Shoulder Pain and Injuries

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Shoulder pain symptoms

Shoulder pain can manifest in various ways and recognizing the symptoms is essential for effective evaluation and treatment. Some common signs and sensations associated with a shoulder injury can include:

Pain
Weakness
Limited range of motion
Stiffness
Swelling
Popping or clicking
Numbness or tingling
Instability
Grinding sensations

Recognizing and describing these symptoms to your doctor is crucial for accurate diagnosis and treatment planning. Early intervention can help alleviate pain, restore function and prevent further complications so you can live your best each day.

Shoulder pain causes

Shoulder pain refers to pain or discomfort in the shoulder joint and surrounding areas. Many possible causes exist, so a personalized diagnosis and treatment plan is essential. Timely intervention can provide effective pain relief and the best chance of restoring normal shoulder function to ensure a healthier, more active future.

Tendon inflammation and tears

Tendons are connective tissue between the bones and muscles in the body. Shoulder pain can often be related to problems with the shoulder tendons, particularly the rotator cuff. The rotator cuff is a group of tendons and muscles surrounding the shoulder joint to keep it stable and allow various shoulder movements.

Bursitis: Bursitis is the inflammation of the bursa, a fluid-filled sac that cushions the joint. It can happen from repetitive movements or trauma and causes localized pain and swelling.
Tendonitis: Tendonitis is where tendons become inflamed or irritated. Calcific tendonitis is the formation of calcium deposits in the tendons, whereas rotator cuff tendonitis affects the rotator cuff tendons.
Rotator cuff tear: Damage or tearing of the rotator cuff tendons is often a consequence of overuse, heavy lifting or traumatic injury. It can cause persistent pain, weakness and limited range of motion.

Impingement

Shoulder impingement occurs when the rotator cuff or the bursa becomes pinched between the bones of the shoulder during specific movements—this friction and compression cause pain and inflammation.

Instability

Instability is when a joint is unable to keep its normal position. It can happen because of a traumatic event or through hypermobility. As the shoulder is one of the largest and most mobile joints, you can experience instability in several ways:

Shoulder dislocation: A sudden displacement of the upper arm bone from the shoulder socket, resulting in severe pain and instability. A dislocation often requires prompt medical attention.
Shoulder separation: A separation is caused by damage to the acromioclavicular (AC) joint due to trauma, causing pain and shoulder deformity.
Hyperlaxity: Hypermobility in the shoulder joint leads to recurrent dislocations and discomfort.
Labral tear: Damage to the labrum, a ring of cartilage surrounding the socket of the shoulder joint, can be caused by trauma, overuse or age-related degeneration.

Arthritis

Arthritis in the shoulder can be a cause of shoulder pain:

Osteoarthritis: A degenerative joint disease primarily affecting older individuals, causing pain, stiffness and decreased mobility in the shoulder.
Rheumatoid arthritis: An autoimmune condition that attacks the synovium, resulting in chronic inflammation and pain in the shoulder joint.
Cuff arthropathy: A degenerative joint disease in older individuals due to chronic rotator cuff problems.

Fracture

A bone fracture is a break or cracks in the bone that can range in severity:

Broken collarbone: A common shoulder injury, typically from falls or trauma, causes acute pain and limited shoulder mobility.
Humerus fracture: A fracture in the upper arm bone can lead to severe shoulder pain and functional impairment.
Scapula fracture: These fractures of the shoulder blade usually occur due to high-impact trauma and can result in significant shoulder pain and discomfort.

Adhesive capsulitis (Frozen shoulder)

Frozen shoulder manifests as the gradual stiffening of the shoulder joint capsule, causing persistent pain and restricting shoulder mobility. It can develop without apparent cause and often affects individuals in their 40s and 50s.

