Which forms are there?
Nearly 150 years ago, French physician Simon Duplay coined the term "periarthritis humeroscapularis" (PHS) for all degenerative changes in the area around the shoulder joint. This term was used until the end of the last century for all kinds of painful shoulder stiffness - but now the diagnostic possibilities are so mature that the different disease processes can be clearly distinguished and the diagnosis of PHS should be a thing of the past.
The impingement syndrome (the bottleneck syndrome of the shoulder)
Between the upper edge of the humeral head and the bony prominence, which represents the shoulder height, the space is exactly sized for the anatomical structures that normally belong there. These include the long biceps tendon, the sinewy muscles of the rotator cuff and a large bursa that allows the movement of the muscles against each other like a smear layer. All these structures can swell in an inflammation, in the tendons can store with constant continuous load of lime and they can - similar to a rope - aufzubestrung by permanent overuse and ultimately tear.
In addition, both the shoulder joint and the overlying joint between shoulder height and collarbone can wear out, swell up and form more bone substance at the edge. In the bursa, more fluid can accumulate, creating a vicious circle: A slight increase in the volume of a tendon attachment due to fibrillation irritates the bursa; The bursa reacts with an increase in volume because it increasingly forms inflammatory fluid.
Different mechanisms lead to the impingement syndrome - the physician can use movement tests and X-ray images to distinguish the cause. For the person concerned, the shoulder bottleneck is such that he feels pain in the shoulder during movements in which he has to lift his arm over the horizontal.
The rupture of the rotator cuff
In this condition, which affects men ten times more frequently, some or all of the tendons that secure the rotator cuff muscles to the humeral head are ruptured. Frequently, a careless movement is enough to break the tendons damaged by wear. The rupture is extremely painful, the arm can not be lifted over the horizontal.
Here, lime is stored in the tendon attachments of the rotator cuff. This storage is favored by a poor circulation of the muscles and tendons, which occurs for example in overhead work (eg painters or stucco workers). The deposits in the tendons are unnoticed, but often the calcification expands into the bursa, which is very painful. Fortunately, the deposits usually dissolve again under the therapeutic measures - however, this can also cause pain.
The damages of the long biceps tendon
The long biceps tendon is wrapped in a tendon sheath, runs through a bony groove of the upper arm and makes all shoulder movements with. Both the tendon sheath and the tendon can wear out and the bone then builds up as a result of bone material around this chronic inflammatory process, which in turn can increase the inflammation. In the final state, the tendon can tear, which can be seen impressively in muscular people, because the muscle belly contracts above the elbow.
The arthroses of the shoulder joints
As a wear and tear, osteoarthritis of the joint between shoulder height and collarbone or between the humeral head and socket on the scapula can be established. This joint wear causes pain in every shoulder movement. As a result of all degenerative diseases, a shoulder stiffness can set in which all movements hurt and the range of motion due to pain decreases more and more.