Dominic Stone
Weak muscles can be a cause and an effect of shoulder and back pain. Shoulder pain is common and could be caused by an injury, dislocation, overuse, or an underlying condition. Shoulder impingement syndrome, also known as swimmer's shoulder or thrower's shoulder, is caused by irritation and inflammation of the rotator cuff's tendons or bursa. This can result in pain when you lift your arm to the side, and if left untreated, can lead to the gradual tearing of tendons around the rotator cuff as they begin to weaken and thin. Parsonage-Turner syndrome (brachial neuritis) is a rare neurological condition that causes sudden and severe pain in the shoulder and upper arm, followed by weakness. On the other hand, shoulder pain can also lead to muscle weakness due to immobilization or lack of movement.
| Characteristics | Values |
|---|---|
| Causes of shoulder and back pain | Injury, dislocation, overuse, or an underlying condition |
| Common causes of shoulder weakness | Nerve, muscle, or tendon coordination deficit, rotator cuff problem, nerve injury |
| Parsonage-Turner syndrome | Rare neurological condition causing sudden and severe shoulder pain followed by weakness |
| Shoulder impingement syndrome | Irritation and inflammation of the rotator cuff tendons or bursa |
| Lack of movement | Can lead to increased weakness and loss of muscle mass, strength, and endurance |
| Bad posture | Slouching or leaning forward can worsen shoulder problems |
| Lung cancer | Certain types, such as a Pancoast tumor, can cause shoulder blade and upper back pain |
| COVID-19 | Can cause muscle weakness or aches, potentially affecting the shoulder |
| Carpal tunnel syndrome | Causes pain and weakness in the hand and wrist, which can strain the shoulder |
| Treatment options | Physiotherapy, strengthening exercises, massage, rest, heat or ice, medication, immobilization |
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What You'll Learn
Shoulder impingement syndrome
Shoulder pain is a common physical complaint, affecting people of all ages and for a variety of reasons. One of the most common causes of shoulder pain is shoulder impingement syndrome, which accounts for 44% to 65% of all shoulder complaints. This syndrome is a painful condition of the upper extremity that results from inflammation, irritation, and degradation of the anatomical structures within the subacromial space. The subacromial space is the area between the top of the shoulder (acromion) and the rotator cuff tendons, and when it becomes narrowed, the acromion can rub against or impinge on the tendon and the bursa below, causing irritation and pain.
Primary impingement, a type of shoulder impingement syndrome, is characterised by a structural narrowing of the subacromial space and can be attributed to abnormal acromion anatomy or swelling of the soft tissues. Examples include a hooked class III acromion, where the acromion has a hooked shape that reduces the subacromial space, or swelling of the soft tissues that compress the subacromial space.
The diagnosis of shoulder impingement syndrome is primarily made through a patient's history and physical examination. Treatment options include physical therapy exercises to strengthen the shoulder girdle, pharmacological interventions to reduce inflammation, and in some cases, surgery may be offered to widen the space around the tendon and prevent further impingement.
While shoulder impingement syndrome is a common cause of shoulder pain, there are other potential causes as well. For example, Parsonage-Turner syndrome is a rare neurological condition that can cause sudden and severe pain in the shoulder and upper arm, followed by weakness. Additionally, certain types of lung cancer, such as a Pancoast tumour, can also cause shoulder blade pain in addition to upper back pain.
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Parsonage-Turner syndrome
Weak muscles can cause shoulder and back pain. This could be due to a rotator cuff problem or a nerve injury. Certain types of lung cancer, like a Pancoast tumour in the upper lung, can also cause shoulder blade pain in addition to upper back pain.
There are three phases of PTS. Phase 1 involves severe and sudden pain that usually affects one shoulder. Phase 2 involves the development of muscle weakness and can lead to muscle loss (atrophy). This phase typically lasts from six to eighteen months but can last longer. In Phase 3, the muscles regain strength and functionality.
The exact cause of PTS is unknown, but it is thought to be caused by an abnormality in the immune system. The condition has been reported in various clinical situations, including postoperative, post-infectious, post-traumatic, and post-vaccination. It is named after British neurologists Maurice Parsonage and John Turner, who described the condition in 1948.
