Common conditions that can result in chronic shoulder pain include rotator cuff disorders, adhesive capsulitis, frozen shoulder, arthritis, tendinitis, muscle tear and injury to the shoulder joint. Rotator cuff disorders include tendinitis, partial or complete tears. A clinical diagnosis of rotator cuff tears includes pain with overhead activity, pain and weakness on empty can and external rotation tests, and a positive impingement sign. Adhesive capsulitis can be associated with diabetes and thyroid disorders. Acromioclavicular joint pain is also associated with range of motion at shoulder. Biceps tendinitis is very common feature with passive and active range of motion of shoulder joint. Clinical presentation includes diffuse shoulder pain with restricted passive range of motion on examination.
Causes of shoulder pain:
⇒ Rotator cuff disorders and tears.
⇒ Glenohumeral disorder like adhesive capsulitis ('frozen shoulder'), arthritis.
⇒ 'Subacromial pain', also referred to as subacromial bursitis, tendonitis.
⇒ Calcified tendonitis.
⇒ Biceps tendonitis
⇒ Acromioclavicular disorders.
Nearly 60% of shoulder pain subsides within one year of conservative treatment, but it tends to recur with time again and again. Symptom pattern is characterized by pain that is increased on sleeping to affected side.
Interventional Pain Techniques:
♦ Subacromial Injection
♦ Intraarticular Injection for Frozen shoulder: gives pain relief for 3-6 months
♦ Continuous Cervical Epidural Infusion
♦ Suprascapular nerve block and RFA: gives pain relief for 3-5 yrs.