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Shoulder Pain

Your shoulder is made of three bones: the upper part of the long arm bone (humerus), your shoulder blade (scapula), and your collarbone. A combination of tendons and muscles keep the humerus inserted and centered within the scapula. These muscles and tendons are called the rotator cuff.

Shoulder pain refers to any pain in or around the shoulder. Pain can also radiate to the right shoulder from the cervical spine. In addition, certain conditions, such as heart disease or gallbladder disease, can cause referred shoulder pain.

Symptoms

The presenting symptoms for shoulder pain vary depending on the origin of the pain. The pain can range from dull to sharp and from intermittent to constant. If the pain is originating from the joint, tendons or muscles, then the pain is primarily worsened by mechanical factors such as movement of the shoulder in certain positions.

Causes

The majority of shoulder pain originates from:

  1. irritation or damage to the rotator cuff
  2. joint instability
  3. osteoarthritis
  4. fracture of the bones

Excessive use or abnormal movement of the shoulder can cause the rotator cuff to become stressed and inflamed (tendonitis) or torn. Shoulder instability occurs when the head of the humerus is forced out of the socket within the scapula. This can happen as a result of a sudden injury or from overuse.

The most common cause of shoulder arthritis is osteoarthritis. Osteoarthritis may be from injury or from repetitive use leading to “wear and tear.” Sometimes patients will minimize the movement of their shoulder to avoid further pain. This can sometimes cause loss of range of motion and subsequently, worsening pain and is commonly called “frozen shoulder.” Fractures can occur in the humerus, scapula, or clavicle and are mostly due to trauma.

Treatment

We will decide on the right plan of care for you depending on your symptoms and examination. Treatment may start with conservative options such as medications and physical therapy. Minimally invasive options such as injections for osteoarthritis or rotator cuff irritation/inflammation may provide some diagnostic information and some therapeutic relief. Ultimately, a referral to an orthopedic surgeon may be warranted if conservative options do not provide relief.