Whether you're a weekend athlete, or a gardener that overdid it, or a person with arthritis, there's hope for you. According to Dr. Nathan Wei, Clinical Director of the Arthritis and Osteoporosis Center of Maryland, "Shoulder problems are one of the most common afflictions of modern times. Fortunately, there are many ways of helping people feel better."

The shoulder is the largest, most complex, and most mobile joint in the body
Four muscles and their tendons (ropes attached to the top of the humerus), collectively known as the rotator cuff allow the shoulder to move as it does. The rotator cuff also plays a role in stabilizing the arm bone to the shoulder blade.

Shoulder pain doesn't always come from the shoulder!
Examples include pain referred from arthritis of the neck, diseases of the chest such as pneumonia and diseases of the abdomen like gall bladder problems can cause pain to be referred to the shoulder. Even ectopic pregnancies have caused shoulder pain!!! Finally, heart conditions can cause referred pain to the shoulder, particularly on the left side. A specialist's physical exam is important. Dr. Wei relates this story. "I saw a patient who had shoulder pain. The pupil of the eye on the same side of the shoulder was enlarged. That set off alarm bells so I got a chest x-ray. He tuned out to have a lung cancer. This combination is called Horner's syndrome."

Most causes of true shoulder pain fall into 3 categories
? tendonitis/bursitis- With repetitive motion, the bursae (small fluid-filled sacs) surrounding the shoulder joint can become inflamed. This condition is called bursitis.
? injury/instability- Keeping your arms extended above your head; chronic compression , ie. forcing the shoulder into its socket; muscle imbalance- if one of the muscles is extra weak, that can cause the rotator cuff to function poorly.
? arthritis- Usually a function of aging.

Patient tips:
? Try to limit the number of overhead reaches.
? If you're wheelchair-bound, tuck your arms a bit closer to your body as you push.
? Avoid repetitive motion.
? Work on rotator cuff strengthening. Range-of-motion exercises are important!
? Use correct posture!

One tip that might help if you have chronic shoulder pain and have a "frozen shoulder" is to use a broomstick for stretching and range-of-motion exercises.
Oral anti-inflammatory medicines are sometimes, but not always, helpful. Patients may require a steroid injection. For people who don't respond to medicines, injections, and physical therapy, another option is surgery. Any type of surgery should be done by a skilled shoulder surgeon. "The shoulder is the most complex joint so make sure whoever works on your shoulder is an expert with shoulders," advises Dr. Wei.

Dr. Wei (pronounced "way") is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: http://www.arthritis-treatment-and-relief.com