Why Does Shoulder Pain Occur?

Only 20% of shoulder pain is directly related to the shoulder’s own problems. 80% occurs due to triggering from reasons outside the shoulder. The shoulder’s ability to move 180 degrees makes it open to strain, but what is more important is that it is in communication with more than twenty muscles around the shoulder and each of these muscles receive signals from different parts of the body. Thus, problems elsewhere in the body tense these muscles, causing the shoulder to strain and get damaged easily. You may have noticed that everyone buys materials from the same shelf or lifts heavy things, but some people’s shoulder tendons tear while others have no problems.

What Are the Factors Preparing the Ground for Shoulder Problems?

The shoulder has a special position in the body through both muscle-fascia connections and neural connections. For this reason, functional or organic problems experienced outside the shoulder, past surgeries and diseases are the main actors in the formation of shoulder problems. These can be listed as follows:

• Head and Neck Region: Past or ongoing tonsil, tooth, sinus infections, jaw joint dysfunctions, thyroid problems, problems in the neck vertebrae
• Chest: Heart, lung, respiratory and esophageal problems
• Upper Abdominal Region: Stomach, duodenum, liver, gallbladder, pancreas, spleen problems

What are the Pathologies that Cause Shoulder Pain?

When a person with shoulder pain goes to the doctor, an MRI is usually requested after the examination and the following problems are usually detected.

• Tendinosis or tear (rupture) is detected in the tendons of the muscle group called rotator cuff, which is most common in 80-90% of patients. It is most frequently detected in the tendon of the supraspinatus muscle.
• In addition, tears in the shoulder capsule, edema and inflammation in the sacs called bursae can be detected.
• Frozen shoulder (adhesive capsulitis), where movements are restricted along with pain in the shoulder, is an important shoulder problem.
• Recurrent shoulder dislocations are also a significant problem.
• Rare cases:
• Shoulder arthritis is rare because it is not a weight-bearing joint.
• The shoulder may be affected in patients with inflammatory rheumatism.
• Infection, tumor of the shoulder

How is it treated?

Along with the problem detected in the shoulder, it is very important to treat the predisposing factors that trigger this problem. Otherwise, the probability of the problem recurring is quite high.

When tears and injuries are seen in muscle tendons, the general approach is to first give a painkiller, and if they do not improve, to inject cortisone into the shoulder. In cases that do not improve, injections such as PRP, ozone, prolotherapy are applied or physical therapy is applied, and if they do not improve with these, surgery is performed.

In all of these applications, the torn tendon is dealt with, but there is no approach to why it is torn. As explained above, the shoulder is a region that communicates with many parts of the body. Especially functional problems experienced in the mouth, jaw, neck, chest and upper abdominal organs or previous surgeries and diseases pave the way for problems in the shoulder. For a permanent cure, both the shoulder and these triggers need to be identified from a neural therapy perspective and treated with neural therapy injections. In this way, there will be improvement as the blood supply to the damaged structures in the shoulder area will be improved, and since the triggering factors are treated, it will not recur.

In frozen shoulders where there is pain in the shoulder and limited movement, manual therapy and mobilization should be performed together with neural therapy. The main problem in frozen shoulder is impaired lymph drainage. Neural therapy is the method that best provides increased blood supply and lymph drainage.

If recurrent shoulder dislocations are mild, prolotherapy injections can be tried to tighten the ligaments. In cases where no results are obtained, surgical intervention is required.