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Overview of Shoulder Pain: Definition, symptoms, causes & treatment

Team AckoJan 17, 2024

The shoulder is a very mobile joint. This can, however, be its downfall as well. As we perform so many activities using this area, the soft tissue structures associated with the joint may get worn down or compressed. The bony structures can become unstable and malpositioned. All of this can result in Shoulder Pain (SP). The pain can occur only on moving the joint or at rest as well. Sometimes it is just a temporary infarction, while other times, it can be a significant issue needing medical intervention. Read ahead for an overview of SP.

Contents

What are the causes of Shoulder Pain?
How is Shoulder Pain diagnosed?
What is the treatment for Shoulder Pain?
Frequently Asked Questions (FAQs)

What are the causes of Shoulder Pain?

Most problems that cause Shoulder Pain can be categorised as follows.

Tendon issues
Bone issues (fracture)
Joint issues (arthritis)
Instability (dislocations)

There are some less common causes aside from these, which are infections, nerve-related disorders, and cancers/tumours. Let us look at the common causes briefly.

1. Tendon issues

Here’s a list of issues related to the tendon.

Tendinitis and Bursitis: Tendinitis is inflammation of tendons, which are cord-like structures that connect the muscle to the bone. A bursa is a small fluid-filled sac that acts as a cushion between the bones and soft tissues. These can present with SP and restricted mobility.
Tendon tears: Tendon tears can occur because of any acute injury, or due to long-standing degeneration from overuse & ageing. Even a partial tear can cause severe pain and loss of movement of the shoulder.
Impingement Syndrome: This is a complicated orthopaedic condition that requires medical attention.

2. Bone Issues (Fractures)

Shoulder fractures are typically seen in high-velocity injuries (road traffic accidents, sports injuries, etc.). In older people, fractures occur after a fall, especially if the hands are used in an attempt to stabilise oneself.

A fracture typically presents with severe pain, especially on moving the arm, swelling, and redness. If the surrounding areas are also injured, there may be tingling due to nerve damage. The treatment depends on the type of fracture. Some may just require casting and immobilisation of the structure to allow it to fuse and heal. Some fractures may require surgical correction.

4. Joint issues (Arthritis)

The word arthritis refers to inflammation of the joint. There are many conditions that can cause inflammation of the joint. Two of the most common types of arthritis are osteoarthritis (OA) and rheumatoid arthritis (RA).

OA is seen in older individuals and makes joints extremely stiff and painful over time. RA is an autoimmune condition that mainly affects smaller bones but can damage larger joints in the long term. Septic arthritis is a lesser-known type of infectious arthritis that is more commonly seen in infants, old people, and those who have prosthetic limbs.

5. Instability (Dislocation)

Have you seen parents frequently holding their children by their arms and spinning them around? While this makes children laugh, it can potentially result in a shoulder dislocation. Think of the shoulder joint as a ball inside a cup. Any outward force will pull this ball out. This can also happen if you fall with your hand stretched out.

6. Other causes

Frozen Shoulder: A condition where the capsule of the shoulder joint becomes thick and tight, resulting in stiffness and joint pain. The affected person becomes progressively unable to even make small joint movements, and the joint becomes stiff and immovable, hence the name Frozen Shoulder. This condition is commonly seen in chronic diabetics. It is rectified by performing physical therapy and exercising the joint, slowly increasing its range of motion.
Brachial Plexus Injury: There is a network of nerves called the brachial plexus that arises from the spine, traverses the shoulder, and goes into the arm to innervate the different structures of the arm & hand. This can get stretched, compressed, or rarely completely torn and damaged.
Heart Attack: While any type of chest pain requires medical attention, if it is accompanied by pain in the left arm and shoulder, you need to rush to the emergency room immediately. You may also experience severe anxiety, sweating, a feeling of impending doom, shortness of breath, nausea, and dizziness.

How is Shoulder Pain diagnosed?

When you visit a doctor for Shoulder Pain, they will begin by taking a history to check for any trauma or fall. They may also ask you to perform a few simple movements to check for pain. You would also need to undergo some radiological investigations such as an X-ray or MRI for the doctor to diagnose the exact cause of pain. Some cases may also require a simple procedure called an arthroscopy where the surgeon would insert a small probe with a camera to look at the inside of the joint.

What is the treatment for Shoulder Pain?

The treatment depends on the cause. Most of the time, painkillers are recommended in addition to physiotherapy. Physiotherapy can work wonders for chronic pain and help improve joint mobility. A trained physiotherapist will teach you to perform different types of exercises that not only alleviate pain but also strengthen and stabilise the joint.

Some inflammatory conditions require the use of steroids, which are also injected into the joint to reduce symptoms. In certain conditions, surgery is the best available option for a permanent solution, especially for recurrent pain. Surgery can involve repairing the joint, removing scar tissue, reconstructing damaged structures, or even complete shoulder joint replacement.

In case you have severe Shoulder Pain, especially after a fall or any injury to the shoulder, it is best to visit a doctor at the earliest.

Frequently Asked Questions (FAQs)

Here are some common questions and their answers about Shoulder Pain.

How can I treat Shoulder Pain at home?

Simple measures such as using ice packs and taking painkillers can be helpful. It is important to rest the joint and avoid trying to move it in case of pain. However, these are temporary measures. It is important to diagnose the cause of pain to prevent complications.

How do I know if Shoulder Pain is serious?

If Shoulder Pain is experienced along with swelling, redness, warmth around the shoulder, or pain in other areas such as the chest or back, it could indicate a serious issue.

How to prevent Shoulder Pain?

To prevent Shoulder Pain, it is important to train and strengthen the muscles around the shoulder and back. Always warm up before workouts to prevent injuries and increase resistance gradually. Ensure that you maintain a good posture while sitting. Avoid sleeping on one side.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions. Shoulder Pain is referred to as SP in this article.