Shoulder pain and rheumatic disease 4/5 (6)

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Pain in the shoulder
Shoulder Pain. Illustration CDC [Public domain], via Wikimedia Commons


The shoulder is a complex joint where overload, injury and disease in joints, muscles, tendons and mucous sacs can cause pain and reduced function. Shoulder pain occurs in up to 50% of the population, and is one of the most common causes of contact with a doctor and other parts of the health care system. The most common causes of shoulder pain are congestion and injury, but rheumatic diseases can also be present. The treatment depends on the cause.

Shoulder pain can stem from many different tendons, muscles and joints. Illustration: National Institute Of Arthritis And Musculoskeletal And Skin Diseases (NIAMS) [Public Domain], by Wikimedia Commons


Shoulder pain can be acute or chronic, localizing to the front, side and back. The pain may be constant or just by movement. Night sweats and fever can occur with joint infection.


Medical history may include prior injury, congestion, or infection. Other diseases may be related, such as other joint disease, infection or cancer.

Clinical examinations are covered by the observation of possible swelling, pain-signs of movement. Examiner rotates the shoulder outward and inward with the elbow bent. Similarly, outward mobility (abduction) is examined. One can also press against tendons frontally, on the side and behind the shoulder.

Blood tests may include CRP, SR, white blood cells (leukocytes), uric acid, anti-CCP.

Imaging can be done with ultrasound, CT or MRI. With regular X-rays, calcifications, fractures and major arthritis can be detected.

Other: If infection or gout is suspected, puncture and synovial fluid examination may be appropriate.

Causes of shoulder pain

  • Injuries to shoulder
    • Acromolecular-jointed injury
    • Armplexus / injury
    • Neck injury
    • Biceps tendon injury
    • Fracture
    • Cervical radiculopathy (nerve damage)
    • Clavicle fracture (Clavicula fracture)
    • Overload / repeated damage
      • Profession
      • Ball games
      • Sports
    • Rotator cuff damage (tendon injury)
    • Tendinitis
    • Shoulder luxation/ Subluxation


Treatment of shoulder pain may include observation, medication, injections, physiotherapy or surgery depending entirely on the cause of the disease.


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