Persistent Right Shoulder Pain: Causes and Treatment Options

The right palm cannot touch the left shoulder, and there is a sharp pain in the right shoulder joint when it is in motion?

Hello Doctor, about four months ago, I seem to have injured my right shoulder due to poor sleeping posture.
In the past, such injuries would usually heal on their own within a week or two.
However, this time it has persisted for a long time.
I also aggravated it while playing tennis by swinging my racket carelessly, and it has now lasted for four months.
During this period, I have received heat therapy and electrical stimulation at a small clinic, but is this type of rehabilitation effective? After my reckless tennis swings, is it possible that I caused a bone dislocation, ligament tear, or dislocation? The pain feels different from the usual muscle strain, and since the doctor did not take an X-ray of my right shoulder, what could be the issue? Currently, I cannot touch my left shoulder with my right hand, and there is sharp pain in the right shoulder joint when I move it, along with joint sounds.
Sometimes, I also feel a dull ache.
I am unable to lift heavy objects with my right shoulder.
This condition has persisted for four months.
I would appreciate your insights and hope you can provide recommendations so I can address the issue directly.
Thank you.

Ms. Chen, 20~29 year old female. Ask Date: 2016/01/21

Dr. Chen Yongxue reply Orthopedics

Hello, vigorous swinging of the racket is unlikely to cause bone displacement, dislocation, or ligament tears; these issues are typically seen in cases of car accidents, trauma, or professional athletes as mentioned in your letter.
An X-ray is not necessary; it is advisable to consult a physician for a thorough physical examination.
It is possible that there is inflammation of the shoulder muscles, and rest with heat application is the most important treatment.
Medication is not crucial, as the shoulder is often in use and cannot rest adequately, which may delay recovery, potentially extending it to three to four months.
If you have further questions, please visit an orthopedic clinic for additional evaluation.
Thank you.

Reply Date: 2016/01/21

More Info

Persistent right shoulder pain can be a frustrating and debilitating condition, especially when it lingers for months without significant improvement. Based on your description, it seems that your shoulder pain may stem from a combination of factors, including a possible rotator cuff injury, tendonitis, or even shoulder impingement syndrome.

Possible Causes of Your Shoulder Pain
1. Rotator Cuff Injury: The rotator cuff is a group of muscles and tendons that stabilize the shoulder and allow for a wide range of motion. An injury to this area can occur from acute trauma, such as a fall or awkward movement, or from repetitive stress, such as swinging a tennis racket. Symptoms of a rotator cuff injury often include pain, weakness, and limited range of motion.

2. Tendinitis: Inflammation of the tendons in the shoulder can occur due to overuse or injury. This condition can cause pain, especially when lifting the arm or performing overhead activities.

3. Shoulder Impingement: This occurs when the shoulder blade puts pressure on the underlying soft tissues (such as the rotator cuff tendons and bursa) during arm elevation. It can lead to pain and restricted movement.

4. Labral Tear: Although less common, a tear in the cartilage that surrounds the shoulder joint (the labrum) can also cause pain and instability.

5. Bursitis: Inflammation of the bursa (a fluid-filled sac that reduces friction between tissues) can lead to pain and swelling in the shoulder.

Treatment Options
Given that your pain has persisted for four months, it is crucial to seek a comprehensive evaluation from an orthopedic specialist. Here are some treatment options that may be considered:
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around the shoulder, improve flexibility, and restore range of motion. A physical therapist can tailor exercises to your specific needs and monitor your progress.

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

3. Imaging Studies: If your symptoms do not improve with conservative treatment, imaging studies such as an MRI may be necessary to assess for any structural damage, such as a rotator cuff tear or labral injury.

4. Activity Modification: Avoiding activities that exacerbate your pain, such as playing tennis or lifting heavy objects, is essential to allow your shoulder to heal.

5. Surgery: If conservative treatments fail and there is significant structural damage, surgical intervention may be necessary. This could involve repairing a torn rotator cuff, removing inflamed bursa, or addressing any impingement issues.

Conclusion
In summary, your persistent shoulder pain could be due to a variety of factors, including rotator cuff injuries, tendinitis, or impingement syndrome. It is essential to consult with an orthopedic specialist who can perform a thorough evaluation, possibly including imaging studies, to determine the exact cause of your pain. From there, a tailored treatment plan can be developed to help alleviate your symptoms and restore function to your shoulder. Remember, early intervention is key to preventing further complications and ensuring a better recovery outcome.

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