skuldersmerter (PH Indholdsside)

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<ul>
    <li>Skuldersmerter forekommer hyppigt</li>
    <li>Smerterne kan skyldes overbelastninger i relation til ens arbejde eller mere akutte skader, fx opst&aring;et under sport </li>
    <li>De typiske symptomer er smerter&nbsp;og nedsat bev&aelig;gelighed af skulderen &nbsp;</li>
    <li>Irritation omkring senerne og slims&aelig;kkene er hyppige&nbsp;</li>
    <li>Ledkapslen kan v&aelig;re p&aring;virket og medf&oslash;re s&aring;kaldt frossen skulder med smerter og nedsat bev&aelig;gelighed</li>
    <li>Behandlingen afh&aelig;nger af &aring;rsagen til lidelsen. De fleste tilf&aelig;lde kan behandles, uden der er behov for operation</li>
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      <HtmlField Name="PageContent"><![CDATA[<h2>Hvad er skuldersmerter?</h2>
<ul>
    <li>Med skuldersmerter menes smerter, der udg&aring;r&nbsp;fra strukturer i og omkring selve skulderleddet eller leddet mellem kraveben og skulder (AC-leddet, acromioclavicul&aelig;rleddet) </li>
    <li>Skuldersmerter forekommer hyppigt. I en almindelig l&aelig;gepraksis kommer der cirka 40-50 patienter &aring;rligt med skulderlidelser </li>
    <li>&frac14; af &aelig;ldre mennesker har mere eller mindre hele tiden smerter fra skulderen </li>
</ul>
<h3>Hvad er smertemekanismerne?</h3>
<ul>
    <li>Skulderleddet er et kompliceret led, hvor bev&aelig;gelser kan foreg&aring; i alle retninger. Leddet omgives af en ledkapsel, af ledb&aring;nd og mange sener. Tilsammen udg&oslash;r dette en kappe rundt om skulderen, som er vigtig b&aring;de som st&oslash;tte for leddet og for normal funktion og bev&aelig;gelighed </li>
    <li>Derudover findes ogs&aring; en r&aelig;kke slims&aelig;kke. De skal sikre, at senerne glider smidigt i forhold til hinanden. Ved skuldersmerter kan der v&aelig;re sygdom i selve leddet, der kan v&aelig;re bet&aelig;ndelse i sener eller ledkapsel, og der kan v&aelig;re bet&aelig;ndelsesreaktion i slims&aelig;kkene </li>
    <li>De allerfleste tilf&aelig;lde af skuldersmerter skyldes overbelastning eller fejlbelastning. Mest almindelige er senebet&aelig;ndelsesreaktioner (tendinitis), som&nbsp;man ansl&aring;r, st&aring;r for 75 % af alle tilf&aelig;lde med skuldersmerter</li>
</ul>
<h2>Hvad kan &aring;rsagen v&aelig;re?</h2>
<h3>Hyppige &aring;rsager</h3>
<ul>
    <li>
    <a href="~/link.aspx?_id=DD08060FA7D04AA68C71538CF3B77366&amp;_z=z">Senebet&aelig;ndelse (tendinitis)</a>
    <ul>
        <li>Udg&oslash;r st&oslash;rstedelen af alle skulderlidelser, og langt hyppigst skyldes det bet&aelig;ndelsesreaktive forandringer i <a href="~/link.aspx?_id=5E8E8E938B4C492DBCE90B5810D686D3&amp;_z=z">supraspinatussenen</a> </li>
        <li>Giver smerter i skulderen, som forv&aelig;rres, n&aring;r man udf&oslash;rer bev&aelig;gelser, som belaster senen</li>
    </ul>
    </li>
    <li>Slims&aelig;kbet&aelig;ndelse (bursitis)
    <ul>
        <li>Udg&oslash;r kun en lille del af alle skulderlidelser og kan forekomme sammen med senebet&aelig;ndelse </li>
        <li>Akut bursitis&nbsp;i skulderen starter ofte med akutte smerter, som kan forstyrre nattes&oslash;vnen. Ved denne tilstand udl&oslash;ser de fleste bev&aelig;gelser smerter</li>
        <li>Kronisk bursitis&nbsp;starter mere gradvist og har ofte et langvarigt forl&oslash;b, hvor bestemte bev&aelig;gelser og belastninger forst&aelig;rker smerte</li>
    </ul>
    </li>
    <li>
    <a href="~/link.aspx?_id=8919ED3E82714BF1BB49D92C6C575D44&amp;_z=z">Ledkapselbet&aelig;ndelse (kapsulitis, "frossen skulder")</a>
    <ul>
        <li>Udg&oslash;r cirka 10 % af alle skulderlidelser, og halvdelen skyldes en tidligere skade </li>
