Shoulder pain (or omalgia) is one of the most frequent reasons for consultation in general medicine and rheumatology.

The shoulder is a very complex joint, and many of the structures that make it up can cause injury or pain.

Thus, the shoulder is made up of two “sliding” spaces and 3 joints:

• the glenohumeral joint
• the acromioclavicular joint
• the sternoclavicular joint

When you move your arm, these different joints come into play simultaneously.

In the vast majority of cases, shoulder pain is linked to a pathology of the “rotator cuff”, a sort of “capsule” of tendons made up of the convergence of the tendons of four muscles.

You should not delay in consulting a doctor or a rheumatologist in case of omegia, in order to maintain as much as possible a good mobility of the arm.

Shoulder pain can reflect multiple pathologies: infections, tumors, systemic pathologies, neurological conditions, etc.

In the majority of cases, however, this pain is related to damage to the rotator cuff (especially after the age of 50).

The causes can also, of course, be traumatic: sprains, tendonitis, injuries, fractures, etc.

When there is no history of trauma, the painful shoulder is often related to “degenerative” tendonitis of the rotator cuff. The rotator cuff can also be the site of calcifications. It can also break completely or partially.

The other most frequently encountered causes are:

– An inflammatory or degenerative pathology of the shoulder joint (rheumatoid arthritis, osteoarthritis, etc.)

– The painful shoulder of the athlete caused by an attack of the cartilage of the glenohumeral joint, most often (“unstable” shoulder, in a young, healthy person, practicing a sport)

To better identify the cause, the doctor will be interested in:

• history (Has he had a trauma? Does daily work strain his shoulder a lot?)
• the location of the pain (anterior, posterior, etc.)
• its character (mechanical, inflammatory, nocturnal, etc.)
• the associated signs (stiffness, inflammation, discomfort and impact on daily life, etc.)

An x-ray can help the doctor, if necessary, to make the diagnosis.

Osteoarthritis of the shoulder is also possible (omarthrosis), but this localization is much less common than osteoarthritis of the hip or knee, for example.

Bursitis (inflammation of the bursa, fluid pocket that lubricates the joint) is common in the shoulder. It typically occurs in people who work with their arms raised.

If the pain occurs violently, and limits movement, it is important to consult urgently: it may be an infection (septic arthritis), bursitis or chondrocalcinosis (microcrystalline arthritis, a bit like drop).

Warning ! You should know that certain pathologies can cause pain that radiates into the shoulder, but is not related to the joint. This is sometimes the case with myocardial infarction, pancreatitis, pleurisy, etc. Hence the importance of consulting your doctor.

Because of their impact on the movements of the arms, shoulder pain quickly becomes disabling.

 They can interfere with daily activities and therefore need to be taken care of quickly.

Most often, the treatment of pain is based on analgesics (such as paracetamol) and anti-inflammatory drugs. Cortisone injections can sometimes be offered, depending on the case.

In the event of severe pain or tendonitis, shoulder rest is recommended.

Finally, functional rehabilitation sessions are often necessary to build muscle and gradually remobilize the joint. The rehabilitation program also aims to maintain joint amplitude and strength.

In rare cases, surgery may be considered. This is the case, for example, if the osteoarthritis of the shoulder has damaged the joint too much and a prosthesis must be placed.