[18M] Experiencing chronic shoulder pain with movement

Patient Description

An 18-year-old male has been experiencing sharp shoulder pain for several years, rated as a 7 out of 10 in severity. The pain is triggered by moving the arm up and out, particularly when reaching overhead, and is accompanied by weakness and audible clicking or popping sounds. The pain also worsens when sleeping on the affected shoulder or arm, and it sometimes limits his range of motion during daily activities. The patient reports the pain persists even at rest and at night. There is a family history of arthritis, but the patient does not engage in activities with repetitive overhead movements, has not had any recent injuries, and does not have any known chronic illnesses or pre-existing conditions. The patient is not currently on any medications and has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Rotator Cuff Tendinitis or Tear: This condition is characterized by damage to the tendons in your shoulder. It often results in a dull ache in the shoulder, which often worsens when you try to sleep on the involved side. The pain is often worse when lifting your arm or reaching overhead, which matches your symptoms.

    • Treatment usually involves rest, physical therapy, and pain relievers. In severe cases, surgery may be necessary.

  • Shoulder Impingement Syndrome: This occurs when the tendons of the rotator cuff, along with the subacromial bursa, become compressed against the acromioclavicular joint. This compression can result in pain and loss of motion in your shoulder.

    • Treatment typically involves physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs), and possibly corticosteroid injections. Surgery may be an option if conservative treatments are ineffective.

  • Frozen Shoulder (Adhesive Capsulitis): This condition involves stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within a two-year period.

    • Treatment often involves range-of-motion exercises and, sometimes, corticosteroids and numbing medications injected into the joint capsule.

What you can do

While you should definitely seek medical attention for your symptoms, here are some things you can do in the meantime:

  1. Rest your shoulder and avoid activities that make your pain worse.
  2. Apply ice to your shoulder for 15 minutes at a time, a few times per day.
  3. Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol), may help reduce shoulder pain.

What you should look out for

Please seek immediate medical attention if:

  • The pain is intense and sudden
  • You have difficulty moving your arm or shoulder
  • You notice a deformity in your shoulder
  • Your shoulder joint appears larger than usual
  • You have difficulty breathing or experience chest tightness

Remember, I'm an AI and this advice is based on the information you've given me. It's always a good idea to consult with a healthcare professional for an accurate diagnosis.

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10 mo ago

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People Also Ask

What are the common causes of shoulder pain in young adults?

Common causes of shoulder pain in young adults include rotator cuff injuries, shoulder impingement, labral tears, and sometimes conditions like frozen shoulder. Overuse, trauma, or degenerative changes can contribute to these conditions.

How can I differentiate between rotator cuff tendinitis and shoulder impingement syndrome?

Rotator cuff tendinitis often presents with a dull ache and pain when lifting the arm, while shoulder impingement syndrome involves compression of the tendons and bursa, leading to pain and limited motion. A healthcare professional can perform specific tests to differentiate between the two.

What are the non-surgical treatment options for shoulder pain?

Non-surgical treatment options for shoulder pain include rest, physical therapy, ice application, and over-the-counter pain relievers like NSAIDs. In some cases, corticosteroid injections may be recommended to reduce inflammation.

When should I seek immediate medical attention for shoulder pain?

Immediate medical attention should be sought if the shoulder pain is intense and sudden, if there is difficulty moving the arm, noticeable deformity, swelling, or if there are symptoms like difficulty breathing or chest tightness.

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