        <li>Tilstanden er kendetegnet af smerter, nedsat aktiv og passiv bev&aelig;gelighed, skulderstivhed ("frossen skulder")</li>
    </ul>
    </li>
    <li>Skader ved sport eller fald
    <ul>
        <li>Kan give bl&oslash;dninger i og omkring senerne, hvilket kan for&aring;rsage bet&aelig;ndelsesreaktioner </li>
        <li>Det er vigtigt at udelukke knoglebrud</li>
    </ul>
    </li>
    <li>Smerter som f&oslash;lge af, at der har v&aelig;ret flere tilf&aelig;lde af <a href="~/link.aspx?_id=C99CE3CD7946445E93795AA2DBE5BC23&amp;_z=z">skulderen ude af led</a> (skulderluksation)
    <ul>
        <li>Skyldes skader p&aring; ledl&aelig;be og ledb&aring;nd</li>
    </ul>
    </li>
</ul>
<h3>Sj&aelig;ldnere &aring;rsager</h3>
<ul>
    <li>
    <a href="~/link.aspx?_id=1CD55A78E42E4F9F90AA6FCE0426DBCE&amp;_z=z">AC-leds overbelastning</a>&nbsp;(<strong>a</strong>kromio<strong>c</strong>lavikul&aelig;rleddet -&nbsp;leddet mellem kravebenet og den &oslash;vre del af skulderbladet)
    <ul>
        <li>Skyldes ofte en skade, som kan give slappe ledb&aring;nd, bet&aelig;ndelsesreaktion og slidforandringer p&aring; sigt </li>
        <li>Tilstanden er pr&aelig;get af smerter over AC-leddet, og smerter som g&aring;r om i nakken </li>
    </ul>
    </li>
    <li>
    <a href="~/link.aspx?_id=48A95046785A427F84EEA12B784B8B63&amp;_z=z">Seneoverrivning (rotator cuff syndrom)</a>
    <ul>
        <li>Efter gentagne skader p&aring; supraspinatussenen kan der opst&aring; sm&aring; rifter, slidforandringer og til sidst komplet overrivning af senen (ruptur) </li>
        <li>Patienten er ofte over 40 &aring;r og kan berette om gentagne skader eller belastninger. Man kan tidligere have v&aelig;ret behandlet med lokale kortisonindspr&oslash;jtninger </li>
        <li>Tilstanden behandles som en senebet&aelig;ndelse. Hvis der ikke sker forbedring, kan man overveje operation</li>
    </ul>
    </li>
    <li>Nerveafklemning
    <ul>
        <li>En nerve (n. suprascapularis) kan komme i klemme ved skulderleddet. Sker blandt andet hos idr&aelig;tsud&oslash;vere, fx volleyballspillere, sv&oslash;mmere, kastere og tennisspillere </li>
        <li>Giver nedsat kraft ved visse bev&aelig;gelser og smerter bagtil i skulderen </li>
        <li>Behandlingen er aflastning og optr&aelig;ning med &oslash;velser. Hvis der ikke er effekt i l&oslash;bet af 6-12 m&aring;neder, kan man overveje operation</li>
    </ul>
    </li>
    <li>Gigtsygdom
    <ul>
        <li>Fx&nbsp;<a href="~/link.aspx?_id=C3123E395838488FA75243672E7CB237&amp;_z=z">leddegigt</a> eller <a href="~/link.aspx?_id=777D0842E3E3409E801F791D08B5820D&amp;_z=z">polymyalgia reumatika</a></li>
    </ul>
    </li>
    <li>Andre sj&aelig;ldne &aring;rsager
    <ul>
        <li>Fx infektion, svulst, blodkr&aelig;ft</li>
    </ul>
    </li>
</ul>
<table summary="Tabel med grøn baggrund">
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        <tr>
            <td style="background-color: #e1f0e1;">
            <h2>Hvad kan jeg selv g&oslash;re?</h2>
            <ul>
                <li>De fleste skulderlidelser g&aring;r over af sig selv med tiden. Det kan dog tage b&aring;de m&aring;neder og &aring;r</li>
                <li>Generes du af den ene eller begge skuldre, kan du begr&aelig;nse generne ved at g&oslash;re f&oslash;lgende:
                <ul>
                    <li>Undg&aring; ensformigt arbejde og se, om du kan forbedre din arbejdsstilling</li>
                    <li>Holde pauser</li>
                    <li>Udf&oslash;re &oslash;velser efter instruktion af l&aelig;ge eller fysioterapeut</li>
                </ul>
                </li>
            </ul>
            </td>
        </tr>
    </tbody>
</table>
<table summary="Tabel med gul baggrund">
