Understanding Shoulder Pain — Anatomy and Common Conditions
The shoulder is the most mobile joint in the body, allowing an extraordinary range of motion for daily activities. This mobility comes at the cost of inherent instability, making the shoulder susceptible to a wide range of injuries and conditions. The joint complex includes the glenohumeral joint, the rotator cuff muscles and tendons, the labrum, bursae, and the acromioclavicular joint. Common conditions causing shoulder pain include adhesive capsulitis (frozen shoulder), rotator cuff tendinitis and tears, shoulder impingement syndrome, acromioclavicular joint arthritis, calcific tendinitis, and glenohumeral osteoarthritis. Each condition presents differently and requires a specific diagnostic and treatment approach.
Frozen Shoulder — What You Need to Know
Adhesive capsulitis, commonly known as frozen shoulder, is characterised by progressive pain and stiffness of the shoulder joint. It typically affects individuals between 40 and 60 years of age and is more common in women and patients with diabetes or thyroid disorders. The condition progresses through three distinct phases: the 'freezing' stage with increasing pain, the 'frozen' stage with marked stiffness and restricted movement, and the 'thawing' stage where motion gradually returns. Early and aggressive management with physiotherapy, anti-inflammatory medications, and intra-articular steroid injections can significantly shorten the course and reduce suffering. At Star Ortho, Dr. Kalekar employs a structured protocol combining hydrodilatation and supervised physiotherapy for optimal results.
Rotator Cuff Injuries — From Tendinitis to Tears
The rotator cuff comprises four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) that work in concert to stabilise and move the shoulder. Overuse, repetitive overhead movements, acute trauma, or age-related degeneration can lead to tendinitis, partial tears, or complete tears. Symptoms include pain with arm elevation, weakness when lifting, night pain, and a clicking sensation during shoulder movement. Diagnosis involves clinical examination with specific provocative tests and confirmation via ultrasound or MRI. Treatment ranges from structured rehabilitation and activity modification for mild cases to arthroscopic surgical repair for complete tears in active individuals. Dr. Kalekar provides evidence-based guidance on the most appropriate management pathway for each patient.
Shoulder Impingement and Bursitis
Subacromial impingement is one of the most frequent causes of shoulder pain, particularly in individuals who perform repetitive overhead activities. It occurs when the supraspinatus tendon and subacromial bursa become compressed between the humeral head and the undersurface of the acromion during arm elevation. This mechanical pinching leads to inflammation, swelling, and pain — especially during overhead reaching or sleeping on the affected side. If left untreated, chronic impingement can progress to rotator cuff tendinitis, bursitis, and eventually rotator cuff tears. Initial treatment focuses on activity modification, anti-inflammatory medications, and targeted physiotherapy. Subacromial corticosteroid injections provide rapid relief in cases with significant bursitis.
Diagnosis at Star Ortho — Our Approach to Shoulder Assessment
Our diagnostic protocol begins with a detailed history covering the onset, nature, and aggravating factors of your shoulder pain. Dr. Kalekar performs a comprehensive clinical examination including range-of-motion assessment, rotator cuff strength testing, and specific provocation tests such as the Neer test, Hawkins-Kennedy test, empty can test, and cross-body adduction test. Digital X-rays are performed at the clinic to evaluate bony structures, joint spaces, and calcifications. When soft tissue pathology is suspected, an ultrasound or MRI review is coordinated for detailed tendon and labral assessment. This methodical approach ensures accurate identification of the pain generator and a targeted treatment plan.
Frequently Asked Questions
Common questions about shoulder pain and treatment.
- How long does frozen shoulder last? 12–24 months untreated; early physiotherapy and injections can significantly reduce this.
- What is a rotator cuff injury? Damage to the four muscles and tendons stabilising the shoulder — from mild inflammation to complete tears.
- Can shoulder pain be treated without surgery? Yes, most conditions respond well to physiotherapy, medications, and injections.
- Why does my shoulder hurt at night? Night pain is typical of rotator cuff pathology and frozen shoulder due to positional compression.
- What is shoulder impingement? Pinching of the rotator cuff between the humeral head and acromion during arm elevation.