Are you experiencing a painful involuntary contraction of your shoulder muscles? Is it hard to get your shoulder muscles to relax? Is the pain from the muscles limiting your sleep or activity level? You may have shoulder muscle spasms. You need to figure out what is causing the spasms so you can alleviate the cause and symptoms.
What Is A Muscle Spasm In The Shoulder?
A muscle spasm, also known as a muscle cramp, is a sudden and involuntary contraction or tightening of a muscle or group of muscles. This can occur in any part of the body but is most commonly experienced in the legs, arms, and back.
These spasms can last for a few seconds up to many minutes. Occasional muscle spasms may not be something to worry about, but chronic muscle spasms can be a serious issue. In the shoulder, there are many muscles that can go into spasm. These spasms or cramps can cause pain, stiffness, and limited mobility.
Types of Shoulder Muscle Spasms
The most common muscle spasms in the shoulder include:
- Biceps Muscle Spasms (Front Upper Arm)
- Pectoral Muscle Spasms (Chest)
- Rotator Cuff Muscle Spasms: There are 4 rotator cuff muscles that attach to the upper shoulder bone or the humerus.
- Supraspinatus Muscle Spasms (Top of the Shoulder)
- Infraspinatus Muscle Spasms (Back of the Shoulder)
- Teres Minor Muscle Spasms (Back of the Shoulder Below the Infraspinatus)
- Subscapularis Muscle Spasms (Front of the Shoulder)
- Trapezius Muscle Spasms (Upper Shoulder and Neck)
- Rhomboids (Between the Shoulder Blades)
Other Symptoms Associated With Muscle Spasm In The Shoulder
There are other symptoms associated with shoulder muscle spasms.
Pain And Stiffness
Pain in the shoulder, upper back, neck, upper arm, and between the shoulder blades; stiffness in the back and shoulders
Limited Range Of Motion
This can involve the Inability to lift the shoulder fully overhead as well as rotating to the side or reaching behind the back. This can be due to pain or stiffness. There also may be limitations in turning or moving the neck.
Common Causes of Shoulder Spasms
Shoulder muscle spasms can be caused by various conditions. Here are some of the conditions that may lead to muscle spasms in the shoulder:
Poor posture can put excessive strain on the muscles in the neck, shoulders, and upper back, leading to muscle tension and spasms.
Overuse or sudden, intense movements of the shoulder muscles can cause muscle strain or injury, leading to spasms.
Certain underlying medical conditions can cause muscle spasms in the shoulder, including:
- Amyotrophic Lateral Sclerosis (ALS): ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord, leading to muscle weakness, atrophy, and spasms.
- Motor Neurone Disease (MND): MND is a group of progressive neurological disorders that affect the nerves that control movement, leading to muscle weakness, atrophy, and spasms.
- Multiple Sclerosis (MS): MS is a chronic autoimmune disease that affects the central nervous system, leading to muscle weakness, and spasms.
- Spinal Cord Injury: Trauma to the spinal cord can disrupt nerve signals to the muscles in the shoulder and lead to muscle spasms. Spinal cord injury can be caused by accidents, falls, or other traumatic events.
More Associated Conditions
Avascular Necrosis of the Shoulder
Avascular Necrosis is essentially a lack of blood flow, eventually resulting in necrosis, or dying of the bone. This happens in multiple joints. And today we are talking specifically about the shoulder. So talking about AVN in the shoulder, patients typically come up with two main questions. Number one, can this heal on its own? And if not, how long or how fast will this progress? Now we classify AVN in multiple different stages: Number one: we have stage one, where it is very normal X-ray — usually, typically, someone just has pain with activity. Is the bone itself continues to deteriorate, then we start getting some changes on your X-ray.
Read More About Avascular Necrosis of the Shoulder
Frozen shoulder, also known as adhesive capsulitis, is a painful loss of shoulder movement and range in motion. The incidence of frozen shoulder is 3-5% in the general population and up to 20% in those with diabetes. The peak incidence is between 40-60 years of age. The exact mechanism is poorly understood. In general, the capsule becomes inflamed, thickened, and contracted with pain and significant restriction in range of motion. causes are poorly understood but risk factors include trauma, prolonged immobility, systematic diseases such as diabetes, stroke, connective tissue disease, and heart disease. Other causes include post-surgery, chronic inflammation causing stimulation of myofibroblasts
Read More About Frozen Shoulder
Shoulder arthritis is a common musculoskeletal condition. It affects about 32% of the US population above 60 (1). Shoulder arthritis causes progressive and irreversible destruction of the glenohumeral (shoulder) joint.
