Shoulder problems

Shoulder problems are very common: an estimated one in five Finns suffers from shoulder pain at some point in their lives. They are common among both athletes and office workers, and their prevalence increases with age. Shoulder problems are one of the most common reasons for seeing an orthopedist or physiatrist.

The typical symptom is pain in the shoulder area, which may radiate to the arm or neck. The pain may be sharp in certain movements, such as lifting the arm above shoulder level, or a constant dull ache. In a frozen shoulder, mobility is significantly restricted in all directions. In a rotator cuff tear, lifting the arm may be impossible or extremely painful.

The most common cause is overuse or a tear of the rotator cuff tendon, which may be partial or complete. Subacromial impingement occurs when the rotator cuff tendons are compressed during movement. Frozen shoulder, or adhesive capsulitis, develops slowly, often without a clear cause, and limits mobility for months. Risk factors include repetitive movements, sports involving the upper limbs, diabetes and previous shoulder injuries.

Diagnosis begins with a clinical examination that assesses shoulder mobility, strength and pain provocation tests. Ultrasound or MRI is needed to detect tendon tears or other structural damage. An orthopedist assesses the situation and recommends suitable treatment, which may be conservative or surgical.

Conservative treatment is almost always started first: physiotherapy, exercise and corticosteroid injections effectively relieve pain in many conditions. Shockwave therapy is an effective option, especially for calcific tendon problems. In frozen shoulder, hydrodilatation, or expansion of the joint capsule with a fluid injection, speeds recovery. Surgical treatment, such as arthroscopic decompression or tendon repair, is considered when conservative treatment is not enough.

Most shoulder problems improve well with conservative treatment within months. Seeking treatment early prevents worsening and shortens the overall treatment time. Physiotherapy after surgery is essential for restoring full function.