Shoulder Pain - Top Causes & Treatment Options
The shoulder is a ball and socket joint that moves in all ranges of motion and planes, making it a very dynamic joint. It is one of the most functional joints in the body, used for lifting, pulling, and other movements.
What causes shoulder pain?
- Tendonitis causes shoulder pain.
This occurs when the tendons of the shoulder become inflamed or irritated, usually from repetitive use or acute injuries. The biceps tendon and rotator cuff tendons are the tendons typically involved in tendinitis. The symptoms feel like a deep ache or soreness in the shoulder, which is often exacerbated by repetitive activities involving the arm and shoulder.
- Sprains and strains cause shoulder pain.
Sprains and strains may occur after an acute injury from an accident, such as a car accident, or an injury to the shoulder muscles and ligaments during a fall or sports-related injury.
There may be swelling in the shoulder joints and surrounding muscles. Overhead reach and raising the arm typically causes shoulder pain.
There is typically pain in the shoulder at night, causing trouble sleeping on the affected shoulder and restriction with a full range of motion in the shoulder. There may also be trouble putting on clothing and reaching behind the back.
- Tearing of the rotator cuff causes shoulder pain.
A tear in the rotator cuff is when one or more of the ligaments in the rotator cuff tear. There are four muscles and ligaments that make up the rotator cuff in the shoulder. The rotator cuff helps you raise and rotate your arm and provides stability to the shoulder joint.
The tear can be a partial tear where the ligament tears but is still intact or a larger, full-thickness tear where the ligament tears completely.
- Tearing of the shoulder labrum causes shoulder pain.
The shoulder labrum is round cartilage that helps to hold together the shoulder ball and socket joint, comprised of the humerus and glenoid. The labrum is a major stabilizing structure in the shoulder. The should labrum tears from a traumatic force. Symptoms include pain, instability in the shoulder, and often clicking or popping with certain movements of the arm.
- Dislocation causes shoulder pain.
This will occur after a traumatic event. Any movement of the arm and shoulder will be severely painful and limited. It’s important to seek immediate attention if one has dislocated their shoulder. It’s very common to have shoulder pain many years after a prior dislocated shoulder.
- Fractures cause shoulder pain.
A fracture is a break in the bone. There are several bones that make up the shoulder that may fracture during a traumatic event, including the clavicle, scapula, and humerus. A fracture may be closed or open.
- Myalgia causes shoulder pain.
Myalgia is muscle pain from chronic or acute inflammation of the muscles around the shoulder. This may include the deltoid muscle, the pectoral muscles, upper back muscles, and muscles around the scapular region of the shoulder.
- Pinched nerves in the neck cause shoulder pain.
When nerves are pinched or pressed on in the neck this irritation radiates down the shoulder and arm. This condition is called radiculopathy and may be the cause of shoulder pain when the underlying condition is a dysfunction in the neck. Symptoms include shooting pain, numbness and tingling, and a chronic ache or intermittent radiating pain into the shoulder, arm, and hand.
- Poor posture can cause shoulder pain.
Chronic poor posture in the upper back and neck causes excessive strain and imbalance in the shoulders, causing shoulder pain. This is referred to as a condition called upper crossed syndrome where the extensor muscles in the body are not properly strengthened and used, leading to a rounding of the shoulders and contraction of the pectoral muscles.
- Arthritis causes shoulder pain.
Like any other joints in our bodies, shoulder joints can get arthritis. This happens when the joint spaces and cartilage deteriorate in the body. This can happen with chronic use or naturally as we age.
- Cancer can cause shoulder pain.
Some forms of cancer cause shoulder pain. This may come from metastasis or other bone tumors which occur in the long bones of the skeleton, such as the humerus. Red flags for shoulder pain from cancer would include lethargy, shoulder pain at night. sudden unexplained weight loss or weight gain.
How is shoulder pain diagnosed?
X-Ray: The typical first step is obtaining plain film x-rays in Raleigh which can show the joint spacing, bony structures, and some general soft tissue findings.
MRI: This is the superior gold standard choice for diagnosing shoulder problems. MRIs are highly sensitive for soft tissue pathology in the ligaments, muscles, and labrum surrounding the shoulder.
What are the common treatments for shoulder pain?
Common treatments include:
- Resting the shoulder from activities that may be causing shoulder pain and dysfunction.
- Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen.
- Heat and ice to reduce chronic pain or acute inflammation and swelling.
- Cortisone injections into the shoulder.
- Physical therapies which include: strengthening and improving the range of motion in the shoulder, therapeutic ultrasound to promote healing and decrease inflammation and pain.
- Electrical muscle stimulation to modulate pain and increase the normal range of motion.
- Spinal chiropractic adjustments to address pinched nerves in the neck or dysfunctions in the upper thoracic spine and shoulder blades.
- Corrective spinal exercises to address underlying postural issues causing shoulder pain.
- Shoulder surgery to repair torn ligaments or labrum.
If you suffer from shoulder pain and are looking for relief, book an appointment today.
Dr. Jeffrey Gerdes, D.C.