Stiff shoulder | Alinamin Pharmaceutical Co., Ltd.

What is stiff shoulder?

Symptoms of stiff shoulder

Stiff shoulder refers to a tensed, stiffened, or painful symptom occurring from the neck or base of the neck to the shoulder or back, and sometimes is accompanied by headache or nausea. Stiff shoulder involves various muscles, but the trapezius muscle, a large muscle covering the scapula, plays a main role. The muscle is prone to being strained because it is involved in the movement of the scapula and supports the neck and shoulder joint moving.

Causes of stiff shoulder

Possible causes of stiff shoulder in daily life

In addition to stiff shoulder caused by some disease, there are other types, the causes of which are unknown. In fact, the cause is unknown in many cases, and it is supposed to occur due to the combination of poor posture, lack of exercise, overwork, coldness, physical/mental stress, disturbed autonomic nerves, etc. as well as tension of muscles and insufficient blood flow around the shoulder. The following are some suggestions.

Desk work in the same posture
When people operate a PC in the same posture for a long time, the movement of the scapula and shoulder joint is impaired and the trapezius muscle, etc. become tense, which leads to stiff shoulder symptoms. In addition to it, if poor posture is added, the nerves continue to be compressed and stiff shoulder advances.

Eyestrain
The overuse of the eyes due to long time use of PCs, smartphones, tablets, etc., unfocused glasses, influence of blue light and ultraviolet rays, disturbed autonomic nerves by stress and lack of sleep, etc. may cause eye fatigue. If this persists, chronic eye fatigue may fix and cause not only eye symptoms but also eyestrain accompanied by systemic fatigue including stiff shoulder.

Muscle fatigue and poor blood circulation due to lack of exercise
People who are not physically active in daily life are more prone to muscle strain and fatigue because their muscles are not used every day. Insufficient exercise leads to poor blood circulation, and this also can cause stiff shoulders. In addition, muscles are tensed in order to maintain a certain posture even if not moving the body. Therefore, lack of exercise may be a major cause of stiff shoulders.

Tension due to stress
When physically or mentally stressed, the autonomic (sympathetic) nervous system, which tenses muscles, is activated. Then, the muscles around the shoulder become tense and stiff shoulder occurs. It will recover if the stress is temporary. However, if exposed to stress continuously, excessive muscle tension continues and stiff shoulder may become chronic.
Chronic stiff shoulder leads to chronic fatigue. Ordinary fatigue can resolve with rest and sleep, but if mental stress is added, the rest and sleep become poor. As fatigue becomes chronic, stiff shoulder may also become chronic.

Tension of shoulder muscles and disturbance of autonomic nerves due to cold temperature
When you spend a long time in a cold place or cooled room, your muscles become tense. In addition, coldness causes a disruption in the autonomic nervous system, resulting in poor blood flow and increased muscle tension, which causes a negative spiral leading to stiff shoulder.

Diseases considered to be the cause of stiff shoulder

Note: The following disorders require a physician's diagnosis:
If you are concerned about any of the following disorders, consult a physician early.

[Stiff shoulder due to age]
The official name is shoulder periarthritis. As people age, the shoulder joint and surrounding tissue become chronically inflamed and the pain limits the ability to lift the arm or rotate it backwards. Sometimes the pain is too severe to sleep even if you lie still at night.
Shoulder pain recovers in about 6 months to 1.5 years depending on the severity, but light shoulder exercise is effective to accelerate the recovery. If you stay still due to pain, your shoulder movement may deteriorate.

See here for information on this disease/symptom. Stiff shoulder due to age

[Cervical osteoarthritis]
This occurs when the elasticity of the intervertebral disc that connects the neck bones decreases with age. As the elasticity decreases, the vertebra adjacent to the intervertebral disc causes spine-like deformation. The spine compresses and stimulates the spinal nerves sent from between the cervical spines to the shoulder, causing severe pain and numbness in the part from the neck to the scapula, arms, and fingers.

[Climacteric disturbance]
When the menopausal stage, about 10 years before and after the menopause, comes, the balance of female hormones may change rapidly to cause problems in the mind and body. Various symptoms similar to autonomic nerve imbalance that occur during this stage are called climacteric disturbance.
Symptoms include stiff shoulder, fatigue, sluggishness, hot flushes, irritability, and anxiety, which often interfere with daily activities such as work and housework.

See here for information on this disease/symptom. Climacteric disturbance

[Hypertension]
This is a condition in which systolic (highest) and diastolic (lowest) blood pressure continue to be 140 mmHg or higher and 90 mmHg or higher, respectively, due to heredity, obesity, excessive salt intake, or other lifestyle habits (Japanese Society of Hypertension 2019). Hypertension may cause serious diseases such as angina pectoris, myocardial infarction, heart failure, cerebral infarction, and cerebral hemorrhage. Many cases have no subjective symptoms, but symptoms such as stiff shoulders, palpitations, hot flush, and shortness of breath may appear.

See here for information on this disease/symptom. Blood pressure is on the high side

[Hypotension]
It is said to occur due to heredity, disease, etc., and generally the systolic blood pressure is less than 100 mmHg. Many hypotensive people feel lightheaded and dizzy. Also, symptoms such as stiff shoulder, sluggishness, fatigue, headache, and bad wake-up may occur.

