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Shoulder pain

Definition

Shoulder pain is any pain in or around the shoulder joint.

Alternative Names

Pain - shoulder

Considerations

The shoulder is the most mobile joint in the human body. A group of four tendons in the shoulder, called the rotator cuff, give the shoulder a wide range of motion.

Swelling, damage, or bone changes around the rotator cuff can cause shoulder pain. You may have pain when lifting the arm above your head or moving it forward or behind your back.

Causes

The most common cause of shoulder pain occurs when rotator cuff tendons become trapped under the bony area in the shoulder. The tendons become inflamed or damaged. This condition is called rotator cuff tendinitis.

Shoulder pain may also be caused by:

  • Arthritis in the shoulder joint
  • Bone spurs in the shoulder area
  • Bursitis, inflammation of a fluid-filled sac (bursa) that normally protects the joint and helps it move smoothly
  • Broken shoulder bone
  • Dislocation of the shoulder
  • Shoulder separation
  • Frozen shoulder, which occurs when the muscles, tendons, and ligaments inside the shoulder become stiff, making movement difficult and painful
  • Overuse or injury of nearby tendons, such as the bicep muscles of the arms
  • Tears of the rotator cuff tendons
Shoulder joint dislocation

Watch this video about:
Shoulder joint dislocation

Sometimes, shoulder pain may be due to a problem in another area of the body, such as the neck or lungs. This is called "referred pain." There is usually no pain when moving the shoulder.

Home Care

Here are some tips for helping shoulder pain get better:

  • Put ice on the shoulder area for 15 minutes, then leave it off for 15 minutes. Do this 3 to 4 times a day for 2 to 3 days. Wrap the ice in cloth. Do not put ice directly on the skin because this can result in frostbite.
  • Rest your shoulder for the next few days.
  • Slowly return to your regular activities. A physical therapist can help you do this safely.
  • Taking ibuprofen or acetaminophen (such as Tylenol) may help reduce inflammation and pain.

When to Contact a Medical Professional

Sudden shoulder pain can sometimes be a sign of a heart attack. Call 911 if you have sudden pressure or crushing pain in your shoulder, especially if the pain runs from your chest to the left jaw, arm or neck, or occurs with shortness of breath, dizziness, or sweating.

Go to the hospital emergency room if you have just had a severe injury and your shoulder is very painful, swollen, bruised, or bleeding.

Call your health care provider if you have:

  • Shoulder pain with a fever, swelling, or redness
  • Problems moving the shoulder
  • Pain for more than 1 to 2 weeks, even after home treatment
  • Swelling of the shoulder
  • Red or blue color of the skin of the shoulder area

What to Expect at Your Office Visit

Your health care provider will perform a physical exam and closely look at your shoulder. You will be asked questions to help the provider understand your shoulder problem.

Blood or imaging tests may be ordered to help diagnose the problem.

Your provider may recommend treatment for shoulder pain including:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Injection of an anti-inflammatory medicine called corticosteroid
  • Physical therapy
  • Surgery if all other treatments do not work

Prevention

  • If you have had shoulder pain before, use ice and ibuprofen after exercising.
  • Learn exercises to stretch and strengthen your rotator cuff tendons and shoulder muscles. A doctor or physical therapist can recommend such exercises.
  • If you are recovering from tendinitis, continue to do range-of-motion exercises to avoid frozen shoulder.

References

DeLee JC, Drez D Jr, Miller MD, et al. Shoulder. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Elsevier Saunders; 2009:chap 17.

Greiwe RM, Ahmad CS. Management of the throwing shoulder: cuff, labrum and internal impingement. Orthop Clin North Am. 2010;41:309-323.

Krabak BJ, Banks NL. Adhesive capsulitis. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Elsevier Saunders; 2008:chap 10.


Review Date: 8/12/2013
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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