Read More About Shoulder Arthritis
Shoulder Impingement Syndrome
Pain is the most common symptom. It typically occurs with the elevation of the arm, forced movement overhead, and when lying on the shoulder. Impingement can also cause shoulder pain when reaching across the body. Narrowing of the subacromial space is the most common cause of shoulder impingement syndrome (6). The subacromial space is the area between the top of the arm bone (humerus) and the AC joint. This narrowing compresses or pinches the rotator cuff tendons and bursa. If left untreated the rotator cuff tendons can become inflamed, damaged, and or torn.Bursa and tendons can not be seen on x-ray. An x-ray may demonstrate…
Read More About Shoulder Impingement Syndrome
Shoulder Labral Tears
The labrum is a cartilaginous cup that circles the shallow shoulder socket (the glenoid) to make the socket deeper. The labrum supports and stabilizes the shoulder joint. Causes of Shoulder Labral Tears
Injury to the labrum typically occurs from repetitive trauma in overhead throwers, such as in baseball. It can also occur from a traction injury to the arm, such as lifting a heavy object off the ground or getting your arm jerked. Symptoms of Shoulder Labral Tears. Typical symptoms include pain in the front of the shoulder or deep inside the joint. Treatment options initially include physical therapy which is designed to restore range of motion and strength to the shoulder.
Read More About Shoulder Labral Tears
How Important Is Proper Diagnosis?
Obtaining the proper diagnosis is the key to managing and treating shoulder spasms.
The treatment(s) will depend on the underlying cause. For the best long term results from therapy, the root causes of muscle spasms need to be addressed. In order to achieve an accurate diagnosis, you need to see a highly skilled musculoskeletal physician such as a physical medicine and rehabilitation doctor, or pain physician.
They should take a lengthy history of your symptoms and medical issues, perform a detailed and thorough hands on physical examination, perform a diagnostic ultrasound when necessary, and order or review any relevant medical imaging such as X Rays and/ or MRIs.
Here at the Centeno Schultz Clinic we are board certified, physician musculoskeletal experts, with fellowship training in interventional orthopedics and regenerative medicine. We spend a full hour on an initial evaluation to determine the diagnosis and come up with a detailed and personalized treatment plan.
Our plans focus on helping you help yourself, treating the root causes of issues, and fostering healing of your body. We try to avoid symptom management only with drugs or high dose steroid injections. We also try to prevent the need for invasive and risky surgery.
Treatments For Shoulder Spasm
The treatment for shoulder muscle spasms depends on the underlying cause but here are some common approaches to treatment.
Only in the most severe case of muscle spasms, due to a direct nerve root or spinal cord injury, would surgery be indicated. However, if it is a more serious problem, or it has failed ALL other non surgical approaches, surgery could be indicated.
- Home Remedies: Ice/heat/activity modification: Ice can be used to temporarily help any swelling or temporary pain relief. Heat can relax the muscles or increase blood flow and may help temporarily with pain. Avoiding painful activities helps manage pain and takes stress off the spine or shoulder.
- Medications: NSAIDs, Tylenol, prescription meds. All medications help the symptoms of pain due to instability but do not address the underlying issues. All medications have potential risks or side effects.
- Physical Therapy (PT): The goal of good physical therapy is to improve posture, alignment, and strength. Physical therapy also aims to correct muscle imbalances, improve range of motion, and relax tight muscles.
A good PT can also show you good exercises and stretches to do at home to help. Lastly, many good PTs will have modalities that they can use to aid in those goals and help reduce pain.
- Modalities: Modalities include treatments such as dry needling, myofascial release (massage, graston, rolfing), shockwaves, and lasers. These modalities often performed by different therapists or chiropractors can help aid in muscle relaxation, muscle strengthening, and reducing pain.
- Platelet-Rich Plasma (PRP) Injection: PRP is made from taking your own blood, centrifuging (spinning it) to separate the components and concentrating the platelets. The concentrated platelets can then be injected into injured tissue to initiate a healing response. Platelets have growth factors, cytokines, proteins, and exosomes that mediate that healing response.
- Bone Marrow Aspirate Concentrate (BMAC): BMAC is a regenerative medicine therapy that uses stem cells and growth factors obtained from a patient’s own bone marrow to promote healing and repair of damaged tissues. The bone marrow is a spongy tissue found inside bones that produces blood cells, including stem cells.
BMAC is obtained by aspirating bone marrow from the patient’s iliac crest bone and processing it to isolate the stem cells, growth factors, and other regenerative components.
This concentrate can then be injected back into the patient’s body at the site of injury or damage, where it can stimulate the growth of new tissue and accelerate the healing process. BMC has been used to treat a variety of orthopedic conditions. It is a minimally invasive and safe procedure that can offer an alternative to more invasive treatments or surgery.
Treat Your Symptom At The Source
Shoulder spasms can be painful and debilitating. They can lead to stiffness, and inability to fully use your shoulder and neck thus limiting your activities. Seek prompt medical attention from a board certified musculoskeletal specialist who can help you prevent the condition from worsening and figure out the root cause of the spasms.
Unless there is a severe traumatic injury causing nerve damage leading to spasms, start with a non-surgical specialist. At the Centeno-Schultz clinic, we are all board-certified fellowship trained musculoskeletal specialists with specific expertise in regenerative medicine and are the source of much of the world’s research in this area.
We have extensive experience treating the causes of shoulder muscle spasms. Our focus is addressing the root causes of the problems and offering non-surgical interventions mostly using platelet rich plasma (PRP) and bone marrow concentrate containing stem cells (BMAC) to help heal damaged tissues to reduce pain and restore function.