Shoulder and Arm Pain: Causes, Treatments, and Solutions

Shoulder and arm pain?

Hello, Doctor Shi: My mother has been experiencing persistent soreness from her left shoulder to her left arm, and now she is having trouble sleeping at night.
Despite our repeated encouragement, she refuses to seek medical attention, fearing it might affect her ability to work.
Currently, she is unable to move her left arm backward due to the pain.
We initially thought it was frozen shoulder, so my grandmother encouraged her to do some joint exercises, but it only worsened the situation.
We are very concerned and have decided to insist on her receiving treatment.
Could you please advise what condition my mother might have? What kind of examinations or therapies would be most suitable for her? (My mother is 52 years old!) Which is more effective, traditional Chinese medicine or Western medicine?

Xiao Yu, 20~29 year old female. Ask Date: 2001/04/28

Dr. Shi Qiming reply Orthopedics

Please visit the orthopedic outpatient clinic for further examination and treatment.

Reply Date: 2001/04/28

More Info

Shoulder and arm pain can stem from various causes, and understanding these can help in determining the appropriate treatment. In your mother's case, her symptoms of persistent pain in the left shoulder and arm, along with limited mobility, suggest a possible shoulder condition that may require medical intervention.

Possible Causes of Shoulder and Arm Pain
1. Rotator Cuff Injury: This is one of the most common causes of shoulder pain, especially in individuals over 40. It involves tears or inflammation of the rotator cuff tendons, which can lead to pain, weakness, and limited range of motion.

2. Frozen Shoulder (Adhesive Capsulitis): This condition is characterized by stiffness and pain in the shoulder joint, often leading to a significant reduction in mobility. It can develop gradually and is more common in women and individuals with diabetes.

3. Bursitis: Inflammation of the bursa (a small fluid-filled sac that reduces friction between tissues) can cause pain and swelling in the shoulder area.

4. Tendinitis: Inflammation of the tendons around the shoulder can result from overuse or injury, leading to pain and difficulty in movement.

5. Cervical Radiculopathy: Issues in the cervical spine (neck) can cause pain that radiates down the arm, often accompanied by numbness or weakness.

6. Osteoarthritis: Degenerative changes in the shoulder joint can lead to pain and stiffness, particularly in older adults.

Recommended Diagnostic Tests
Given your mother's symptoms, it is crucial to conduct a thorough evaluation. The following tests may be recommended:
- X-rays: To check for any bony abnormalities or arthritis.

- MRI: This imaging test can provide detailed images of soft tissues, including muscles, tendons, and ligaments, helping to identify rotator cuff tears or bursitis.

- Ultrasound: This can also be used to assess soft tissue structures around the shoulder.

Treatment Options
1. Physical Therapy: A structured rehabilitation program can help improve strength and flexibility in the shoulder. A physical therapist can design a program tailored to her specific needs.

2. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. In some cases, corticosteroid injections may be recommended to provide relief.

3. Activity Modification: Avoiding activities that exacerbate the pain can help in the healing process.
4. Surgery: If conservative treatments fail and her quality of life is significantly affected, surgical options may be considered, especially for conditions like rotator cuff tears or severe cases of frozen shoulder.

Traditional Chinese Medicine vs. Western Medicine
Both Traditional Chinese Medicine (TCM) and Western medicine have their merits. TCM may offer acupuncture and herbal remedies that can help alleviate pain and promote healing. However, for conditions like rotator cuff tears or significant structural issues, Western medicine's diagnostic tools and surgical options may be more effective.

Conclusion
It is essential for your mother to seek medical attention, as early intervention can lead to better outcomes. Encourage her to consult with an orthopedic specialist who can provide a comprehensive evaluation and recommend an appropriate treatment plan. While she may have concerns about her ability to work, addressing her pain and mobility issues is crucial for her overall well-being.

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