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Learning About Internal Derangement of the Shoulder

What is it?

Internal derangement of the shoulder is a broad term for a shoulder problem inside the joint that causes pain or makes it hard to move your shoulder normally.

What causes it?

There are three main causes of internal derangement of the shoulder.

  • Injury. For example, falling on your shoulder, sustaining a hard shoulder impact, or grabbing onto something to keep from falling can cause it.
  • Repeated overhead motion. Regularly playing sportslike tennis or volleyball can be a cause. So can swinging a hammer often.
  • Aging. Wear and tear over time and arthritis can also cause it.

What are the symptoms?

If you have a sudden (acute) injury, some symptoms may include:

  • A severe pain or a “popping” feeling in your shoulder.
  • Bruising or swelling around your shoulder.
  • Weakness in the arm.

If you have a chronic or overuse injury, some symptoms may include:

  • A “clicking” or “catching” feeling in your shoulder.
  • Pain that is worse at night or when doing any overhead activity.
  • Continued weakness in the arm.

How is it diagnosed?

Your doctor will ask you questions about your symptoms and do a physical exam. This exam involves checking your range of motion and strength, as well as looking for other things that may have caused your pain. Other tests may include X-rays, an MRI, or an ultrasound.

How is it treated?

Your treatment will be based on your age, the demands on your body, and the cause of the issue.

Common treatments include:

  • Avoiding activities that cause shoulder pain.
  • Taking over-the-counter medicines to reduce pain and swelling.
  • Doing physical therapy to improve movement, strength, and endurance.

If these treatments don't help, or if repeated overhead motion is a big part of your life, your doctor may recommend surgery.

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