Shoulder Pain Causes and How to Treat Them?

Introduction

Shoulder pain is a common problem that can occur in all age groups. The shoulder is the most flexible joint in the human body, enabling a wide range of movements, but this very mobility makes it vulnerable to injuries, overuse, and degenerative conditions. Discomfort in the shoulder can arise due to muscle strain, tendon inflammation, joint instability, or underlying medical conditions such as arthritis. 

It can impact daily activities, from simple tasks like lifting objects to more complex movements required in sports and physical work. Identifying the cause of shoulder pain is crucial for determining the appropriate treatment and ensuring long-term relief. Addressing the pain early can prevent further complications, whether the pain is sudden or develops gradually. 

Understanding the nature of shoulder pain, its causes, and potential treatments can help individuals manage their symptoms effectively and maintain optimal shoulder function.

What is Shoulder Pain?

Shoulder pain refers to any discomfort, aching, or stiffness in or around the shoulder joint, which is made up of two primary joints:

• Acromioclavicular (AC) joint – This connects the collarbone (clavicle) to the shoulder blade (scapula).
• Glenohumeral joint – This is where the head of the upper arm bone (humerus) fits into a shallow socket in the shoulder blade, allowing extensive movement.

These joints are supported by a network of muscles, tendons, and ligaments, including the rotator cuff, which plays a key role in shoulder stability and movement. Additionally, fluid-filled sacs called bursae help reduce friction within the joint. However, excessive strain, injury, or age-related wear and tear can result in pain, stiffness, swelling, and restricted mobility. Shoulder pain may be mild and temporary or severe and chronic, depending on the underlying cause. Proper diagnosis and treatment are essential to prevent further complications and restore normal function.

Shoulder Injury Symptoms

Recognising the symptoms of a shoulder injury is essential for early diagnosis and effective treatment. The most common indication is pain, which may intensify with movement, making everyday activities challenging. The other common signs include:

• Stiffness or limited range of motion
• Weakness in the shoulder or arm
• Popping or grinding sensation
• Swelling or bruising around the shoulder
• Numbness or tingling in the arm

If the pain is severe or persistent, medical attention is necessary.

Shoulder Pain Causes

Shoulder pain can result from various factors, including overuse, nerve injuries, trauma, arthritis, frozen shoulder, poor posture, bone spurs, referred pain from internal organs, or even serious conditions like a heart attack.

1. Overuse

Repetitive shoulder movements from activities like weightlifting, swimming, or playing sports can strain the muscles and tendons. Over time, this may lead to conditions such as bursitis or tendinitis, causing inflammation, pain, and reduced mobility in the shoulder joint.

2. Nerve Injury

Nerve-related shoulder pain can occur due to conditions like brachial plexus injury, pinched nerves, or cervical radiculopathy. These injuries may result in sharp pain, weakness, tingling, or numbness in the shoulder and arm, sometimes radiating down to the fingers, affecting movement.

3. Trauma or Fall

A direct blow, fall, or accident can cause severe shoulder injuries, including fractures, dislocations, or ligament tears. These injuries often result in immediate pain, swelling, bruising, and difficulty moving the shoulder, requiring medical evaluation and, in severe cases, surgical intervention.

4. Frozen Shoulder

Also called adhesive capsulitis, frozen shoulder leads to stiffness and pain due to the thickening and tightening of shoulder joint tissues. It typically develops gradually, restricting movement, and may take months to years to fully recover with physical therapy and treatment.

5. Bone Spurs

Bone spurs (osteophytes) are extra bony growths that develop on the shoulder joint due to arthritis or chronic irritation. These spurs can press against tendons and nerves, causing pain, reduced range of motion, and discomfort during movement, requiring physical therapy or surgery.

6. Poor Shoulder Posture and Mechanics

Slouching, improper lifting techniques, or repetitive overhead motions can strain shoulder muscles and tendons, leading to stiffness and pain. Poor posture increases stress on the shoulder joint over time, contributing to chronic discomfort and an increased risk of musculoskeletal injuries.

Other Causes of Shoulder Pain

The other causes of shoulder pain include:

1. Arthritis

Both osteoarthritis and rheumatoid arthritis can cause chronic shoulder pain, stiffness, and swelling. Osteoarthritis results from cartilage breakdown, while rheumatoid arthritis is an autoimmune disorder causing joint inflammation. These conditions can limit movement and may require medication, therapy, or joint replacement.

