Human Anatomy – Shoulder

There are many joints in the body, and one of its largest is the shoulder. A ball-and-socket type of joint, the shoulder is the most movable joint in the body. It is found wherever the upper arm bone (humerus) meets the shoulder blade (scapula).

Besides the scapula and the humerus, the shoulder joint is also composed of the collarbone, also known as the clavicle. The bone-like protrusion off the collarbone is called the acromion, while that of the scapula is known as the coracoid process.

Though very movable, the shoulder is quite susceptible to injury. This is because the ball of the humerus is too large to fit into its socket in the scapula. The rotator cuff, a band of muscles and tendons, must surround and anchor the shoulder to make it more stable. Furthermore, the ball of the humerus is made to be accommodated in a cartilaginous rim called the labrum.

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Still, the inherent instability makes the shoulder a problematic area. Most anyone can experience sprains, fractures, dislocations, strains and separations here.


Shoulder diseases and conditions

On any ordinary day, the shoulder is one of the most freely moving joints in the body. But the shoulder can become stiff and painful, “frozen” as it were. This condition is called adhesive capsulitis, known to many as “frozen shoulder.” It happens when the shoulder becomes inflamed, making the humerus adhere to the scapula.

Like all joints, the shoulder is vulnerable to arthritis. As it wears and tears over the years, the shoulder can develop osteoarthritis, though the risk is less than the knee. The shoulder is also liable to develop rheumatoid arthritis, which has to do with an overactive immune system, triggering inflammation in the joints. Yet another kind of arthritis, potentially bound to undermine all joints including the shoulder, is called gout. Characterized by the growth of crystals in the joints, gout is unusual in the shoulder however.

By some injury, the bones around the shoulder, especially the humerus, can become dislocated or deviate from its normal position. Dislocation, which is always heralded by a popping sound, instantly limits movement around the shoulder.

Shoulder health is not only about bones though; it is also closely tied with the rotator cuff. A torn rotator cuff hampers movement around the shoulder. Rotator cuff tears are either caused by injuries or gradual wear-and-tear.

Shoulder tendonitis happens when the tendons in the rotator cuff get inflamed. This is already painful enough without impingement, a condition wherein the acromion presses on an inflamed rotator cuff during overhead arm activities.

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If the inflammation occurs in the bursa, it is called bursitis. This condition brings with it pain while raising the arm. The bursa acts as a cushion for the rotator cuff.

Tears can also happen in the labrum, also due to injuries or wear-and-tear. A labral tear can nonetheless resolve on its own.

Treating shoulder conditions

Open surgery may be required to make the shoulder more stable. Otherwise, the surgeon can use arthroscopic surgery, which needs smaller incisions. The latter is performed using an endoscope and takes lesser downtime than the former.

As a rule of thumb, healthy lifestyle specialists recommend RICE (Rest, Ice, Compression and Elevation) to alleviate inflammation and pain accompanying most shoulder conditions. Meanwhile, the patient can get pain relief in the form of non-prescription medicines or drugs such as acetaminophen, naproxen and ibuprofen.

A doctor can prescribe stronger drugs. If the pain is too much for the patient already, then the doctor may choose to inject him or her with cortisones or corticosteroids. Known to last for weeks, these medicines are especially designed to improve symptoms of bursitis and arthritis.

Most healthy lifestyle tips would urge patients with injured shoulders to follow through their treatment with physical therapy. Certain exercises can effectively make the muscles and tendons around the shoulder stronger. As a result, the shoulder would be all the more flexible.

Tests for shoulder conditions

MRI scans (magnetic resonance imaging) are always used to determine conditions of the shoulders. The medical examiner does this by taking hi-res photos of the shoulder and nearby areas through a computer and a powerful magnet.

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Alternatively, CT scans can be used to detect shoulder conditions. The doctor can prescribe appropriate treatments from this test, which essentially pools many X-ray images to build a single image of the shoulder.

Even a simple shoulder X-ray can expose dislocations, fractures and osteoarthritis. However, a basic X-ray could not show the muscle and tendons, making it unfit to determine conditions related to those tissues.

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