What Causes Shoulder Pain?
The shoulder consists of a whole system of bones, ligaments, and muscles that keep the bones in place and functioning well.
- Acromioclavicular (AC) joint, where the clavicle and acromion meet.
- Sternoclavicular joint, where the clavicle and sternum meet.
- Shoulder joint (glenohumeral joint), or a ball-and-socket joint that facilitates shoulder movement.
- The Clavicle, or the Collarbone
- The Scapula, or the Shoulder Blade
- The Humerus, or the upper arm bone
- Ligaments: Flexible bands of fibrous tissue that bind joints and connect bones and cartilage.
- Tendons: Cords of tissue that connect muscles to bones, with rotator cuff tendon tears being common causes of shoulder pain.
- Muscles: Supporting the shoulder and facilitating movement.
- Bursa: A closed space between 2 moving muscle layers to prevent friction from causing issues.
Most shoulder problems involve this system and often include fractures, instability, arthritis, inflammation, tumors, infections, nerve problems, and tendon tears. When one part of your shoulder becomes injured, the rest may be affected, worsening the problem over time. Be sure to identify the issue quickly to address the problem and treat it appropriately.
Issues That Cause Shoulder Pain
- Bursitis: Your bursae are fluid-filled sacs located in your joints. They are essential because they act as cushions between your bones and soft tissue, helping your muscles and bone move without friction issues. But overuse of your shoulder can cause inflammation and swollen bursae, making every shoulder movement slow and painful.
- Tendinitis: Your tendons connect muscle to bone, and tendinitis is when your tendons become inflamed. You may suffer from either the acute version, which occurs due to constant use of your shoulder, or the chronic version, which occurs due to overuse and age.
- Impingement: When the top of your shoulder blade puts pressure on the soft tissues underneath.
- Rotator Cuff Tear: Where the rotator cuff tendons become inflamed from injury, overuse, and aging.
- Dislocation: When the head of the humerus is forced out of the shoulder socket due to overuse or injury. This leads to partial or full dislocation, with partial dislocation referred to as a subluxation. This is dangerous because repeated dislocations loosen your muscles, ligaments, and tendons. A problem that increases the risk of dislocations every time and increases the risk of arthritis.
- Arthritis: Several types of arthritis occur due to overuse of the shoulder muscles and ligaments, causing "wear and tear." Most of them cause swelling, stiffness, and pain that worsens over time if not treated. In addition to being painful, arthritis can cause stiffness which leads to restricted movement.
- Lung Conditions: Any conditions that affect your lungs may also affect your shoulder.
- Tendon Tears: Acute injuries and degenerative changes cause your tendons to split and tear. These tears may also occur due to age, overuse, or a sudden injury. If the tear is complete, your tendon is pulled from the bone.
- Fracture: When your bone breaks, the fractured area may undergo swelling, bruising, and severe pain.
- Frozen Shoulder: Where the muscles, tendons, and ligaments inside your shoulder become stiff, which makes movement difficult and painful.
- Calcific Tendonitis and Calcific Periarthritis: Calcium crystals form or shed inside a tendon, causing swelling and difficulty moving your shoulder.
- Osteoarthritis: Where the cartilage becomes thinner and tiny bits of extra bone, called osteophytes, can form on the joint. This may change the bone’s shape and be an extremely painful problem.
- Polymyalgia Rheumatica: A condition with unknown causes that cause pain, inflammation, and stiffness.
- Rheumatoid Arthritis: Inflammation of the joint capsule that typically starts in your hands and feet.
Treating Shoulder Pain
- Medications: Your doctor may prescribe anti-inflammatory and pain medications to relieve shoulder pain. Only take these as directed, and be sure to note any specific instructions to avoid negative reactions to the medication.
- Avoid Overexertion: Do not overdo activities or overexert your shoulder when feeling pain. Keep away from activities that may aggravate your condition, and rest until the pain subsides.
- Physical Therapy: With the proper treatment, your shoulder strength and flexibility will increase without aggravating any issues.
