Causes of Shoulder Pain

By Alex Bigale, PTA

Please watch this video on how to properly wear a sling for shoulder pain.

JOI has identified 5 Shoulder Symptoms That You Should Not Ignore if you are living with Shoulder Pain. There are 3 reasons shoulder pain can’t wait which are discussed in this JOI Video.

Causes of Shoulder Pain

The shoulder is a very dynamic joint that can move through many planes of motion. It allows you to complete your activities of daily living as well as perform higher-level activities and sports. The shoulder is held together by many ligaments, tendons, and muscles that allow the shoulder to have more mobility than any other joint in the body. The joint itself is a ball and socket style joint, with the head of the humerus being the ball and the labrum the socket.

5 Common Causes of Shoulder Pain

• Tendinopathy/bursitis.
• Instability.
• Arthritis.
• Fracture.
• Muscle tear.

• Please read this article on Proximal Humerus Fractures. 

Shoulder Tendinopathy

A tendon connects a muscle to a bone, and tendinitis is when the tendon becomes inflamed and painful. This is a common cause of pain in the shoulder since the shoulder has many muscles attached to it. There are two types of tendinitis:

• Chronic: Degenerative diseases such as arthritis or wear and tear over time can cause this type.
• Acute: Most acute tendinitis situations arise from repetitive overhead throwing or pressing motions.

The bursa is a fluid-filled sac on the shoulder, which acts as a cushion between the muscle and bone. It also helps the muscles glide easily. These sacs can become inflamed and painful in a similar cause of injury as tendinitis.

Instability of the Shoulder

Shoulder pain results when the humeral head moves out of the socket (dislocation). This injury can be the result by trauma or by loose ligaments and tendons of the shoulder and injure the glenoid labrum.  In fact, it is the most commonly dislocated large joint in the body. If you have had recurring shoulder dislocations, then the joint may become very unstable and cause impingement or re-dislocation with reaching.

Arthritis of the Shoulder

There are many forms of arthritis, but the most common form that causes shoulder pain is Osteoarthritis. This form of arthritis occurs over time from wear and tear. Symptoms of OA are pain, swelling, and stiffness of the shoulder. This typically occurs in the middle to late age and progresses over time. Often, due to the pain with overhead reaching from OA, people will reduce their reaching and shoulder motions, leading to a condition called frozen shoulder where a person will have pain and a minimal range of motion.

Fractures of the Shoulder

Fractures are broken bones and can occur in any of the 3 bones that make up the shoulder joint. These would include the clavicle, humerus, or scapula (shoulder blade). Depending on the injury’s significance, a person may need a sling to restrict movement or surgery to repair the bone. With elderly individuals, fractures are usually the result of falling. Fractures that occur in younger people are typically the result of high energy impacts from car accidents or sports injuries.

Muscle Tear or Rotator Cuff Tears

The most commonly torn muscle is part of the rotator cuff.  These are the supraspinatus, infraspinatus, teres minor, and subscapularis.  Out of these muscles, the supraspinatus is the most commonly torn muscle due to its action and location that it enters the shoulder joint.  Muscle tears can be full or partial and can occur over time or be acute from an injury.  Depending on the size of a person’s muscle tear and age, they will either need surgical repair or may elect conservative treatment such as physical therapy.

Treatment of Shoulder Pain 

There are several techniques to treat shoulder pain, depending on the cause of the pain and the severity of the injury. An orthopedic physician will be able to perform a physical exam and utilize an X-ray or MRI if necessary, to determine the cause of your shoulder pain. The physician can then prescribe a treatment plan which may include:

• Rest/ice.
• Physical therapy.
• Injections.
• Surgical intervention, if necessary.

If you have recently had a shoulder surgery please watch this helpful video: Dressing the Upper Body After an Injury or Surgery

Related Articles: Exercises for shoulder pain,  shoulder osteoarthritis, 5 Best Rotator Cuff Exercises, Types of Shoulder Surgery, Rotator Cuff Repair, and Rotator Cuff Tears.

To schedule physical therapy at JOI Rehab, please call 904-858-7045.

If you are having any shoulder pain, call us at (904)JOI-2000. We have trained orthopedic shoulder physicians that can evaluate your pain and set up a treatment plan.

By: Alex Bigale, PTA