Shoulder Pain: Common Causes, Home Care and When to Be Seen

What it involves

MedlinePlus defines shoulder pain as any pain in or around the shoulder joint. The shoulder is the most movable joint in the human body, and a group of four muscles and their tendons, called the rotator cuff, gives it a wide range of motion. Swelling, damage, or bone changes around the rotator cuff can cause pain when you lift the arm overhead or move it forward or behind your back.

Who this is for

• Adults with shoulder pain that has lasted more than a few days of rest and home care
• Patients who cannot lift the arm overhead or reach behind the back without pain
• Patients with a past shoulder injury, arthritis, or a stiff shoulder that is getting worse
• Patients who want to know whether shoulder pain needs a visit, imaging, or a specialist

What to expect

• Questions about how the pain started, where it is, and which movements make it worse
• A close look at the shoulder, and often the neck and arm, during a physical exam
• A plain explanation of the likely cause and what you can do at home while it heals
• A plan that may include medicine, exercises, or a referral for imaging or physical therapy

The most common cause

MedlinePlus says the most common cause of shoulder pain happens when rotator cuff tendons become trapped under the bony area in the shoulder. The tendons become inflamed or damaged, a condition called rotator cuff tendinitis or bursitis. That is why pain with lifting the arm overhead is such a typical complaint, and why the same shoulder can feel fine at your side and sore above your head.

Other causes on the list

MedlinePlus says shoulder pain may also come from:

• Arthritis in the shoulder joint, or bone spurs in the shoulder area
• Bursitis, inflammation of the fluid-filled sac that helps the joint move smoothly
• A broken shoulder bone, a dislocation, or a shoulder separation
• Frozen shoulder, when the muscles, tendons, and ligaments inside the shoulder become stiff
• Tears of the rotator cuff tendons, or overuse of nearby tendons such as the biceps
• Nerve injury, an imbalance of the shoulder muscles, or poor posture and mechanics

When the shoulder is not the source

MedlinePlus notes that shoulder pain can be referred pain from another part of the body, such as the neck or lungs. With referred pain there is usually pain at rest, and moving the shoulder does not make it worse. If neck pain or tingling down the arm comes with it, the neck pain evaluation covers that side of the problem.

Call 911 first in these cases

MedlinePlus warns that sudden left shoulder pain can sometimes be a sign of a heart attack. Call 911 for sudden pressure or crushing pain in the shoulder, especially if it runs from the chest to the left jaw, arm, or neck, or comes with shortness of breath, dizziness, or sweating. A severe injury that leaves the shoulder very painful, swollen, bruised, or bleeding also needs the emergency room. The chest pain guide explains how to tell an emergency from a visit.

What you can try at home

MedlinePlus suggests wrapping ice in cloth and holding it on the shoulder for 15 minutes, then leaving it off for 15 minutes, three to four times a day for two to three days. It also advises resting the shoulder for a few days, then slowly returning to regular activities, and says ibuprofen or acetaminophen may help with pain and inflammation. The MedlinePlus health topic adds that the first treatment for shoulder problems is often RICE: rest, ice, compression, and elevation. Good posture keeps the tendons in their right positions, and range-of-motion exercises after tendinitis help avoid frozen shoulder.

Signs you should be seen

MedlinePlus says to contact your provider if you have:

• Shoulder pain with a fever, swelling, or redness
• Significant pain even when the arm is moved for you by someone else
• Pain that lasts more than 2 to 4 weeks despite home treatment
• Swelling of the shoulder, or red or blue color of the skin around it

Tests and treatment

MedlinePlus says your provider examines the shoulder closely and asks questions about it. Blood or imaging tests such as x-rays, ultrasound, or MRI may be ordered, and treatment may include anti-inflammatory medicine, an injection of the anti-inflammatory medicine corticosteroid, physical therapy, or surgery if other treatments do not work. Imaging and physical therapy would be arranged through a referral. Serenity offers joint injections at the Loxahatchee and West Palm Beach offices, and whether one fits depends on the cause.

Sources

• MedlinePlus — Shoulder pain
• MedlinePlus — Shoulder Injuries and Disorders