Shoulder pain

What is shoulder pain?

Shoulder pain is pain that you feel in your shoulder area. It’s often a sign that a part of your shoulder is injured, strained, or not working properly.

Up to 2 in 3 people will experience shoulder pain at some point in their lifetime.

What symptoms are related to shoulder pain?

Usually, you can feel shoulder pain in the front of your shoulder, or at the top of your arm. Often, you can feel the pain only when you move your arm in a certain way. Sometimes you can also feel shoulder pain when you lie on your sore side when in bed at night.

Symptoms you may feel include:

• pain deep in the shoulder joint
• numbness
• tingling
• pins and needles

The shoulder pain you feel may radiate down into the arm or up into your neck or head. Sometimes the pain may be caused by problems with your neck or spine, rather than your shoulder.

You may experience weakness of the shoulder and upper arm or reduced movement.

What causes shoulder pain?

Your shoulder pain can be serious or minor. Your symptoms may be acute (meaning with a sudden onset) or chronic (meaning they develop over and last for a long period of time).

The causes of shoulder pain include:

• osteoarthritis, due to general wear and tear with increasing age or an injury
• inflammation of the shoulder capsule
• inflammation in the fluid sacs in your joints, called bursitis
• a frozen shoulder (when the tissues harden around your joint)
• an injury to your shoulder (tears or strains, dislocation or fracture)
• pain from a problem in your neck or spine
• nerve pain

Other causes of shoulder pain can include:

• weakness or overuse of the muscles around your shoulder, called the rotator cuff
• poor posture
• inflammation of the tendons, called tendonitis
• problems with the muscles, ligaments or tendons around your shoulder

Often shoulder pain is caused by a combination of these factors — as one factor can aggravate another. For example a torn muscle in the rotator cuff might cause:

• bursitis
• tendonitis
• inflammation of the ligaments

Your shoulder pain could sometimes be caused by an underlying medical condition, such as fibromyalgia or polymyalgia rheumatica. Occasionally, someone having a heart attack may have shoulder pain and shortness of breath.

In many cases of shoulder pain, it’s not be possible to find the exact cause. However, it’s still possible to treat your shoulder pain even if the exact cause is unknown.

When should I see a doctor?

You should see your doctor if:

• you have shoulder pain after an accident or a fall
• your pain isn’t going away or is getting worse, especially if you have pain when you are resting your shoulder
• you have a fever, night sweats or start losing weight
• you have other symptoms that are causing you concern

How is shoulder pain diagnosed?

Your doctor will most likely examine your shoulder and ask about your symptoms. In many cases the diagnosis can be made without the need for any further tests.

In some cases your doctor may order tests including:

• x-ray
• computed tomography (CT) scan
• magnetic resonance imaging (MRI) scan
• ultrasound

These tests are only helpful in certain situations, such as if there is an injury that needs to be investigated.

How is shoulder pain treated?

The treatment recommended for your shoulder pain will depend on the cause.

In many cases involving muscle tears or strains and the associated inflammation of other tissues around the joint, then rest and physiotherapy may be enough to settle your symptoms.

In the first few days after an injury, you can use a cold pack on the sore area. This can help to reduce inflammation. After that, a hot pack can be used to help relax the shoulder muscles.

Pain relievers or anti-inflammatory medications may also help control the pain. If you have high blood pressure or heart or kidney disease, you should speak with your doctor before using these medicines.

For persistent or intense pain, or if you’re injured, you should see a doctor or physiotherapist, who may suggest:

• resting your shoulder for some time (usually only a couple of days)
• taping your shoulder for support, or resting your arm
• massage
• strengthening exercises

If your shoulder pain lasts for a long time, you should discuss treatment options with your doctor. This might include medicine to treat nerve pain or steroid injections to relieve inflammation. Surgery may be recommended for some cases.

Sometimes surgery is needed to correct structural problems, such as an arthroscopy, stablisation surgery or a joint replacement.

Can shoulder pain be prevented?

You may be able to prevent some shoulder pain by:

• staying in good physical shape
• being aware of your posture and how you perform activities
• warming up before exercise and stretching after exercise
• lifting and carrying heavy items correctly
• taking breaks, stretching and relaxing