- Surgery: In more severe cases, surgery may be required to repair damage to your shoulder.
Shoulder Pain Diagnosis
Normally, low shoulder pain disappears after some rest and a few days to allow the body to handle the issue on its own. In more severe cases, you should always seek out a medical professional immediately. A doctor will diagnose your issues using the following:
- Your Medical History: The first step to understanding your shoulder issues is taking a look at past medical issues. Dislocations cause your ligaments and muscles to loosen, making further dislocations a serious issue. In that vein, your doctor will ask questions like when the pain started, if it has occurred before, how it was handled, and other medical history-specific questions. They will also ask about your normal activities in order to narrow down potential causes for shoulder pain.
- Physical Exam: Typically, your doctor will check for any obvious signs of the cause of your shoulder pain issues. Swelling, deformity, muscle weakness, physical abnormalities, misshapen looks, and tender areas are commonly checked for first. You may also be asked to move your arm to see its possible range of motion and muscle strength.
- Testing: Specific tests may be needed to identify the source of your shoulder pain.
- Magnetic Resonance Imaging (MRI): Uses radio frequencies and large magnets to create detailed internal images.
- Ultrasound: Magnetic resonance imaging is used to create a fast, real-time diagnosis and treatment.
- X-Rays: Electromagnetic energy beams are used to create images of your internal tissues and bones/
- Computerized Axial Tomography Scan (CAT Scan): A combination of X-rays and computer technology to create detailed internal imagery.
- Arthroscopy: A fiber-optic camera is inserted through a surgical incision to look inside and, potentially, help fix your shoulder joint.
- Arthrogram: Dye is injected into the shoulder in order to study the muscles and tendons, along with the ball and socket joint.
- Electrical Studies: Surface electrodes will transmit a tiny electrical current to evaluate nerve function.
Shoulder Pain Self Care
- Heat and Cold Therapy: An ice or cold pack will help with swelling and is a common treatment after injuries. But make sure to use an ice pack intermittently in order to avoid frostbite. Heat packs offer help for sore and tense muscles by helping the soft tissue in the covered area relax with increased circulation.
- Fix Your Posture and Habits: Your shoulder problems will only worsen with bad posture preventing proper circulation. Sit upright, relax your shoulders, and allow your arms to hang by your sides. While sitting, try to avoid resting on your arms too much and change your position often.
- Use a Pillow: Upper body posture is affected by your lower back, so give yourself some support with a pillow for your lower back or use a chair offering lumbar support. A pillow on your lap can be used to rest your arm.
- Lie Down Carefully: Be sure to lay down with your shoulder pain in mind to avoid aggravating the issue. Stick to your good side when lying down and use a pillow to support your injured arm. Another pillow or two behind your back or under the affected arm can help prevent rolling in your sleep.
- Rest the Shoulder: Work to reduce the strain placed on your affected shoulder by minimizing the pressure you place on it. Pace yourself and be mindful of your limits if you are forced to use the injured arm.
Treating Shoulder Pain
Several treatments are commonly used to help relieve shoulder pain and return the range of motion and strength to normal. Acupuncture, aromatherapy, chiropractic or osteopathy treatments, supplements, and more are used to help relieve pain.
- Occupational Therapy: Where a specialist helps you alter your daily lifestyle in order to reflect your injuries and prevent further issues.
- Physiotherapy: A common treatment for shoulder pain, a medical professional will provide you with strengthening and stretching exercises, massages, and other therapeutic techniques. Your treatment will reflect your symptoms. Commonly, physiotherapy helps combat weakened muscles, lower muscle function, stiffness, lower shoulder movement, and strained tissues.
- Surgery: Many forms of shoulder pain stem from issues that do not require surgery, but some shoulder problems require more than just time and rest. Potential surgeries include:
- Rotator Cuff Repair Surgery
- Subacromial Decompression
- Open Surgery
- Frozen Shoulder Capsule Release
- Shoulder Replacement
- Reverse Shoulder Replacement