Soft tissue lesions of the shoulder

Overview

Chronic wear and tear and overuse of a shoulder can lead to various lesions (injuries) of the soft tissue of the shoulder (muscles, tendons, capsules, etc.). Typical symptoms include exertion-related pain, combined with restricted mobility. Sufferers should take it easy, but shouldn't immobilise the shoulder.

Symptoms

Main symptoms

• Shoulder pain
  • Movement-related
  • Spontaneous pain and pain at rest
  • Pressure pain, pain when lying on the sore side

Other symptoms

• Restriction of movement, including stiffening (“frozen shoulder”)
• Weakness, impossible to stretch arm horizontally
• Swollen and overheated joint
• For torn biceps tendon: bulging muscle in the centre of the upper arm

Causes and treatment

Causes

• Chronic wear and tear of the soft tissue of the shoulder (muscles, tendons, etc.)
  • Regular (over)use of the shoulder, jerking movements
  • Age-related processes
  • Creeping process
  • Seldom caused purely by an accident (e.g. accompanying injury to shoulder luxation)

Consequences

• Recurrent infection of joint capsule
• Chronically thickened, inflamed bursa
• Bone spurs
• Calcification of tendons and joint capsules (“calcific tendonitis”)
• Squeezing and compression of the muscle and tendon sheath (impingement syndrome)
• Weakening, fraying and finally tearing of muscle fibres or tendons (rotator cuff)
• Arthrosis in the shoulder joint

Further treatment by your doctor / in hospital

Possible tests

• Examination of shoulder muscles and surrounding structures
• Testing of mobility and neurological functions
• Imaging procedures
  • Ultrasound (first choice)
  • X-ray
  • MRI (magnetic resonance imaging)

Possible therapies

• Medication, injections into and around the joint
• Physical therapy
  • Movement exercises
  • Also electrotherapy, shock wave therapy
• Alternative methods (e.g. acupuncture)
• Operation (if other options are unsuccessful)
  • Minimally invasive procedures are often an option (“keyhole surgery”)
  • Follow-up treatment lasts weeks to months

What can I do myself?

• Try out each of the different measures individually
• Treat gently (but don’t immobilise!)
• Avoid sports and activities that require reaching overhead
• Cooling
• Heat treatment (not while inflamed)
• Maybe fango treatment (mineral mud) or baths

When to see a doctor?

• Pain and restricted movement in shoulder
• Swollen and reddened shoulder
• Suspicion of injury to a muscle or tendon
• Acute loss of strength or signs of paralysis in the arm

Synonyms

soft tissue lesions of the shoulder, soft tissue injuries of the shoulder, periarthritis of shoulder joint and impingement syndrome, periarthritis humeroscapularis, soft tissue lesion of the shoulder, frozen shoulder, periarthritis and impingement syndrome of the shoulder