Shoulder stabbing pain in the shoulder joint

Stinging in the shoulder

Shoulder puncture refers to a common form of shoulder pain, which usually occurs when the arm is moved, concentrating on either the front or back of the shoulder, the shoulder joint, or the area at the top, below the shoulder roof. The shoulder is highly mobile but at the same time relatively unstable, which makes the joint very vulnerable to injury, such as the impingement syndrome or rotator cuff tear.

Contents:
Complaints and Causes Shoulder stabbing
diagnosis
Shoulder options treatment options
Naturopathy at shoulder piercing

Complaints and Causes Shoulder stabbing

The shoulder is the most flexible, but also the most unstable joint of the human musculoskeletal system, because it is stabilized not like other joints by bone, but by ligaments and muscles. At the back of the shoulder lies the so-called "rotator cuff", which consists of several muscles and provides stability of the joint by pulling the relatively large humeral head into a comparatively small socket. Due to the complex structures in a small space, the shoulder is very vulnerable to damage, which can sometimes lead to severe shoulder discomfort or shoulder piercing.

Impairment of finely tuned structures in the shoulder can cause stinging pain. (Image: bilderzwerg / fotolia.com)

For example, the shoulder piercing can be triggered by the so-called "impingement syndrome" (or "bottleneck syndrome"). This arises when soft tissues such as tendons and bursae are trapped due to a narrowing in the shoulder joint during movements on the shoulder roof or abut there (translated from English: "to impinge": hit, bounce).
The tightness in the shoulder joint is often the result of thickening of the tendon of the superior bone muscle (Musculus supraspinatus) by overexertion - accordingly affects the impingement syndrome athletes often with a chronic overload of the shoulder such as swimmers or ball athletes with high overhead (including handball, volleyball, golfer , Javelin throwers), but also people who practice a profession with constant overhead work, such as painters or aircraft mechanics. Other causes of lack of space in the joint can be signs of wear or lime deposits ("calculus shoulder") and a congenital unfavorable form of the shoulder roof. The friction on the shoulder roof and the resulting irritation or inflammation sometimes results in very severe pain when lifting the arm to the rear or to the side - often particularly pronounced in abrupt movements or under stress, in some cases, the pain also at night and leave Lying on the affected area will be impossible. If the friction persists for an extended period of time, the risk of (partial) tearing of the tendons of the rotator cuff also increases.
However, rotator cuff rupture can also be caused by long-term wear (degeneration), high stress (such as strength training, heavy lifting, etc.), accidents (for example, a fall on the outstretched arm), or pathological changes in the tendons (enthesopathy). In any case, a Rotatorenmanschettenriss usually means burden and position-dependent pain under the shoulder roof, which radiate partly in the upper arm and are described by those affected as stinging and / or pulling. In case of minor tears complaints may be absent or appear only after two days, in older patients in some cases the pain intensifies over a longer period of time. In addition to the pain, a rotator cuff tearing often leads to reduced functionality, as special movements can not be executed so powerful.

Another cause of stabbing pain in the shoulder may be a so-called "Bankart lesion", a special injury to the shoulder joint due to dislocation of the shoulder joint (shoulder dislocation or shoulder dislocation). Thus, in the case of shoulder luxation, the joint capsule is maximally stretched, which may result in bony or cartilaginous damage to the anterior margin of the shoulder joint, accompanied by a sharp, bright pain and often a feeling of instability. Especially affected are younger and physically active patients with overstretchable ligaments.

In addition, in a stabbing in the shoulder and a vertebral block (also cervical spine blocking) into consideration, in which case the pain is not caused by the blockade itself, but by the associated muscle tension. In a vertebral blockage, there are "entanglements" of small vertebral joints, which connect two vertebral bodies with each other and as a result to a limited mobility in the respective area of ​​the spine. Such entanglement can occur in the flexed position, but also in the extended position, affecting both the right and the left vertebral joints, resulting in the typical pain with limited mobility for rotations to the right or left as well as bending or stretching, in some cases the restriction also all directions of movement. A vertebral blockage arises in most cases as a result of a jerky movement or while sleeping, but an accident can be the trigger here, the pain usually starts suddenly and radiates from the cervical spine to the back of the shoulder, in part, is only the rear Shoulder affected.

