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Home > Bones & Joints > Pain > Shoulder Pain: Causes, Symptoms, Prevention, and More

Shoulder Pain: Causes, Symptoms, Prevention, and More

November 15, 2022
7 min read
By Angela Drewniak, RN, MSN, ACNP-BC | Acute Care Nurse Practitioner

In this article:

  • Prevalence of Shoulder Pain
  • Causes of Shoulder Pain
  • Signs and Symptoms of Shoulder Pain
  • Prevention of Shoulder Pain
  • When to See a Doctor
  • Expert Answers (Q&A)
  • Final Word

The shoulder is perhaps the most flexible and the most overworked ball-and-socket joint of the entire human body. It is composed of three bones, namely, the humerus or upper arm bone, the scapula or shoulder blade, and the clavicle or collarbone.

shoulder pain: causes, signs, and when to see a doctor

The head of the humerus is shaped like a ball, which fits into a shallow round socket in your shoulder blade called glenoid. This relatively small ball-and-socket joint called the glenohumeral is encapsulated by a covering of muscles called rotator cuff and is secured in its place by strong cords called tendons.

Moreover, a layer of cartilage forms a cushion between the bones to keep them from rubbing together and to absorb any shock impact. Within this cocoon of cartilage, muscles, and tendons, a soft tissue called synovium secretes fluid to keep the joints lubricated and the cartilage healthy.

This intricate framework of muscles and ligaments accords a wide range of motion to your shoulder, making it the most mobile joint in your body. But with this increased mobility comes its fair share of hassles. A glitch in the working of any of the element of this complex shoulder architecture can trigger mild to chronic discomfort and pain.

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Prevalence of Shoulder Pain

According to a 2005 study published in the BMJ, self-reported cases of shoulder pain are estimated to be between 16 percent and 26 percent, which goes to show how prevalent this problem actually is. Also, it has been noted that shoulder pain is the third most common cause of musculoskeletal-related visits in primary care. (1)

People of all ages can experience shoulder pain. However, people who use laptops, tablets, and smartphones for extended periods are more prone to this problem than others.

Causes of Shoulder Pain

causative factors of shoulder pain
  • Since the shoulder is the most flexible joint, a number of factors and conditions can contribute to shoulder pain.
  • The most prevalent cause is an injury to the soft tissues, including the muscles, tendons, and ligaments within the shoulder. This could be due to repetitive use or overuse injury.
  • It can even be due to soreness of the tendon in the rotator cuff. (2)
  • Sometimes, the pain in your shoulder is actually emanating from injury to some other adjoining area, such as the neck or biceps. This is known as referred pain and does not aggravate with shoulder movement.

Some other causes of shoulder pain can include:

  • Arthritis
  • Bursitis
  • Tendinitis
  • Bone spurs
  • Tear in the cartilage
  • Fractured shoulder bone
  • Frozen shoulder due to stiffening of the tendons, ligaments, and muscles
  • Spinal cord injury
  • Dislocated shoulder
  • Certain diseases can also cause shoulder pain, such as diseases of the cervical spine in the neck as well as liver, heart, and gallbladder diseases

Signs and Symptoms of Shoulder Pain

In addition to pain, one may experience symptoms such as:

  • Swelling
  • Difficulty moving the shoulder
  • Tenderness around the joint

Prevention of Shoulder Pain

tips to prevent shoulder pain
  • If you have previously suffered from any shoulder injury or ailment, it is well advised to regularly perform a few simple range-of-motion exercises to keep your shoulder muscles and tendons properly stretched and flexible to avoid recurrence or a frozen shoulder.
  • If you are prone to shoulder issues, it may be a good idea to follow up your regular workouts with 15 minutes of massaging your shoulder area with an ice compress.
  • Drink a few glasses of warm lemon water daily to prevent mineral deposits in the joints that can cause pain in your shoulder and other body parts.

When to See a Doctor

If the pain on your shoulder is interfering with your daily activities, then it may be a good idea to see a doctor about it. Additionally, if the pain tends to worsen with even the slightest movement of the shoulder, then a consultation with an orthopedic specialist is warranted.

If the pain and discomfort continue to persist despite proper rest and care or spike to an unbearable degree, professional medical assistance must be sought for proper diagnosis and treatment.

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Some worrisome symptoms that call for immediate medical help include:

  • An arm that becomes incapacitated to the extent that you are unable to carry even light objects
  • A severe injury that causes the joint to appear deformed
  • Shoulder pain that is triggered at night or while resting
  • Shoulder pain that persists beyond a few days
  • Loss of mobility in the arm, including the inability to raise it
  • Swelling or noticeable bruising around the joint or arm
  • Signs of an infection, including fever, skin redness, and warmth
  • Abdominal pain
  • Labored breathing

More importantly, sudden shoulder pain without any culpable cause or injury can be a telltale sign of a heart attack. If you experience any such unfounded discomfort, seek emergency medical help.

Expert Answers (Q&A)

Answered by Dr. Mark Miller, MD (Orthopedic Surgeon)

Can shoulder pain occur without any external injury?

Yes. Certain shoulder problems such as rotator cuff tears and biceps tendinosis, can occur as a result of injury or be insidious and gradually worsen. The patient may not even know that they have a problem until it starts to hurt. We call that a sub-clinical problem until it breaks through that point. Kind of like the straw that broke the camel’s back.

What is the best treatment to get instant relief from shoulder pain?

Often an injection with numbing medicine (such as Lidocaine), sometimes combined with a steroid, can give relief. Over-the-counter medications such as Ibuprofen and Naproxen can also help. Sometimes just simple activity modification can be of benefit. In general, I prefer to make the diagnosis prior to embarking on the treatment.

Can shoulder pain be treated as a sign of a heart attack?

Yes, but that is usually accompanied by chest pain as well and is more acute. An urgent visit to the Emergency Room is appropriate for chest pain.

What are the best-suited sleeping positions when one is suffering from shoulder pain?

Different positions work for different people. You will have to figure out which position makes it hurt the least, and settle into your own comfortable spot.

Can shoulder pain escalate during the night or during certain weather conditions?

Yes. Night pain is very common for patients with rotator cuff tears. Certain tumors may also cause night pain. Weather-related pain is common in patients with arthritis.

About Dr. Mark Miller: He is the S. Ward Casscells Professor of Orthopedic Surgery at the University of Virginia in Charlottesville, Virginia. He is a nationally recognized expert in ‘Sports Medicine’ and ‘Knee & Shoulder Surgery.’ He has published over 200 papers as well as written or edited three dozen textbooks.

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Final Word

Shoulder pain can spring from any of the muscles, ligaments, or tendons in and around your shoulder and can be awfully debilitating. First of all, an impairment in the shoulder greatly hampers your ability to move freely. Second, once your shoulder starts hurting, it can be hard to concentrate on anything else.

Thus, something as common as a shoulder ache is not to be taken lightly as it can significantly impede your ability to carry out daily chores and office work.

Continue Reading Continue Reading13 Ways to Relieve Shoulder Pain at Home
References
  1. Mitchell C, Adebajo A, Hay E. Shoulder pain: diagnosis and management in primary care. BMJ. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1283277/. Published November 12, 2005.
  2. Shoulder Pain. AAFP. https://www.aafp.org/afp/2003/0315/p1319.html. Published March 15, 2003.
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