Shoulder pain in the elderly is fairly common. As we age, our joints can become stiff, inflamed, and painful due to the wear and tear of everyday life. However, there are specific shoulder conditions and injuries can cause severe shoulder pain. These conditions include fractures tendonitis, arthritis, and frozen shoulder. Let’s dive into each of these shoulder conditions.
Anatomy of the Shoulder
Before we begin, let’s briefly review the anatomy of the shoulder. We typically just think about the ball-and-socket joint, but the shoulder complex is much larger. The shoulder is actually made up of 4 joints.
- Glenohumeral joint: The ball-and-socket joint that connects our arm to our chest.
- Acromioclavicular joint: Joint that attaches the shoulder blade to the collarbone.
- Sternoclavicular joint: Joint that connects the collarbone and the breastbone.
- Scapulothoracic joint: The junction between the shoulder blade and rib cage.
When considering shoulder injuries, seniors are likely to incur injuries in the glenohumeral and acromioclavicular joints. However, the muscles or tissue surrounding these joints can also become injured.
Common Shoulder Injuries
Seniors could break bones in the shoulder as a result of a fall. There could be a break in the collarbone or in the humeral head.
In general, the most common bone fracture in the shoulder is a clavicle fracture; however, this is the type of fracture doctors see most often in children and is quite rare in seniors. More frequently, seniors fracture their humeral head, which is "ball" part of the glenohumeral ball-and-socket joint.
Because the collarbone sticks out and is relatively superficial, it is a common bone for kids to break as they run around and accidentally collide with something. But a broken collarbone in a senior could be a sign of abuse. If a senior were to fall, you might expect to see a broken hip, wrist, hand, or ankle — not a broken clavicle.
Additionally, seniors who break their collarbone face a hard recovery. A broken collarbone can lead to serious infection. Plus, the body is no longer able to heal bones as quickly. As a result, almost 1 in 4 seniors who breaks their clavicle will die as a result.
Signs of a broken clavicle include:
- Immediate pain
- Grinding when trying to move the shoulder
- Inability to raise the arm
A doctor will diagnose a broken clavicle through an X-ray. A senior may need to keep their arm in a sling while the clavicle heals, or they may need surgery. A doctor may also prescribe pain medication.
Humeral Head Fracture
Seniors will more commonly break the humeral head due to the natural weakening of bones. This bone can be broken during a fall if a senior tries to break their fall with an outstretched arm. Plus, women are 2 times more likely than men to fracture this bone.
Signs of a broken humeral head include:
- Immediate pain
- Bruising in the armpit, chest, or arm
A doctor can diagnose a humeral head fracture with an X-ray. This type of fracture can heal without surgery if the bone is still aligned properly. However, if there are fragments that have shifted out of position, a senior may require surgery. A senior may need to receive nails, plates, or screws, to secure the bone back together.
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Shoulder Tendonitis and Impingement
Seniors can get tendonitis around their rotator cuff, which includes the muscles and tendons that support the ball-and-socket joint. The rotator cuff essentially keeps your arm in your shoulder socket. These tendons can become inflamed with tendonitis. When the bone at the top of your shoulder rubs against the tendons, it can also cause pain. This condition is known as shoulder impingement.
Signs of rotator cuff tendonitis or impingement include:
- Loss of motion
- Swelling in shoulder or down the side of the arm
- Loss of mobility
A doctor can diagnose both of these conditions and recommend some treatment options, including rest, ice application, pain medication, physical therapy, or surgery.
Rotator Cuff Tear
The rotator cuff can also tear, which can be very painful. It can happen as a result of a sharp movement or when performing a repetitive motion. These tears are more common among seniors. In fact, 50% of adults over 60 years old have had a rotator cuff tear and 95% of adults over 80 years old have had a rotator cuff tear. In large part, this is due to the regular wear and tear of the rotator cuff along with the decreased elasticity of the muscles.
Signs of a rotator cuff tear include:
- Dull pain
- Weakness in the arm
- Cracking or clicking sound when arm is moved
A doctor can diagnose a rotator cuff tear. They may perform a physical examination, order X-rays, request an MRI, or call for other tests. Generally, treatment for a rotator cuff tear includes rest and ice. However, if tendons or muscles have detached from the bone, a senior may need surgery because no amount of physical therapy can cause those tissues to reattach to the bone.
Frozen shoulder, or adhesive capsulitis, is a condition in which the shoulder becomes stiff and ultimately immobile. It causes stiffness and pain in the shoulder caused by inflammation or an injury. Ultimately, the shoulder becomes frozen in place and doesn’t want to move. However, further immobility can cause the condition to get worse, so seniors with frozen shoulder need to try and move it.
Frozen shoulder is a gradual stiffening and does not happen at once. Some health conditions, like diabetes or cardiovascular disease, can increase a senior’s risk of getting a frozen shoulder.
Signs of frozen shoulder include:
- Stiffness of shoulder joint
- Dull pain
A doctor can diagnose frozen shoulder and recommend physical therapy or other treatment options. The “thawing” stage of frozen shoulder can take anywhere from a few months to a few years.
Seniors may also get arthritis in their shoulders. However, the most common type of arthritis in this joint is osteoarthritis, which is associated with regular wear and tear of joints. A senior could also experience rheumatoid arthritis in their shoulder, although less likely.
Signs of arthritis in the shoulder include:
- Limited range of motion
- Joint stiffness
- Cracking, popping, or crunching sound (crepitus) when moving the joint
A doctor can diagnose arthritis and recommend a variety of treatment options, including rest, ice application, pain medication, physical therapy, and even surgery when arthritis is severe. These surgeries aim to remove bone spurs, damaged bone, or scar tissue that could be causing the pain. However, doctors may also perform a joint replacement on the elbow if the arthritis is severe enough.
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Overcoming Shoulder Injuries
If you or a loved one experiences shoulder pain, work with your doctor to determine the underlying cause and create a treatment plan. If your injuries interfere with your activities of daily living, don’t hesitate to reach out to Caring Senior Service. Our caregivers can assist you at home so you can maintain your daily routines safely and comfortably. Reach out to a Caring team near you today.