Common Causes Leading to Pain When Stretching Arms Upwards

Shoulder Joint

Our shoulder joint is a complex union of our upper arm, shoulder blade and the collar bone. These three bones articulate over more than one surfaces to provide maximum range of motion at this joint. However, stability of the joint is compromised in providing wide range of movements.

Many tendons, ligaments and muscles surround this joints to provide ample support and implement the different movements here. Apart from this, there are fluid filled sacs or cushions, called bursae. These are carefully placed at locations where two bones slide over each other.

Pains in and around this joint may chiefly arise from either of these structures that make up the joint-

• Bones involved, collar bone, shoulder blade or the humerus or arm bone
  Joint capsule
• Joint capsule is composed of chiefly four muscles and their tendons.

Structures In Joint Capsule

• Muscles
• Tendons
• Bursae

Bursa

A bursa is a fluid filled bag placed between the bones which move over each other. It serves the purpose of reducing friction during movements.

Causes of Pain When Arms Are Stretched Upwards

Tendonitis

Very commonly encountered. It results from irritation leading to inflammation of the tendons that connect joint muscles to joint bones.

It occurs due to repeated movements. When you overwork these muscles again and again, without giving adequate rest. Common in swimmers, ploughers. May be seen in after excess household works too.

Symptoms

• Pain in front and side of the joint
• Pain exists all the time
• Typically, it may improve slightly with activity
• Stiffness in the joint area
• It is worse at rest
• Movements affected are stretching the arm upwards or backwards
• Working with arm at a level below the shoulder is usually not affected
• Slight swelling may be palpable in front

Activities affected commonly include swimming, brushing hair, playing tennis, picking up objects from high shelves, unclothing yourself etc.

Why Stiffness Occurs?

Stiffness is a protective response caused by the muscles forming the shoulder cuff. In order to restrict any further movements there, muscles become rigid and stiff like a cardboard, preventing you form any further movements. This is to give rest to the affected injured areas and allow time for healing.

Bursitis

Another soft tissue commonly affected is the bursa. It may get inflamed due to overuse of the joint, repeated activities there.

Symptoms

• Very painful
• You get excruciating pain on some movements
• Pain is located on the front and side of the joint
• Stiffness in the joint area
• Feels like there’s a wound inside
• Movements affected are upwards, rotations or backwards

Tendon Tears

You may understand the tendon as group of stiff threads connecting the elastic muscle to the bony surfaces. Muscles are not directly attached to the bones. They need these sticky glue like fibers for insertion.

If there’s a tear of few fibers of these tendons, you get shoulder pain

Symptoms

• Sever pain at shoulder joint
• Increasing sharply on movements
• Most affected are those movements involving the arm going upwards, backwards or across the body.
• Pain is perceived as coming from deep inside
• Stiffness in the joint area
• This pain does not improve on rest
• It may wake you up at night

Muscle Sprains

Chiefly, there are four muscles making up the shoulder cuff. Sprain due to any abrupt movement, or over use  may give pain at he joint area .

Osteoarthritis

The bony surfaces of bones that meet to form the joint are lined internally by cartilages. This is to make the articulating, that is, joint forming surfaces cushiony. As these cartilages get eroded with time, the bony surfaces become exposed.

This may result in direct rubbing of one bone over other. Rubbed areas get irritated and inflamed. They grow rough and may even develop tiny spurs over them.

Spurs further hinder movements there, and make it painful to move the joint.

Symptoms

• Shoulder pain is a first sign to come.
• Pain appears to be coming from deep inside, it’s an ache as deep in as the shoulder blade
• Restriction of movements at the joint, which is progressive in nature
• Does not improve with rest or time.

Diagnosing

This may involve a thorough clinical check up, where your doctor may require you to move your arm up and down, forward, backwards and rotate. What movements are restricted by pain may give a strong clue.

He may feel and palpate the affected area.

Clinical exam is commonly supplemented by a simple X ray shoulder. Zanca View may be done to visualize the acromio clavicular joint as well.

In some cases, further soft tissue analysis may require an MRI of the region.

Management

All soft tissue injuries, including Tendinitis, bursitis, Muscle Sprains, Tendon Tears etc. improve with time when given adequate rest.

There’s a role of anti inflammatory medications to speed up the recovery process. Some cases may require corticosteroid injections, given directly at the affected area.

Surgical repairs of torn tendons may need to be done in severe cases.