As we grow older, one of the most common areas for joint and muscle pain can be found in our shoulders. From our posture and the way we carry ourselves to tote bags and backpacks, our shoulders can take on a lot of weight during our day to day (both figuratively and literally.) Akhil Chhatre, M.D., director of spine rehabilitation and assistant professor in the departments of Physical Medicine and Rehabilitation and Neurosurgery at the Johns Hopkins University School of Medicine, advises everyone to “think of [their shoulders] as driving a car — you’re given one set of tires and that’s it.”
At some point in our lives, we may experience shoulder pain from a myriad of activities. The pain can arise from the shoulder joint itself or from the muscles in the surrounding area. As we age, “you’ll see changes in the lining of the joint, changes in the integrity of the bones, and degeneration of the ligaments,” Chhatre explained. Regular strength training and stretching can help prevent damage to these joints, however, wear and tear of your shoulder joints is natural overtime.
“If you don’t participate in a strengthening or exercise routine, you’ll see some atrophy and loss of bulk (in the muscles) that surround and protect the stability and strength of the shoulder joint,” Chhatre said.
Because the shoulders have a crucial role in our everyday lives, any pain in the area should be monitored. Specifically, here are just a few symptoms that are worth paying attention to.
Osteoarthritis, one of the most common forms of arthritis, can cause this stiffness in the shoulders. It is typically known as “wear and tear arthritis”, where cartilage and other joint tissues that cushion the region degrade with time, causing joints to become painful, swollen, and stiff, with the stiffness worsening at night and in the mornings.
Osteoarthritis can worsen over time, with 1 in 3 people over 60 exhibiting shoulder osteoarthritis, according to the Arthritis Foundation. Relieving this sort of pain can be done through the help of a physical therapist, who can provide exercises to lessen the pain.
Pain when reaching overhead or behind your back.
If you notice frequent pain when reaching for an object overhead or when you twist behind your back to retrieve something, you may be experiencing a rotator cuff tear. These kinds of tears are extremely common in those over fifty, as these motor functions can debilitate and limit your movement over time. The rotator cuff is a group of “four small muscles that function to keep the ball centered on the socket. They glide between two bony surfaces, so they not only work hard, but they’re susceptible to tendonitis from both age-related and overuse injuries” says Leesa Galatz, M.D., professor and chair of the Department of Orthopedic Surgery at the Icahn School of Medicine at Mount Sinai Health System. The tendon can wear down over time, or it may be torn from trauma, such as a fall. If the tear is severe, it may require surgery, but in most cases, a physical therapist may recommend exercises that help to improve strength and flexibility of these muscles.
Pain that extends to the elbow.
If you are experiencing pain from your shoulder to your elbow, you may be experiencing symptoms of tendinitis. This may also be known as swimmer’s or tennis elbow, because it may result after repetitive movements (such as swimming laps), or it may come about from injury. Tendinitis is usually self-treatable with ice packs and over the counter pain medicine. If the injury is more severe, physical therapy can once again help strengthen those muscles around the damaged tendon.
Dull ache when moving arm up or to the side.
Rather than feeling a sharp pain, a constant dull ache resulting from bursitis could leave your shoulders feeling irritated and pained. Much like tendonitis, bursitis can be a result of frequent, repetitive shoulder movement. More specifically, it results when the fluid-filled cushions (bursae) that cushion your shoulder’s bones, tendons, and muscles wear down. This leaves the area inflamed or irritated, and it can be treated by ice packs and over the counter medication to reduce the inflammation.
Researchers examined the treatment outcomes of individuals with shoulder bursitis in a study published this year in the British Journal of Sports Medicine. After five years, individuals who had physical therapy and those who had surgery reported experiencing the much lower shoulder discomfort.
Extreme pain followed by stiffness.
“Frozen shoulder” or adhesive capsulitis could be the culprit of these two hand-in-hand symptoms. The capsule that covers the shoulder joint and rotator cuff tendons swells and stiffens, resulting in a frozen shoulder. Unlike the other symptoms, this can develop over the course of a few months in three stages. The “freezing” begins to set in the first stage, causing your shoulders pain and weakening your range of motion. The “frozen” or second stage, the shoulders begin to stiffen. Lastly, in the “thawing” stage, the range of motion finally begins to improve. “If you do nothing and just gut it out, the frozen shoulder will run its course and you’ll get better,” says Andrew Rokito, M.D., professor of orthopedic surgery and chief of the Division of Shoulder and Elbow surgery at NYU Langone Health.
If the pain is too debilitating, consulting with a physical therapist for help may help improve your range of motion and flexibility much quicker. Letting the frozen shoulder run its course can often take up to a year, resulting in prolonged pain. Women between the ages of 40 and 60 are more likely to have frozen shoulder, and those with diabetes are also more likely to develop it.