Shoulder Pain Causes and Treatments
Symptoms: Shoulder pain can be a result of injury or disease of the shoulder joint. Injury can affect any of the ligaments, bursae, or tendons surrounding the shoulder joint. Injury can also affect the ligaments, cartilage, menisci (plural formeniscus), and bones of the joint. The design of the shoulder joint is such that it sacrifices stability for mobility. As an extremely mobile joint that plays a central role in the action of a major extremity, the shoulder is at risk for injury. Common injuries of the shoulder can lead to inflammation of the bursae (bursitis) or tendons (tendonitis) and result in rotator cuff dysfunction as well as instability and frozen shoulder. Fracture of the bones of the shoulder (such as from biking falls) can cause intense shoulder pain.
Pain can also occur in the shoulder from diseases or conditions that involve the shoulder joint (including arthritis), the soft tissues and bones surrounding the shoulder, or the nerves that supply sensation to the shoulder area. Occasionally, shoulder pain can be a result of a heart attack. It is unusual for cancer to cause shoulder pain.
There are several types of treatment for shoulder pain, depending on the cause of your shoulder pain and your symptoms.
Some treatment options, such as heat or ice packs and painkillers, may help to reduce pain and treat minor injuries at home.
You should see you GP if your pain is either the result of an injury, it’s particularly bad, or there is no sign of improvement after a couple of weeks.
Your GP may refer you for specialist treatment with an orthopaedic surgeon (a specialist in conditions that affect the bones and muscles) or a rheumatologist (a specialist in conditions that affect the muscles and joints) if you have:
- a frozen shoulder
- a rotator cuff disorder
- an acromioclavicular joint disorder
- a rotator cuff tear
- shoulder instability and you are under 30 years old
The main treatment options for shoulder pain include:
- avoiding activities that make your symptoms worse
- using ice packs
- arthrographic distension (hydrodilatation)
- surgery (in some cases)
These are described in more detail below, and you can also see a summary of the pros and cons of these treatments, which allows you to easily compare your options.
As well as pain, you may also have reduced strength or movement in your shoulder. In this case, a combination of different treatments may be used.
Depending on what is causing your shoulder pain, your GP may recommend that you avoid certain activities or movements that could make your symptoms worse.
For example, in the early, painful stage of frozen shoulder, you may be advised to avoid activities that involve lifting your arms above your head and stretching vigorously. However, you should continue using your shoulder for other activities, because keeping it still could make your symptoms worse.
If you have shoulder instability, you may be advised to avoid any movements that are likely to make the instability worse, such as overarm throwing or bench pressing.
If you have sprained your acromioclavicular joint (the joint at the top of your shoulder), you may be advised to avoid activities that involve moving your arm across your body (such as a golf swing or weightlifting). You should keep the shoulder mobile with light tasks if possible, but avoid heavy lifting and contact sports for 8 to 12 weeks. You may also be given a sling (a supportive bandage) to wear to support your arm for up to a week after your injury. Osteoarthritis is the most common cause of acromioclavicular joint disorders.