bursa in the shoulder is bacterial, so-called B symptoms may also occur, which are typical of bacterial inflammation. These include night sweats, fever, body aches and general malaise with accompanying fatigue.

With classic shoulder inflammation, however, the patient usually has inflammation in other joints in addition to the inflammation in the shoulder. Usually the pain gets better after some time of movement, as the joints are then warmed up.

With this type of shoulder inflammation, it is typical that the symptoms appear equally with every type of movement. So it makes no difference whether the arm is lifted to the side, forwards or backwards. Every time the shoulder is strained, this leads to pain.

The patient should also mention when the symptoms appear. If the patient complains of pain in the shoulder area due to inflammation in batches, this indicates rheumatic omarthritis. In addition to the pain due to the inflammation in the shoulder, there may also be functional losses in which the patient can hardly use the shoulder and therefore can only use the arm to a very limited extent.

With tendonitis, the patient often complains of general pain in the shoulder area, but the pain is worst when the patient tries to lift the arm only sideways (i.e. neither forwards nor backwards) in the stretched position. Typically, the patient can raise the arm to a 90 degree angle, anything above it, which causes severe pain due to the inflammation of the tendon that the arm cannot be raised any further.

Inflammation in the shoulder can often be diagnosed based on the patient's medical history. If the patient complains of increasing shoulder pain and restricted movement, the situation is often clear. In addition, the palpation can be used to localize the pain more precisely and inflammation signs (overheating of the shoulder joint) can be determined. In addition, a blood sample should always be taken, from which one can see whether the inflammation in the shoulder is a bacterial inflammation or rather an overload of the shoulder. The doctor often takes additional synovial fluid to detect inflammatory cells. In rare cases, the shoulder is x-rayed or magnetic resonance imaging (shoulder MRI) is performed.

In the case of rheumatoid arthritis, which can lead to shoulder inflammation, antibodies are directed against the inner skin of the joint and damage it. In addition to the shoulder, other joints are usually affected, such as the finger joints or the knee.

In addition to the pain, patients complain of swelling of the joints and limited mobility.

Since the shoulder consists not only of the actual shoulder joint but also of ligaments and muscles, tendonitis can occur in the area of ​​the muscles, especially with the supraspinatus muscle, the tendon of which extends over the shoulder joint and is thereby narrowed by the bone protrusion, the acrominon , The supraspinatus muscle arises from the upper part of the shoulder blade (scapula) and extends from here over the shoulder to the upper arm bone (humerus).

When the muscle contracts, we can stretch our arm sideways upwards, as if we wanted to fly with our arms. An inflammation in the shoulder occurs when the tendon of the supraspinatus muscle is inflamed; this is called tendinitis.

Above all, excessive stress often leads to inflammation, for example if the patient very often sleeps with his arms raised. In addition to the supraspinatus tendon, the tendon of the biceps muscle (the prominent biceps on the upper arm) can also become inflamed. The causes of this inflammation in the shoulder are the same as for the supraspinatus tendon - also overload in the area of ​​the shoulder movement.

The bursitis of the shoulder is usually the bursa under the shoulder roof (acromion), the so-called subacromial bursa. This ensures that the thigh bone does not touch the roof of the shoulder while the arm is raised and causes pain with every movement.

If the bursa is inflamed, it can cause stinging pain. The inflammation usually arises from loads such as overhead movements of the arms. The pain is initially felt when the arms are raised above the shoulder level. If the shoulder is not spared in the further course, the pain can become worse and also occur at rest. The shoulder can also become sensitive to pressure and cause pain at night.

Swelling and reddening of the shoulder joint are rarely observed. The shoulder should be examined by a doctor in any case; imaging tests such as ultrasound, X-ray or MRI may be necessary.

The treatment of bursitis is usually done using cold compresses, anti-inflammatory pain medications such as ibuprofen or sports ointments. In addition, physiotherapy can accelerate healing. If, despite these therapies, there is no cure and permanent pain that restricts everyday life, surgery may be necessary.

Therapy for inflammation in the shoulder depends on the cause of the disease.

In the case of bursitis, i.e. inflammation of the bursa in the shoulder, the focus is primarily on immobilizing the joint, since the inflammation in the shoulder was caused in this case by overloading the shoulder. In addition, the patient should take non-steroidal anti-rheumatic drugs (short: NSAIDs) in order to counteract the inflammation in the shoulder and thus the pain.

In addition, depending on the feeling, the patient can treat the inflammation in the shoulder with heat or cold therapies (for example with cold compresses or with heat pillows, as required). The patient can simply pay attention to this. whether the cold helps the pain or whether the warmth provides relief.