An osteoarthritis (or osteoarthrosis) can be the cause of stinging shoulder pain, which is relatively rare in the shoulder area, as in comparison to knees or hips load no large weights on the joint. In the main joint of the shoulder, however, arthrosis can develop as a result of permanent damage to the tendon or as a result of fractures or other injuries or unstable conditions on the shoulder joint. Osteoarthritis, however, is more likely to occur in the smaller shoulder joint, for example, as an injury in a Schultereckgelenksprengung or by a constant "over-head wear" in athletic (basketball, handball, etc.) or professional field (for example, painters), is also believed that predisposition also plays a role. In the case of shoulder arthrosis, the shoulder joint is swollen and sensitive to pain, but in many cases the pain only sets in when the arm is held higher or when it is guided at shoulder height to the opposite shoulder.

diagnosis

In the case of shoulder stabbing, the doctor will first conduct a thorough questioning of the complaints and the medical history. This is followed by the physical examination, which determines in which movements and in which positions the patient complains of pain and to what extent there are restrictions on movement or a reduction in muscle strength. In many cases, special functional tests are used, such as in a suspected impingement syndrome, the so-called "neck grip" in which the patient puts both hands in the neck so that the thumbs pointing down. If there are ambiguities regarding the diagnosis, the doctor often also scans the tendon attachments, joints and trigger points, which cause pain when pressure is applied. Further support is offered by imaging techniques such as ultrasound (ultrasound), MRI (magnetic resonance imaging) or an X-ray examination, which is often used in the diagnosis of osteoarthritis or joint wear, for example. Magnetic resonance tomography is also used for stabbing pain in some cases, as a result, for example, a rotator cuff rupture can be detected directly. If these examinations continue to lead to no clear diagnosis, joint arthroscopy may also be appropriate depending on the case. In this minimally invasive procedure, the doctor gets a direct impression of the joint structures via a miniature camera and can not only detect damage, but also treat it at the same time, for example by removing inflamed tissue in the case of an impingement syndrome or by sewing a tendon tear.

Shoulder options treatment options

The therapy for stinging shoulder pain depends on the underlying disease as well as on various other factors such as the extent of the injury or damage, the duration of the pain and the severity of the pain, but also on the patient's personal aspects such as age and degree of activity For some sports and occupations a full functioning of the shoulder joint is essential.

In most cases, a conservative, non-surgical therapy in the form of protection of the shoulder and a basic drug therapy with so-called non-steroidal anti-inflammatory drugs (NSAIDs) for pain and inflammatory reactions. At the same time, depending on the case, physical therapy measures (cold and heat therapy, electrotherapy) and physiotherapy are used, which in many cases significantly alleviates the pain and, at the same time, maintains or promotes flexibility.

If the symptoms are already advanced, injections may be necessary, with stronger inflammations often helps by the doctor performed "infiltration" in which cortisone is injected directly into the site of inflammation - which, however, in most cases, only temporarily successful and therefore in Considering possible side effects should be used sparingly. A "softer" method, which can be pain-relieving, for example, in the case of osteoarthritis, are injections of hyaluronic acid, which improves the lubrication and, as a result, the flexibility and resilience of the affected joint.

If conservative measures are unsuccessful, operative care may be considered - in many cases (for example rotator cuff rupture, impingement syndrome, or mild osteoarthritis) in the form of articular arthroscopy or open, minimally invasive surgery with a small incision , However, in more severe cases, such as advanced osteoarthritis, in some cases, major surgery (insertion of an artificial shoulder joint) is necessary.

Naturopathy at shoulder piercing

In the case of stinging pain in the shoulder, natural medicine or alternative medicine offers some useful treatment options that can be used as an alternative or as a supplement to classic conventional medical therapy.

For example, acupuncture has been proven to help relieve pain; in many cases, massages, chiropractic, rolfing or osteopathy help with sharp pains in the shoulder, as the therapist uses his hands to sense currents, movements and tensions in the body, release blockages and mobilizes the self-healing powers of the body.

A modern alternative treatment method without chemical aids, which is very effective for chronic shoulder pain, is extracorporeal shock wave therapy, in which high-energy sound waves can be directed into the painful areas of the body and targeted lesions on tendons, ligaments, capsules, muscles and bones can be eliminated.

Furthermore, heat therapy in naturopathy is a classic among the alternative treatment for joint pain, because strong heat reduces the sensation of pain and stimulates the self-healing powers. Cold works here in the so-called "cryotherapy" in a similar way, so that the regular visit to a so-called "cold chamber", especially in chronic shoulder pain often has a positive effect.

In addition, with tension in the shoulder area (for example, in connection with a vertebral blockage) in some cases, an aromatherapy is an effective aid from nature - here are essential oils from camphor, peppermint, eucalyptus and capsicum used by the relaxed muscles and relax have a vitalizing effect. Also Schüssler salts and certain homeopathic remedies can help with shoulder piercing - but here, as with all alternative treatment options, it is advisable to receive intensive advice from an appropriate expert. (No)

1: Brandtmarke / pixelio.de