March 1, 2008

Doctor0 My Shoulder Really Hurts. What Do You Recommend?

Patients with inflammatory types of arthritis such as rheumatoid arthritis and psoriatic arthritis often have shoulder problems. However, more often than not, a patient presenting with shoulder pain to the rheumatologist will have another reason besides the arthritis for the discomfort they are feeling.
The shoulder is a complicated and complex joint consisting of the interaction of two major bones forming the glenohumeral joint- the joint that joins the upper arm bone to the shoulder blade. The acromioclavicular joint which joins the clavicle (collarbone) to the shoulder blade is also part of this complex. The muscles that help move the shoulder consist primarily of the rotator cuff muscles and their associated tendons: supraspinatus, infraspinatus, subscapularis, and teres minor.
The biceps muscle and tendon are also responsible for shoulder movement as is the deltoid muscle. The shoulder complex is held together via a complicated network of ligaments and tendons that allow the shoulder to have the widest range of motion of any joint in the body. The shoulder complex is surrounded by small fluid filled sacs, called bursae that help to cushion the shoulder joint and allow more purposeful gliding motions of the joint.
Shoulder pain is responsible for about 16% of all complaints […]