If the inflammation in the shoulder bursa does not heal, the doctor can also inject glucocorticoids directly into the patient's shoulder.

In the worst case with persistent symptoms, removal of the bursa (bursectomy) must also be considered. However, this should be the last form of therapy because removing the shoulder bursa always takes a certain amount of mobility.

If the bursitis is bacterial, it is also important to keep the shoulder still. However, this alone is not enough and the patient must also take antibiotics to eliminate the bacteria that are responsible for the inflammation in the shoulder. In addition, the inflamed secretion can be released from the bursa.

In the case of classic shoulder inflammation (omarthritis), the same therapy as in rheumatic arthritis is always carried out. However, since the shoulder is usually only limited in the late stage, only one operation often helps in which the shoulder joint is (partially) replaced and renewed.

Nevertheless, the patient should try to minimize the inflammation in the shoulder and the associated pain as much as possible before undergoing surgery using physiotherapy. The therapy of omarthritis is usually very long and not always promising.

With tendonitis of the muscles of the shoulder, it is important to protect the affected muscles and to calm the shoulder as much as possible. Usually the tendonitis should go away on its own after a while. In addition, you can apply an anti-inflammatory cream to the shoulder to help the affected muscles heal.

Cold also helps most patients to relieve pain and at the same time curb the swelling that often occurs with tendonitis. In more difficult cases, the doctor can prescribe a cortisone-containing cream or inject the cortisone directly into the affected shoulder area.

Surgery is only necessary in rare cases.

Inflammation of the shoulder joint is usually referred to as frozen shoulder.

There are a variety of causes for this very painful condition that affects the soft tissues, muscles and tendons near the joint. It is usually degenerative diseases in the shoulder joint that lead to pain and stiffness in the shoulder.

The technical term for inflammation of the shoulder joint is periarthritis humeroscapularis. The first part of the name is made up of the Greek words peri (around, around), arthros (joint) and -itis (inflammation). The second part of the word means that there is an inflammation between the humerus and the shoulder blade (scapula).

Symptoms

Inflammation of the shoulder joint causes shoulder pain and restricted movement. Most people only have one joint affected, but with every third illness both shoulders are inflamed.

Both active and passive movement are severely restricted. If there is no previous damage or an accident, one speaks of the so-called primary frozen shoulder.

The primary form has three different phases of the disease. There are characteristic symptoms in each phase:

• Phase 1: The pain occurs mainly at night. Those affected wake up when they turn from side to side. Pressure on the diseased shoulder joint also causes pain. The joint then increases in stiffness - also due to the fact that the sick almost no longer move the arm in order to keep the pain as low as possible.
• 2nd phase: Here the pain becomes less and tends to take a back seat. The mobility of the joint is becoming increasingly restricted. Due to the lack of movement, the shoulder muscles also degenerate. To prevent the pain, most patients adopt an incorrect posture, which then causes further pain, for example in the neck.
• 3rd phase: Here the shoulder stiffness slowly decreases. However, the inflammation often does not heal completely and there are often significant restrictions on movement.

Causes

Inflammation of the shoulder joint usually comes from a degenerative change in the shoulder girdle such as bursitis (bursitis), tendinitis (tendinitis) or impingement syndrome (bottleneck syndrome - for example, through the thickening of the soft parts, the space under the shoulder roof can shrink and this happens to a bottleneck - there is not enough space to offer enough space for all structures running there.)

Tendon cracks or calcifications can also lead to inflammation. Even immobilizing the joint quickly leads to a frozen shoulder.

Therapy

In the first place, therapy always depends on the cause, the duration and the severity of the pain. In most cases, conservative treatment methods are used. That means no surgery is needed.

The effective alternative methods are primarily understood to mean physiotherapy and treatment with medication, and very rarely radiation therapy or acupuncture. With the alternative treatment methods, the symptoms only improve in a few weeks or months. With physiotherapy, it is important that the exercises, especially at the beginning, do not overload and do not strain the shoulder joint incorrectly. The exercises should be well adapted to the pain so as not to aggravate the condition of the shoulder.

In addition to manual therapy and physiotherapy, electrotherapy or heat and cold treatments are often used.

The form of treatment depends very much on the stage of shoulder stiffness. In the first stage, it is important that mobility remains intact and that the pain is relieved. In the second stage, the pain does not get much more, but the joint becomes increasingly stiff. Pain relief and relaxation come first here. In the last phase there is a decrease in pain and here again the focus is on training flexibility. You should always stay on the ball, because the treatment of a shoulder infection is very lengthy. In very rare cases, surgery is necessary if the cause cannot be combated otherwise, or if there is no improvement after about 6 months.