See here for information on this disease/symptom. Blood pressure is on the low side

[Angina pectoris]
If the blood vessel surrounding the heart is blocked due to arteriosclerosis, the flow of blood will be impaired, causing oxygen deficiency in the heart muscles. The typical symptom is squeezing chest pain, but as referred pain (radiating pain) the symptom may occur at sites other than the heart such as the shoulder.
For example, you may feel stiff shoulder suddenly or have a seizure in which pain spreading to the shoulders continues for several minutes simultaneously with chest constriction.

[Myocardial infarction]
This is a condition in which the blood vessels surrounding the heart are completely blocked due to arteriosclerosis, thereby stopping the blood flow. An attack with severe pain occurs in the chest, and may be accompanied by dyspnea, nausea, or cold sweat. The pain lasts more than 20 minutes, and severe pain may occur not only in the chest but also in the shoulders, arms, and stomach.

[Other diseases hidden behind stiff shoulder]
Stiff shoulder may be a warning sign of various diseases. Main other diseases hidden behind stiff shoulder are as follows:
Migraine, dissecting aortic aneurysm, liver disease, cholelithiasis, pancreatitis, cerebral hemorrhage, cerebral infarction, Parkinson disease, visual impairment, inflammatory diseases in the inner and outer ear, sinusitis, temporomandibular arthrosis, psychosomatic disease, depression, etc. If you are concerned about these disorders, consult a physician early.

Treatment of stiff shoulder
Treatment of stiff shoulder includes massage therapy, heat therapy, exercise therapy, orthotic therapy, physical therapy, pain clinic therapy (nerve block: a therapeutic method in which anesthetics or steroid hormones are injected to the nerves or surrounding areas of the part with severe stiff shoulder symptoms, etc. to relieve pain or stiffness), and drug therapy. There is also fascial therapy that works on the fascia (a membrane that envelops muscles) considered to be the cause of pain.
However, at first, try prevention methods that you can do every day. It is important to prevent stiff shoulder from becoming severe persistent symptoms.

Daily prevention of stiff shoulder

Move the body to improve blood circulation

Appropriate movements of the scapula and shoulder joint improve blood circulation in muscles such as the trapezius muscle. Try to do exercises that use muscles throughout the body in a balanced way little by little, aiming the relief of pain. Radio gymnastic exercises, yoga, and stretching along with exercises such as walking, cycling, and walking in water are recommended.

Prevent the shoulders and neck from being cooled

Overcooling by the air-conditioner in summer or coldness in winter causes muscle tension to shrink the body, which leads to stiff shoulder. Avoid direct exposure of the body to cold air from the cooling apparatus while paying attention to heat attack in summer. Also, in winter, wear a scarf and high-necked clothes when going out, or use a steaming towel or heat pack to warm the shoulders and neck.

Review the work environment

It is suggested that the time operating PCs, smartphones, or tablets is increasing in recent years, regardless of at the office or at home for telework, etc. As described above, desk works in the same posture and eyestrain may cause stiff shoulder. So, pay attention to the posture and the duration of continuous use.

The distance between the PC screen and the eyes should be 40 cm or more, adjusting the position to be lower than the eye level. Sit back in a seat with the back straight, and place the keyboard to keep the elbow angle at approximately 90-100 degrees when you touch it.
In the same way, keep a reasonable distance when using smartphones and tablets. When using them for a long time, use an external keyboard, etc. to prevent fatigue. If you continuously use them in a head-forward posture, there is a great burden on the neck that receives the weight of the head and the shoulders that support the neck. So you must be careful.

Care should be taken to ensure that the working hours per day are not too long regardless of PCs, smartphones, or tablets. Set a cycle to be within 1 hour, take a break once or twice during the cycle, and occasionally stand up to stretch. When looking at the screen and documents alternately, place the documents in a position where your eyes are not tired. In telework, you tend to have a bad posture even if you noticed it. Try to have a good posture and take an appropriate break.

Treatment for stiff shoulder

Self-care at home

We introduce ways to improve stiff shoulder at home, such as improving blood circulation, reducing stress, relaxing tension, and using OTC drugs appropriately.

Improve blood circulation with effective bathing
Soak in a tepid bath slowly. It is also recommended to take a shower with a little hot water and water alternately every 2-3 minutes while paying attention to the temperature, and finally end with a hot shower. This not only improves blood circulation, but also helps to eliminate stress.

Receive a moderately stimulating massage
Try to relieve muscle tension and pain in the shoulder and neck with appropriate massage. However, a painful massage may cause excessive tension, local fatigue, or a small wound in the muscle.
If performed by your family member, a person around you, or yourself, it is better to keep the strength at a moderate level, such as rubbing, gently pressing, or kneading. (Any massage requiring strong force must be performed by a physician or licensed “massage and finger pressure practitioner”.)

Use of OTC drugs
For stiffness in the shoulders and neck, topical or oral analgesic and anti-inflammatory agents containing the active ingredients are effective. Vitamin preparations containing active ingredients such as vitamins B₁, B₆, and B₁₂ are also involved in muscle activity, metabolism, and blood circulation, and help to relieve pain from the inside of the body. In addition, some products contain ingredients that can relax muscle tension.

Visiting a medical institution
Diseases that must not be overlooked may be hidden behind stiff shoulders that cause aching pain, pain without using the shoulder, gradually aggravating stiffness, shoulder pain in the body movement such as climbing stairs, numbness in the hands, and stiffness that interferes with daily life. Visit a medical institution to have an examination.

Note: Graphics are images.