Common causes of Shoulder Pain

By Alex Bigale, PTA

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. This complex joint is held together by a multitude of 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.  With this mobility comes a multitude of possible causes of shoulder pain when you are injured.

Common causes of shoulder pain can be seen by studying the anatomy of the shoulder

Illustration of the shoulder joint.

5 common causes of Shoulder Pain

Most shoulder injuries can be broken down into a few main categories:

Tendinopathy

A tendon is what 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 that attach 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 pain in a similar cause of injury as tendinitis.

Instability

This cause of shoulder pain comes when the head of the humerus is forced out of the socket (dislocation). This injury can be caused by trauma or by loose ligaments and tendons of the shoulder. In fact, it is the most commonly dislocated large joint in the body. If you have had recurring shoulder dislocations, then the joint may be come very unstable and cause impingement or re-dislocation with reaching.

Arthritis

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 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 which can lead to a condition called frozen shoulder where a person will have pain and very limited range of motion.

Fracture

Fractures are broken bones and can occur in any of the 3 bones that make up the shoulder joint. These would include the clavical, humerus, or scapula (shoulder blade). Depending on the significance of the injury, 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 a car accident of sports injury.

Muscle Tear

There are many muscles that attach to the shoulder joint, but most commonly torn muscle are part of the rotator cuff muscle group.  These are: 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 the muscle tear and age of a person, they will either need surgical repair or may elect conservative treatment such as physical therapy.

Common causes of shoulder pain include tearing of the rotator cuff.

Image of the rotator cuff muscles.

Treatment of Shoulder Pain 

There are several techniques to treat shoulder pain depending on the cause of the pain as well as 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:

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

Book An Appointment with a JOI Physician in Jacksonville.

Book An Appointment with a JOI Physician.

By: Alex Bigale, PTA


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