Shoulder Injuries in Nursing Homes

Your shoulder is the most flexible joint in your body.  Shoulder pain is one of the top three causes of musculoskeletal referral to a primary care physician.  

There are several factors that can be attributed to shoulder pain/injury.

  • Physical factors that are caused by repetitive movements such as those used by the vibration of tools.
  • Athletes who execute repetitive motions or those in high impact sports.
  • Jobs that require repetitive movements such as, keyboarding, cashiers, construction workers, production line workers and cashiers.
  • Job and personal stressors

The most often sighted causes of shoulder pain/disability are:

  • Rotator cuff disorders.
  • Glenohumeral disorders/Frozen Shoulder.
  • Acromioclavicular joint disease.
  • Referred neck pain.

Rotator Cuff This injury can happen at any age and often happens from a sharp fall, repetitive injury, heavy lifting. People who dislocate their shoulder(s) can also develop this injury.  This is the most common of shoulder injuries for people over the age of forty.

Symptoms

  • Intense pain.
  • Shoulder and or arm weakness.
  • Loss of movement.

Glenohumeral Disorder It is a very mobile joint but also very unstable.  This injury generally occurs in people ages 40 – 65.  Repetitive motions or frequent dislocation of the shoulder can produce this injury.  It presents in patients who have inflammation or scar tissue formation in the shoulder from previous injuries.  This can be caused by over use of the shoulder or from a stroke or diabetes.  The tissue around the shoulder becomes stiff and movement is difficult and painful.  

Symptoms

  • Dull or aching pain in the shoulder area.
  • Pain in the upper arm.
  • Stiffness and or restrictive movement of the shoulder/arm.

Acromioclavicular joint disease/Osteoarthritis – This joint is at the top of the shoulder.  This generally happens to people over fifty.  Soreness/tenderness of the shoulder is generalized to the top of the shoulder making it painful to lie on or preform any activities that may require overhead movement.  Some people complain of grinding or clicking noises emanating from the affected shoulder.

Symptoms

  • Shoulder pain.
  • Swelling.
  • Pain associated with resting on the shoulder.
  • Loss of range of motion.
  • Difficultly with over the head activities.
  • Visible lump/bump at the top of the shoulder.

Referred Neck Pain – People may seek out a doctor with shoulder pain that is actually emanating from the neck.  The shoulder and neck share numerous nerve pathways.  Because pain can be misleading a complete exam from your physician must be done in order to determine if it is truly your shoulder or if the pain is coming from your neck.

Symptoms

  • Pain that is relieved when your neck is supported.
  • Pain that travels down your arm past your elbow and into your hand.
  • Stabbing pain.
  • A tingling or burning sensation in your shoulder, neck or arm.
  • Pain that radiates toward the neck or shoulder.

This is by no means a complete list of shoulder injuries.  If your symptoms are not listed here or if they do the best advice is to make an appointment with your primary physician.  Your physician will refer you to a specialist who will evaluate your symptoms and provide a well-developed treatment plan.  The plan may include:

  • Daily stretching.
  • Physical Therapy.
  • Resting the shoulder from activities that cause or aggravate the shoulder pain.
  • Ice/heat.
  • Exercise to build muscles that surround the shoulder.
  • Loss of weight if necessary.
  • Use of anti-inflammatory creams or over the counter pain relievers.
  • Braces or wraps to support the affected area.
  • Injection of cortisone.
  • Possible surgical procedures may be necessary.