Risk factors for developing shoulder pain

Shoulder pain can affect anyone, but certain factors can increase the likelihood of experiencing discomfort in this joint. Recognizing these risk factors is essential for proactive shoulder health:

Age: As we age, the wear and tear on our joints, including the shoulder, can lead to conditions like osteoarthritis, making older adults more susceptible to shoulder pain.
Overuse: Frequent or heavy lifting, reaching overhead or repetitive shoulder motions can strain the shoulder joint, potentially leading to pain.
Sports and physical activity: Participation in sports, such as swimming, tennis or weightlifting, can increase the risk of shoulder injuries, including rotator cuff tears.
Previous injuries: If not correctly rehabilitated, a history of shoulder injuries can weaken the joint and make it more susceptible to recurrent issues.
Poor posture: Maintaining poor posture, especially while working at a desk or using handheld devices, can strain the shoulder and neck muscles.
Lack of muscle strength and flexibility: Weak or imbalanced muscles around the shoulder can fail to provide adequate support and increase the risk of injury.
Smoking: Smoking can compromise blood flow and the body's ability to heal, potentially delaying recovery from shoulder injuries.
Chronic health conditions: Conditions like diabetes and obesity can contribute to inflammation and joint stress, increasing the risk of shoulder pain.
Gender: Some shoulder conditions, such as frozen shoulder, are more common in women.

Diagnosing shoulder pain

Our expert healthcare professionals will work together to diagnose your shoulder pain and create a tailored treatment plan so you can get back to living your daily life pain-free.

Medical history

Your doctor will discuss your symptoms, previous injuries and medical history to understand the potential causes of your shoulder pain. Details about your daily activities, work and hobbies can offer valuable insights.
Physical exam

A hands-on physical examination is the next step. During this examination, your doctor will assess your shoulder's range of motion, strength and stability. They'll check for signs of swelling, tenderness or deformity. A physical exam can often pinpoint the area of concern and get a sense of the potential injury or condition.
Imaging and procedures
Your medical team may use various imaging techniques to gain a better understanding of your shoulder's condition:
- X-ray: An X-ray provides a clear view of the bones, revealing fractures, dislocations or signs of arthritis.
- CT (computed tomography): CT scans offer detailed cross-sectional images of the shoulder, helping diagnose complex fractures and bone and joint abnormalities.
- Ultrasound: Ultrasound uses sound waves to create real-time images of the shoulder's soft tissues, making it a valuable tool for assessing tendons, ligaments and muscles.
- Arthrogram: A contrast dye is injected into the shoulder joint to enhance the visibility of joint structures in X-rays or CT scans. Arthrograms are particularly useful for evaluating ligament and labral tears.
- Arthroscopy: In some cases, arthroscopic surgery may be required to visualize and diagnose internal shoulder issues directly. This minimally invasive procedure involves inserting a tiny camera into the joint.

Shoulder pain treatment

A tailored approach to your specific condition is key to achieving lasting relief when addressing shoulder pain. Working closely with your doctor, your treatment plan will be designed to meet your diagnosis and individual needs to ensure a comprehensive, personalized path to recovery and pain management for your shoulder.

Self-help

Here are some tips for helping shoulder pain get better:

Rest: Resting the affected shoulder is often the initial step to allow the injured area to heal. During this phase, avoiding activities that exacerbate pain is essential to prevent further pain and damage to the joint.
Improve posture: Correcting poor posture is fundamental in improving chronic shoulder pain. Ergonomic adjustments in your workspace and daily modifications can significantly reduce stress on the shoulder joints and surrounding muscles.
Ice and heat application: Ice helps reduce inflammation, while heat can alleviate muscle tension. Alternating between these two things can manage pain and facilitate the healing process.

Physical therapy

Physical therapy plays a pivotal role in shoulder pain recovery. Skilled therapists create customized exercise regimens and stretching routines to enhance shoulder strength, flexibility and range of motion.