    <tbody>
        <tr>
            <td style="background-color: #fdf3d5;">
            <h2>Kontakt egen l&aelig;ge</h2>
            <ul>
                <li>Ved st&aelig;rke smerter</li>
                <li>Ved vedvarende gener</li>
                <li>Ved skader mod skulderen og efterf&oslash;lgende smerter&nbsp;</li>
            </ul>
            </td>
        </tr>
    </tbody>
</table>
<h2>Hvad g&oslash;r l&aelig;gen?</h2>
<h3>Sygehistorie</h3>
<h4>Hvad vil l&aelig;gen gerne vide noget om:</h4>
<ul>
    <li>Hvor l&aelig;nge har du haft skuldersmerterne? </li>
    <li>Hvordan startede det hele? </li>
    <li>Har du v&aelig;ret udsat for skulderskade? Hvad skete der? </li>
    <li>Er der et arbejde eller aktiviteter, som is&aelig;r er belastende for skulderen? </li>
    <li>Kan smerterne beskrives n&oslash;jagtigt? </li>
    <li>Str&aring;ler smerten ud i armen? Hvor? </li>
    <li>Er smerterne til stede i hvile? Om natten? </li>
    <li>Kan du sige, hvilke bev&aelig;gelser i skulderen som udl&oslash;ser smerter? </li>
    <li>Kan du sige, hvilke belastninger af skulderen som udl&oslash;ser smerterne? </li>
    <li>Har skulderen tidligere v&aelig;ret ude af led? </li>
    <li>Hvilke konsekvenser har skuldergenerne for din arbejde eller andre daglige aktiviteter?</li>
</ul>
<h3>L&aelig;geunders&oslash;gelsen</h3>
<ul>
    <li>L&aelig;gen vil foretage en grundig skulderunders&oslash;gelse:
    <ul>
        <li>Se efter sk&aelig;vheder eller andre synlige forandringer </li>
        <li>F&oslash;le p&aring; skulderen for at finde ud af, hvor smerterne sidder </li>
        <li>Udf&oslash;re forskellige tests med passive og aktive bev&aelig;gelser og teste, om bestemte belastninger udl&oslash;ser smerte eller om muskulaturen er sv&aelig;kket </li>
    </ul>
    </li>
    <li>Det kan ske, at l&aelig;gen anl&aelig;gger en blokade med lokalbed&oslash;velse for at f&aring; bekr&aelig;ftet &aring;rsagen til lidelsen (forsvinder smerterne efter bed&oslash;velsen?)</li>
</ul>
<h3>Andre unders&oslash;gelser</h3>
<ul>
    <li>Blodpr&oslash;ver og r&oslash;ntgen giver ofte ringe information om skuldersmerter</li>
    <li>I nogle tilf&aelig;lde kan MR-skanning eller ultralydsskanning v&aelig;re nyttig </li>
    <li>Ved mistanke om en gigtsygdom f&aring;r du taget en blodpr&oslash;ve</li>
</ul>
<h3>Henvisning til fagspecialist eller hospital</h3>
<ul>
    <li>De fleste personer med skuldersmerter behandles af deres egen l&aelig;ge og eventuelt fysioterapeut. I nogle tilf&aelig;lde kan det dog v&aelig;re n&oslash;dvendigt at blive henvist&nbsp;til en specialist </li>
</ul>
<h2>Illustrationer</h2>
<ul>
    <li>
    <a href="~/link.aspx?_id=0F1E0D23FF4749E48BA47F7162581BAE&amp;_z=z">Tegning af skulder med ledb&aring;nd og slims&aelig;kke</a> </li>
    <li>
    <a href="~/link.aspx?_id=5E8E8E938B4C492DBCE90B5810D686D3&amp;_z=z">Tegning af supraspinatussenen</a></li>
</ul>
<h2>Vil du vide mere?&nbsp;</h2>
<h3>Tr&aelig;ningsfilm for skulderen&nbsp;</h3>
<ul>
    <li><a href="~/link.aspx?_id=CC188691765C40D1A150CDA2CC2056BF&amp;_z=z">&Oslash;velsesprogram, 3 &oslash;velser</a><br>
    <br>
    <a href="~/link.aspx?_id=53CEA00218DB44EEBD4E17E8E92AA51E&amp;_z=z"><img alt="" width="135" height="84" style="width: 135px; height: 84px;" src="F29C024F18294B948DCBD5C5BE19CD28-135-84"></a></li>
</ul>
<ul>
    <li><a href="~/link.aspx?_id=9F6E392D800F48B18D827DF35EF95F3C&amp;_z=z">&Oslash;velsesprogram, 3 &oslash;velser med arabisk tale - فيديوهات تمارين رياضية باللغة العربية</a><br>
    <br>
    <a href="~/link.aspx?_id=8425CFC13C1647309B1A14D3B31AF98D&amp;_z=z"><img alt="" width="135" height="84" src="ECD34BA7D13E4B0BA41E5E9B16E3E3D7-0-0"></a></li>
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