Shoulder and Clavicle Pain: Causes and Solutions - Rehabilitation

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Shoulder and clavicle pain can be quite debilitating and may arise from various underlying issues. Based on your description, it seems that you are experiencing pain in the shoulder and clavicle area, particularly when raising your arm above 120 degrees. The fact that you have noticed a protrusion of the left clavicle and have not experienced any direct trauma suggests that this could be related to overuse or strain rather than a fracture or acute injury.


Possible Causes
1. Rotator Cuff Injury: The rotator cuff is a group of muscles and tendons that stabilize the shoulder. Overuse, especially from repetitive activities like holding or lifting, can lead to inflammation or tears in these tendons, causing pain when lifting the arm.

2. Shoulder Impingement Syndrome: This occurs when the shoulder tendons are intermittently trapped or compressed during shoulder movements. It can lead to pain, especially when raising the arm.

3. Acromioclavicular Joint Dysfunction: The AC joint is where the clavicle meets the highest point of the shoulder blade. Overuse or strain can lead to inflammation or degeneration of this joint, causing pain that may be exacerbated by arm movements.

4. Cervical Radiculopathy: Sometimes, pain in the shoulder can be referred from the neck due to nerve compression. If there are issues in the cervical spine, such as herniated discs or degenerative changes, they can cause pain that radiates into the shoulder.

5. Muscle Strain: If you have been engaging in activities that require prolonged holding or lifting, you may have strained the muscles around the shoulder and clavicle, leading to pain and discomfort.


Recommended Actions
1. Consult a Specialist: Since you have been undergoing rehabilitation without improvement, it may be beneficial to consult an orthopedic specialist or a sports medicine physician. They can perform a thorough examination and may recommend imaging studies such as an MRI or ultrasound to assess the soft tissues around the shoulder.

2. Physical Therapy: Continuing physical therapy with a focus on strengthening the rotator cuff and improving shoulder mechanics can be beneficial. A physical therapist can provide specific exercises tailored to your condition.

3. Rest and Activity Modification: It is crucial to avoid activities that exacerbate the pain. Allowing time for the shoulder to rest can help reduce inflammation and promote healing.

4. Pain Management: Over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen, can help manage pain and reduce inflammation. However, consult with a healthcare provider before starting any medication.

5. Corticosteroid Injections: If conservative treatments do not provide relief, your doctor may recommend corticosteroid injections to reduce inflammation in the shoulder joint.

6. Surgical Options: In cases where conservative management fails and there is significant impairment, surgical options may be considered. This could include arthroscopic surgery to repair any rotator cuff tears or to address impingement issues.


Conclusion
In summary, your symptoms could be indicative of several conditions affecting the shoulder and clavicle. It is essential to seek a comprehensive evaluation from a healthcare professional who can provide a tailored treatment plan based on the underlying cause of your pain. Early intervention is key to preventing further complications and ensuring a better recovery. Remember to listen to your body and avoid activities that worsen your symptoms while you seek appropriate care.