Shoulder pain is one of the most common orthopedic complaints in Alaska, driven by the state's fishing industry, outdoor recreation culture, and physically demanding occupations. The shoulder is the most mobile and complex joint in the body, which makes it both incredibly versatile and vulnerable to injury. Understanding the common causes of shoulder pain and available treatments can help you make informed decisions about your care.
Anatomy of the Shoulder
The shoulder is a ball-and-socket joint formed by the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone). The rotator cuff, consisting of four muscles and their tendons (supraspinatus, infraspinatus, teres minor, and subscapularis), provides dynamic stability and enables the wide range of motion the shoulder is known for. The labrum is a ring of cartilage that deepens the socket, and the biceps tendon runs through the front of the shoulder connecting the biceps muscle to the top of the socket.
Common Causes of Shoulder Pain
Rotator cuff injuries are the most common cause of shoulder pain in adults. These range from tendinitis (inflammation) and bursitis to partial and full-thickness tears. In Alaska, rotator cuff injuries are especially common among commercial fishermen, construction workers, and overhead athletes. Symptoms include pain on the side of the shoulder, weakness with overhead activities, and pain that worsens at night.
Frozen shoulder (adhesive capsulitis) causes progressive stiffness and pain that can severely limit shoulder movement. It often develops gradually and can take 12 to 18 months to resolve. Frozen shoulder is more common in diabetics and often follows periods of shoulder immobility.
Shoulder impingement occurs when the rotator cuff tendons are pinched between the bones of the shoulder during overhead arm movements. This causes pain with reaching overhead, behind the back, or to the side. Impingement is common in swimmers, painters, carpenters, and anyone who performs repetitive overhead work.
Labral tears, including SLAP tears (superior labrum anterior to posterior), cause clicking, catching, and pain deep in the shoulder. They often result from falls onto an outstretched hand, repetitive overhead activities, or shoulder dislocations.
Shoulder arthritis causes progressive pain and stiffness as the cartilage surfaces of the joint wear down. Osteoarthritis and post-traumatic arthritis are the most common types affecting the shoulder.
Diagnosis
Your orthopedic evaluation will typically include a detailed history of your symptoms and activities, physical examination with specific tests for each potential diagnosis, X-rays to evaluate bone structure and arthritis, and MRI when soft tissue injury is suspected. In some cases, diagnostic injections or advanced imaging may be needed.
Treatment Options
Conservative treatment is appropriate for many shoulder conditions. Physical therapy focusing on rotator cuff strengthening, scapular stabilization, and range of motion is the foundation of most non-surgical treatment plans. Anti-inflammatory medications, activity modification, and cortisone injections provide additional relief.
Surgical options are considered when conservative treatment fails. Arthroscopic surgery is used for rotator cuff repair, labral repair, impingement decompression, and treatment of frozen shoulder that does not respond to therapy. Total shoulder replacement and reverse shoulder replacement are options for advanced shoulder arthritis.
Finding Shoulder Specialists in Alaska
Alaska orthopedic surgeons with sports medicine or upper extremity fellowship training are best equipped to evaluate and treat shoulder conditions. These specialists have advanced training in both arthroscopic and open shoulder surgery techniques. Alaska Orthopedic Guide lists shoulder specialists across the state with practice details and contact information.