What Causes Shoulder Pain?

Have you ever reached for something and felt a sharp pain in your shoulder? If so, you are not alone. Shoulder pain is one of the most common orthopedic conditions, affecting up to 70% of people at some point in their lives.

“If you have shoulder pain, moving, reaching, and stretching can be difficult and cause further injury,” said John Lee, MD, Catholic Health Orthopedic Surgeon. “Talk to your doctor for the right diagnosis and treatment so you can feel better sooner.”

What is the anatomy of the shoulder?

The shoulder is considered a ball-and-socket joint, but it includes many parts that work together to allow your shoulder and arms a full range of motion.

Three bones
- Clavicle (collarbone)
- Humerus (upper arm bone)
- Scapula (shoulder blade)
Two joints
- Acromioclavicular joint where the highest point of the scapula meets the clavicle.
- Glenohumeral joint that connects your upper extremity to your shoulder blade.
Rotator cuff. Four tendons connect the muscles and bones.
A fluid-filled, cushioning sac between the rotator cuff and shoulder bones.
Soft tissue. Any tissue that is not bone and connects and supports other tissues.

What are the common causes of shoulder pain?

Shoulder pain causes discomfort in one or more of the many parts that make up the shoulder.

“Overuse and repeated shoulder movements are the most common causes of shoulder pain,” said Dr. Lee. “These movements can include lifting your arm above your head or moving your arm back and forth.”

He explained that rotator cuff injuries can also result from overuse. These injuries may include tendonitis—swelling of pinched tendons—and bursitis when muscle and bone rub against the bursa too much. A rotator cuff tear can occur after a fall or lifting something heavy.

Other common causes of shoulder pain include:

Arthritis is redness and swelling in a joint. Osteoarthritis, or wear and tear arthritis, affects joints that do a lot of work.
Falls or trauma. Accidents or blows to the shoulder can cause pain.
Frozen shoulder. Abnormal bands of tissues can build up in the shoulder joint and stop it from moving freely.
Tendons in the rotator cuff can get pinched in the bones of the shoulder.
Referred pain. Pain can start with another part of the body, such as nerve issues in the spine.
Shoulder dislocation. If your shoulder is pulled back too hard or rotated too far, the top of your arm can pop out of its socket.

What are the risk factors for shoulder pain?

“Activities requiring repetitive movements are a major risk factor for shoulder pain,” said Dr. Lee.

Common risk factors:

People who play sports such as basketball or tennis.
Jobs like construction and painting.
Age because soft tissue breaks down over time.
A previous injury to the shoulder.

What are the symptoms of shoulder pain?

In addition to discomfort and pain, other symptoms of shoulder pain may include:

Arm, back or neck pain
Clicking or popping when you move your arm
Limited range of motion
Muscle stiffness or weakness
Redness or warmth in the shoulder
Swelling or tenderness

When should I see a doctor for shoulder pain?

“If your shoulder pain does not improve with rest or at-home treatments, you should see an orthopedist specializing in muscles and bones,” said Dr. Lee.

You should also see an orthopedist if:

The skin of your shoulder turns blue or red.
You have shoulder pain with a fever, redness or swelling.
Your pain intensifies or increases with movement.
Your pain lasts for more than two to four weeks after home treatment.

If you experience sudden pain in your left arm, this can be a sign of a heart attack, and you should seek immediate help.

How is shoulder pain diagnosed?

An orthopedist will complete a routine physical exam, review your medical history and ask about your symptoms. They will also test your range of motion to see if your shoulder has flexibility.

You will likely need an imaging test, such as an X-ray, CT scan or MRI, to help determine the cause of your pain and reach a diagnosis.

How is shoulder pain treated?

“Shoulder pain can often be treated at home, but consult with your doctor first,” said Dr. Lee. “You want to avoid worsening the pain, especially if the cause is unknown.”

Home remedies include:

Rest, which is helpful for overuse injuries caused by repetitive movements.
A sling that can relieve pain by keeping your shoulder immobilized.
Icing for relief from pain and swelling. It works best for 15 minutes up to four times a day. Cover the ice with a cloth to keep your skin from getting too cold.
Using a heating pad to reduce muscle tightness. Heat is recommended only if the pain is not from a recent injury.
Over-the-counter medication, such as ibuprofen or acetaminophen, to reduce pain and inflammation.

Your orthopedist may recommend physical therapy to teach you how to stretch and strengthen the rotator cuff tendons to prevent a future shoulder injury.

“Surgery is not commonly used to treat shoulder pain,” said Dr. Lee. “However, for some patients, at-home treatments and physical therapy do not improve their shoulder pain, so we have to explore the option of minimally invasive surgery.”

The most common surgery for shoulder pain is arthroscopy, a minimally invasive surgery that uses a small incision to diagnose and treat joint problems. Surgeons use arthroscopy to remove inflamed or damaged tissue.

It is done on an outpatient basis so you can go home on the same day.

Can I prevent recurring shoulder pain?

“Your shoulders work hard, whether doing everyday routine activities or playing sports, which makes it easy to injure one or both,” said Dr. Lee. “However, you can take steps to help reduce your risk of injury and pain.”

Tips to help prevent shoulder pain include:

Exercise to strengthen the rotator cuff. Your orthopedist can recommend you to a physical therapist to learn safe and effective exercises.
Use proper lifting techniques.
Rest after exercise or other activities that use the shoulders.
Maintain good posture.
Take breaks when sitting at a computer for several hours.
Join a sports clinic to prevent overuse injuries from recreational or professional sports.