2. Referred Pain

Shoulder pain is sometimes caused by issues unrelated to the joint itself, such as heart, lung, or gallbladder conditions. These underlying problems can trigger pain in the shoulder without direct injury, making it important to seek medical advice for unexplained pain.

3. Heart Attack

A heart attack can cause left shoulder pain, often accompanied by chest pain, shortness of breath, nausea, or dizziness. This type of pain is a medical emergency and requires immediate attention, as it may indicate a life-threatening cardiac event.

Shoulder Pain Diagnosis

Diagnosing shoulder pain requires a thorough evaluation by a healthcare professional. The process typically begins with a physical examination, where the doctor assesses shoulder movement, strength, and swelling to identify potential causes. X-rays are commonly used to detect bone-related issues such as fractures or arthritis. For soft tissue injuries like rotator cuff tears or ligament damage, an MRI or CT scan may be necessary to provide a detailed view of the shoulder’s internal structures. If nerve-related problems are suspected, electromyography (EMG) can help assess nerve function. In more complex cases, arthroscopy, a minimally invasive procedure, allows direct visualisation and treatment of internal shoulder injuries. A precise diagnosis is essential for developing an effective treatment plan, ensuring proper recovery, and preventing long-term complications.

Shoulder Pain Treatment

Shoulder pain can result from various injuries and conditions, ranging from mild strains to severe fractures. Treatment depends on the underlying cause and severity of the injury.

• Dislocated Shoulder: A dislocated shoulder occurs when the upper arm bone pops out of the shoulder socket. A doctor will perform a closed reduction to reposition the joint, and recovery may involve immobilisation with a sling followed by physical therapy to restore strength and mobility.
• Separated Shoulder: A separated shoulder involves ligament damage between the collarbone and shoulder blade. Mild cases heal with rest, a sling, and pain relievers, while severe separations may require surgical intervention to repair torn ligaments.
• Shoulder Fracture: Fractures in the collarbone, humerus, or scapula vary in severity. Mild fractures heal with a sling and pain management, while complex fractures may necessitate surgery or joint replacement.
• Rotator Cuff Tears: The rotator cuff stabilises the shoulder joint. Minor tears are treated with rest, physical therapy, and anti-inflammatory medications, but severe tears may need arthroscopic surgery for tendon repair.
• Most Other Injuries: For common shoulder injuries like sprains, strains, and tendonitis, first-line treatments include rest, ice application, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and corticosteroid injections for pain relief and inflammation reduction.

Shoulder Pain Home Remedies

Here are some home remedies for helping shoulder pain get better:

1. Ice 

Applying an ice pack to the affected area for 15–20 minutes every few hours helps reduce swelling and numbness and minimise inflammation. Always wrap the ice pack in a towel to prevent skin damage. Cold therapy is particularly useful in the first 48 hours after an injury.

2. Over-the-Counter (OTC) Pain Relievers 

NSAIDs such as ibuprofen or naproxen help reduce inflammation and pain, while acetaminophen provides pain relief without reducing swelling. These medications can be taken as directed for short-term relief, but prolonged use should be under a doctor’s guidance to avoid stomach or kidney complications.

3. Immobilization 

A sling or brace can stabilise the shoulder, prevent further injury, and aid in recovery. Immobilisation is particularly beneficial for fractures, dislocations, and ligament injuries. However, prolonged use should be avoided as it may lead to stiffness and reduced mobility, so follow medical advice on duration.

4. Exercises/Physical Therapy 

Once pain subsides, gentle stretching and strengthening exercises improve flexibility, restore range of motion, and prevent stiffness. Common exercises include pendulum swings, wall walks, and resistance band exercises. A physical therapist can guide you through safe movements and prevent complications during recovery.

When to See Your Doctor for Shoulder Pain

Seek medical attention if you experience:

• Intense pain that doesn’t improve
• Inability to move the shoulder
• Swelling, redness, or warmth around the joint
• Numbness or weakness in the arm
• Shoulder pain associated with chest pain or difficulty breathing

Conclusion

Shoulder pain can result from various causes, including injuries, overuse, and underlying conditions. While many cases improve with home remedies and conservative treatments, persistent or severe pain may require medical intervention. Early diagnosis and appropriate management can prevent complications and restore shoulder function.

Frequently Asked Questions (FAQs)