What disease should I beware of if my right arm hurts?

Modern people attach great importance to physical health, so exercise has become a compulsory course for many people. Some run in the morning; some go to the gym after get off work, all for the purpose of improving physical fitness. However, any exercise must be maintained in a certain amount and not excessive. Some people suffer from shoulder pain, leg pain, etc. due to excessive exercise. Of course, in addition to shoulder pain caused by exercise, we cannot rule out the possibility that it is caused by disease. So what disease should we be alert to if we have pain in our right shoulder?

Causes

1. Trauma

It is the main cause of rotator cuff injury in young people. It is caused by falling with the hands abducted to the ground or holding heavy objects, and the shoulder joint is suddenly abducted and raised or sprained.

2. Insufficient blood supply

Causes degeneration of rotator cuff tissue. When the humerus is in internal rotation or external rotation in a neutral position, this dangerous area of ​​the rotator cuff is most susceptible to compression by the humeral head, which squeezes the blood vessels and causes relative ischemia in the area, leading to degeneration of the tendon. Clinically, complete rotator cuff rupture mostly occurs in this area.

3. Chronic impingement injury of the shoulder

The rotator cuff tissue of middle-aged and elderly patients degenerates due to long-term subacromial impact and wear. The disorder often develops during repetitive activities that require extreme abduction of the shoulder (eg, baseball, backstroke and butterfly stroke, weightlifting, racquet sports). When the upper limb is extended, the humeral head hits the acromion and coracoacromial ligament forward, causing supraspinatus tendon injury. Chronic irritation can cause subacromial bursitis, aseptic inflammation, and tendon aggravation. Acute, violent injury can cause rupture of the rotator cuff.

Clinical manifestations

This disease is more common in patients over 40 years old, especially those who do heavy physical labor. There are no symptoms in the shoulder before the injury, but there is temporary pain in the shoulder after the injury. The pain worsens the next day and lasts for 4 to 7 days. The patient cannot use the affected shoulder automatically. When the upper arm is extended and the shoulder joint is internally rotated and abducted, there is obvious tenderness between the greater tuberosity and the acromion. When the rotator cuff is completely ruptured, the shoulder abduction function will be seriously affected due to the loss of its stabilizing effect on the humeral head. When the rotator cuff is partially torn, the patient can still abduct the arm, but there is a 60° to 120° arc of pain.

examine

1. X-ray examination

It is helpful to judge the acromion morphology and changes in the bony structure of the shoulder joint. Some patients with rotator cuff injury have obvious bone hyperplasia at the anterolateral edge of the acromion and the greater tuberosity.

2. Magnetic resonance imaging (MRI)

It can help determine the site and severity of tendon injury, especially magnetic resonance imaging (MRA), which can clearly show partial tears of the rotator cuff and has a high diagnostic value.

diagnosis

The diagnosis can be made based on clinical manifestations and related examinations.

Differential Diagnosis

1. Frozen shoulder

Frozen shoulder, also known as periarthritis of the shoulder, adhesive shoulder arthritis, frozen shoulder, etc., is a condition caused by soft tissue lesions around the shoulder joint that causes shoulder pain and dysfunction of movement. It is more common in patients over 40 years old, with more females than males (3:1). It is characterized by gradually increasing shoulder pain and shoulder joint movement disorders, with limited active and passive movements.

2. Subacromial bursitis

The main symptoms are pain and tenderness under the acromion, which may radiate to the deltoid muscle, and in severe cases there is slight swelling. A long course of the disease may cause local muscle atrophy and the shoulder joint cannot perform movements such as abduction and external rotation.

3. Long head of biceps tendinitis

The onset is slow and gradually worsens. The pain and tenderness are mainly in the intertubercular groove of the humerus, and the local pain in the biceps brachii is aggravated when the elbow is flexed against resistance. Over time, there will be functional disorders and muscle atrophy.

treat

1. Conservative treatment

The injured tendon should be given adequate rest and the healthy shoulder muscles should be strengthened. Patients should avoid pushing movements and instead perform stretching activities. Topical medications such as ointments can be used for local treatment. For more severe pain, nonsteroidal anti-inflammatory analgesics can be taken orally.

2. Surgery

If the injury is severe, the rotator cuff is completely torn, or conservative treatment for 3 to 6 months is ineffective, surgical treatment is required.

With the development of arthroscopic technology, most surgical treatments for rotator cuff injuries are now minimally invasive treatments under arthroscopy, with better results. For partially huge tears or poor conditions, a small incision open surgery can be performed to repair the damaged rotator cuff.

prevention

1. Vitamin supplements are beneficial to the healing of tendonitis. In particular, avoid doing movements that may cause joint sprains. If there are no ice packs, use bags of frozen vegetables instead. It is best to wrap the injured area with a sports bandage.

2. Athletes should do sufficient warm-up before exercising.