Medications

Several medication options can help to reduce your shoulder pain:

Pain relievers: Over-the-counter pain relievers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce discomfort associated with shoulder pain and decrease inflammation in the affected area.
Steroid injections: Corticosteroid injections, delivered directly to the affected area, provide rapid relief for conditions such as bursitis and tendinitis.
Corticosteroid injections: Corticosteroid injections, delivered directly to the affected area, provide rapid relief for conditions such as bursitis and tendinitis. A healthcare provider administers these injections.
Prescription medications: In cases of severe pain, stronger prescription pain medications may be recommended by your doctor.

Surgery

When conservative methods prove insufficient, surgical intervention may be necessary for lasting relief from shoulder pain:

Rotator cuff repair: Surgical repair of torn or damaged rotator cuff tendons to restore function.
Labral repair or SLAP repair: This surgery addresses the damage to the labrum, a cartilage ring in the shoulder socket.
Subacromial decompression: A procedure designed to relieve pressure on the rotator cuff tendons.
Total shoulder replacement: A replacement of the entire shoulder joint with artificial components.
Reverse total shoulder replacement: A specialized procedure that replaces the shoulder while restoring the function of a torn rotator cuff.
Revision shoulder surgery: Corrects issues from any previous shoulder surgeries.
AC joint reconstruction: Addresses problems related to the acromioclavicular (AC) joint.
Latarjet procedure: A surgical option to treat recurrent shoulder dislocation.

Complementary therapy

Complementary therapies can address the underlying causes of shoulder pain. These therapies often focus on improving joint mobility, reducing muscle tension, enhancing overall joint health, and providing additional options for pain relief and improved shoulder function.

Hydrodilatation: A treatment that injects sterile fluid into the shoulder joint to stretch the joint and enhance the range of motion
Platelet-rich plasma (PRP) therapy: This innovative treatment uses the body's platelets to stimulate tissue healing.
Ultrasound-guided needling: This procedure helps break up scar tissue and release tight structures.

Shoulder arthroplasty clinical trial

The Most Effective Local Infiltration Analgesic (LIA) in Reducing Overall Opioid Use and Nausea in the Acute Postoperative Period of Shoulder Arthroplasty Patients; a Prospective, Blinded, Randomized, Observational Study

Study evaluation to determine the least opioid and antiemetic intake during the acute postoperative period in shoulder arthroplasty patients.

Frequently asked questions

Can shoulder pain cause neck pain?

Yes, shoulder pain can cause neck pain. When the shoulder is injured or tense, it can impact neck movements and cause muscle tension, resulting in neck discomfort.
Where is shoulder bursitis felt?

Shoulder bursitis is typically felt as pain and tenderness on the outer part of the upper arm and shoulder. It can worsen with arm movement.
What is shoulder impingement?

Shoulder impingement occurs when the rotator cuff tendons or bursa sac become compressed or pinched between the bones of the shoulder. Impingement can lead to pain, inflammation and restricted shoulder movement. Treatment may involve rest and physical therapy or, in severe cases, surgery to create more space in the shoulder joint.
Why do I have shoulder pain while sleeping?

Shoulder pain during sleep can be due to various factors, including poor sleeping posture, underlying shoulder conditions or shoulder impingement. Changing your sleep position or using a supportive pillow can help alleviate this discomfort.
My shoulder is popping. Should I call a doctor?

Occasional popping in the shoulder is common and often harmless. However, if it's accompanied by pain, weakness or limited mobility, it's advisable to consult a doctor to rule out underlying issues.
I have shoulder pain with internal rotation – what does this mean?

Shoulder pain with internal rotation (turning your arm inward) can indicate rotator cuff issues, labral tears or joint problems. It's recommended to see a doctor for a proper evaluation.
I have shoulder pain with external rotation – what does this mean?

Pain during external rotation (outward arm movement) can indicate rotator cuff problems or issues with the joint. Seek medical evaluation to determine the cause.

Expert care for shoulder pain and injuries

Shoulder pain symptoms