Author: Jodie Chan

Common Causes of Shoulder Pain

Posted on July 4, 2024 by

What is Shoulder Pain?

Shoulder pain encompasses discomfort felt in the shoulder region. The shoulder is characterized as a ball-and-socket joint, notable for its extensive range of motion, which makes it the most mobile joint in the body. However, due to this mobility, the shoulder is also inherently unstable. Moreover, the ball of the upper arm (humerus) being larger than the shoulder socket increases its vulnerability to injury. Soft tissues muscles, tendons, ligaments and bursa are also essential to support the shoulder joint, and they are also subject to injury, overuse and under use.

Given the complexity of its components, shoulder pain can arise from various causes. Injuries from falls or accidents, repetitive activities such as painting, and conditions like arthritis are common triggers.

Some Common Causes of Shoulder Pain

Overuse Injuries/Repetitive Strain Injuries

Repetitive use of shoulder like swimming or playing tennis or gardening can cause overuse injuries.

One common overuse injury is bursitis, which occurs when the bursa—a sac filled with fluid that cushions the shoulder joint—becomes swollen and inflamed due to repetitive motions. The pain associated with bursitis becomes particularly noticeable during shoulder movement.

Cartilage tear, also known as SLAP tear can also happen with overuse. This tear typically occurs at the front of the upper arm where the biceps tendon attaches to the shoulder. Athletes at highest risk for this injury include baseball pitchers, volleyball players, and lacrosse players who perform rapid, high-energy movements that stress the shoulder structures.

Rotator cuff tear is the tearing of the group of muscles and tendons in the shoulder that hold our arms in place and let us lift our arms overhead. It can be damaged through overuse and can also begin to show wear and tear as we age.

Tendinosis can develop when the rotator cuff and/or biceps tendon wear down and sometimes become inflamed, typically as a result of being pinched by surrounding structures. The severity of the injury can range from mild inflammation to extensive damage involving most of the rotator cuff. In cases where the rotator cuff tendon thickens and becomes inflamed, it may become trapped beneath the acromion, leading to impingement syndrome.

Frozen Shoulder/ Adhesive Capsulitis

Frozen shoulder is a highly restrictive condition often resulting from injury, which limits movement due to pain. Infrequent use exacerbates the issue by promoting inflammation and the development of adhesions between joint surfaces, further restricting motion. Additionally, reduced synovial fluid fails to lubricate the gap between the arm bone and socket, necessary for normal shoulder joint movement. The main symptoms of a frozen shoulder are pain and stiffness that make it difficult or impossible to move. Frozen shoulder occurs more frequently in individuals assigned female at birth. It is more prevalent between the ages of 40 and 60. Another significant risk factor is prolonged immobility of the shoulder, such as during recovery from conditions like stroke or surgeries like mastectomy, which restrict arm movement.

Arthritis

The predominant form of arthritis affecting the shoulder is osteoarthritis, commonly referred to as wear-and-tear arthritis. Symptoms such as pain and stiffness generally commence in middle age. Osteoarthritis progresses gradually, with the associated pain intensifying over time. This condition can be linked to sports or work-related injuries, as well as chronic wear and tear. People often refrain from moving their shoulder to alleviate arthritis discomfort, which can lead to tightening or stiffening of the soft tissues around the joint, ultimately causing painful limitations in motion.

Bone Spurs/Osteophytes

Bone spurs formation on the joints is often a result of arthritis due to aging and one of the most common areas a bone spur develops is under the acromion of the shoulder. Those whose sports or jobs require repetitive overhead movement are at risk for this condition. These small pieces of bone rub up against and wear on the rotator cuff and keep the shoulder from moving the way it should. This can lead to tendinitis or a rotator cuff tear.

Shoulder Pain Diagnosis

Alongside a thorough medical history and physical examination to assess range-of-motion, pain location, and joint stability, diagnostic procedures for shoulder issues may encompass the following:

Shoulder Pain Treatment

For dislocations, separations, and fractures, medical assistance is required to relocate your shoulder to its correct position, followed by the use of a sling to support it during the healing process.

For many other conditions, your doctor may advise rest, application of heat or ice, and medications such as aspirin or ibuprofen to alleviate pain and reduce swelling.

In cases where conditions like cartilage tears, rotator cuff tears, or frozen shoulder do not respond to rest and medication, surgical intervention may be recommended by your doctor.

Regardless of the specific shoulder problem, your treatment plan will likely incorporate exercises designed to stretch and strengthen the joint, aiming to enhance your range of motion.

References

Shoulder pain and problems. Johns Hopkins Medicine. (2021a, August 8). https://www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-pain-and-problems

WebMD. Frozen shoulder: Symptoms, causes, diagnosis, treatment. WebMD. https://www.webmd.com/a-to-z-guides/what-is-a-frozen-shoulder

WebMD. Shoulder pain: Causes, symptoms, and treatments. WebMD. https://www.webmd.com/pain-management/why-does-my-shoulder-hurt