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Rotator cuff tear
A rotator cuff tear is a common cause of shoulder pain and disability among adults. The rotator cuff is a group of four muscles that come together as tendons to form a covering around the head of the humerus. The rotator cuff attaches the humerus to the shoulder blade and helps lift and rotate the arm. A rotator cuff tear may weaken the shoulder, making daily activities like combing hair or getting dressed painful and difficult.
There are two main causes of rotator cuff tears: injury and degeneration. An injury to the rotator cuff may happen suddenly when falling on an outstretched hand or lifting something heavy with a jerking motion. It may also develop over time due to repetitive activities such as baseball, tennis, rowing, weightlifting, or even routine chores.
Degeneration refers to the breakdown of tissues, which may happen as part of the aging process. As we get older, the blood supply to our rotator cuff tendons decreases, impairing the body's natural ability to repair tendon damage. This can ultimately lead to a tendon tear. Most rotator cuff tears are largely caused by the normal wear and tear that comes with aging, so people over 40 are at greater risk. In many cases, torn tendons begin by fraying and gradually progress to a complete tear.
The symptoms of a rotator cuff tear may include pain that keeps coming back, especially when doing certain things such as lifting overhead, pain that prevents sleeping on the injured side, muscle weakness, limited ability to move the arm, and grating or cracking sounds when moving the arm. Treatment may include rest, medicine, strengthening and stretching exercises, and, in some cases, surgery.
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Bad posture
A person's posture while using a computer or working can also cause tension in the muscles between the neck and shoulder. This can lead to inflammation in the bursa, the fluid-filled sacs that help muscles and tendons slide smoothly over the shoulder bones. Bursitis, or inflammation of the bursa, can also be caused by overuse injuries, such as from swimming, washing, painting, playing tennis, or gardening. This can result in pain when moving the shoulder, especially when lifting the arm to the side or above the head.
In addition to shoulder pain, bad posture can also cause back pain. For example, problems in the neck can cause pain in the shoulder blade or upper outer arm, known as referred or radiated pain.
Physiotherapy can help reduce shoulder pain and improve shoulder function through strengthening and stretching exercises, massage, and other therapeutic techniques.
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Lung cancer
While weak muscles can cause shoulder and back pain, there are many other possible causes, including injury, dislocation, or an underlying condition. One such underlying condition is Parsonage-Turner Syndrome (PTS), a rare neurological condition that causes sudden and severe pain in the shoulder and upper arm, followed by weakness. PTS mainly affects motor nerves and axons, which are responsible for controlling movement. This can lead to muscle atrophy.
Another possible cause of shoulder and back pain is lung cancer. Lung cancer can cause referred pain in the shoulder and other body parts, although this is uncommon. Certain types of lung cancer, such as Pancoast tumors, can invade tissues near the shoulder and cause pain that radiates down the arm and to other areas of the body, including the head, neck, and chest. Lung cancer can also spread to the bones in and around the shoulder, causing shoulder pain.
Shoulder pain may be a symptom of lung cancer if it occurs at rest, is worse at night, and is not associated with any loss of motion. Other symptoms of lung cancer include shortness of breath, coughing up blood, and chest pain. If you are experiencing any of these symptoms, it is important to talk to your healthcare provider.
It is important to note that shoulder pain is a common symptom with many possible causes, and it may be unrelated to cancer. However, any persistent, unexplained pain warrants further investigation by a medical professional.
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Frequently asked questions
Shoulder pain can be caused by an injury, dislocation, overuse, or an underlying condition. Some common causes of shoulder pain include bursitis, tendonitis, shoulder impingement syndrome, and rotator cuff tears.
Yes, weak muscles can cause shoulder pain. Lack of movement can lead to increased weakness and a loss of muscle mass, strength, and endurance. Shoulder pain can also be caused by nerve injuries, such as Parsonage-Turner Syndrome, which causes sudden and severe pain followed by weakness.
Yes, weak muscles can contribute to back pain. Back pain can be caused by poor posture, which puts strain on the muscles and joints. Strengthening the muscles of the back, shoulders, and core can help improve posture and reduce back pain.
