The shoulder is incredibly mobile: several joints connect to many muscles and tendons for a large range of motion. This doesn't mean, however, that excessive or unusual activity won't cause shoulder pain and other issues.
Some people with shoulder pain feel it constantly, while others only experience it when they move their arm. A doctor might prescribe temporary inflammation that needs rest or discover that a more serious problem is at play. Each of the conditions that cause pain in the shoulder presents unique symptoms.
Bursitis
Bursae are tiny, fluid-filled sacs that line joints and cushion the bones. Excessive movement can cause swelling, and inflammation of the bursa in a part of the shoulder called the rotator cuff. The pain usually goes away after a few weeks with rest, though it may flare on occasion.
Dislocated Shoulder
Shoulder dislocation or instability happens with the top of the humerus — the upper arm bone — pops out of the shoulder socket. It can occur due to injury or from constant overuse. Dislocation may be partial or complete. Recurring dislocations put a person at risk of arthritis and cause pain or instability while lifting the arm.
Tendon Tears
Tendon tears happen from injury or as a normal part of aging. The tendon may tear only slightly, or it could completely disconnect from the bone. These are a common injury and often affect the rotator cuff. While medication won't help heal the tendon — rest is essential — it can relieve pain and make the injured person more comfortable.
Shoulder Fracture
A fractured shoulder can cause intense pain and discomfort. Older people often experience a broken shoulder if they fall, while younger people usually incur these injuries from car accidents or contact sports. Anyone who suspects they have fractured their shoulder should seek medical attention because some more complicated injuries require surgery. Until the person can be taken to a doctor, place an ice pack to the shoulder and keep the arm still.
Tendonitis
There are two forms of tendonitis, acute and chronic. Acute cases result from overhead motions like throwing or lifting, while chronic issues may stem from degenerative diseases like arthritis. Calcific tendonitis involves a build-up of calcium deposits that rub against the tendons, causing severe pain. In some cases, injections of cortisone can help alleviate the pain.
Arthritis
Osteoarthritis is a common cause of shoulder pain. Symptoms include pain, swelling, and stiffness, usually beginning in middle-aged people. Osteoarthritis starts slowly and gets worse with time. It can be triggered by an injury or from daily wear and tear. The first line of treatment is rest, activity modification, and icing the inflamed area.
Frozen Shoulder
A frozen shoulder causes pain and stiffness in the shoulder joint. Symptoms start slowly and get worse over time. The good news is that the condition generally goes away on its own, but it can take up to three years. Some corticosteroids and numbing medications lower pain, improving mobility.
Impingement
Shoulder impingement happens when the shoulder blade presses on the soft tissues underneath. When the arm lifts, a part of the shoulder blade rubs against the tendons of the rotator cuff, causing pain and limiting movement. Treatment involves gentle stretching and avoiding overhead motions until it feels better. Anti-inflammatory medication may help with discomfort.
SLAP Tear
A SLAP tear happens over time from continuous overhead motions. Athletes often develop this tear from throwing a ball, playing tennis, or swimming. The tear affects the rim of cartilage around the shoulder socket and causes an achy feeling that is hard to pinpoint. A doctor may recommend physical therapy exercises and anti-inflammatory medications to help with the pain.
Winged Scapula
A winged scapula is recognizable by the way the shoulder blade sticks out, rather than lying flat against the chest wall. People with poor posture are likely to develop this condition, which causes considerable pain and discomfort. Treatment often involved surgery, but a doctor may suggest physical therapy, especially for older adults.
Brachial Plexus Injury
The brachial plexus is a nerve bundle that starts in the neck and upper back and connects the nerves in your arms, wrists, and hands to your spinal cord. Brachial plexus injuries can occur from stress, pressure, or overstretching. They can cause significant pain as well as loss of sensation and weakness in the hand, arm, and shoulder.
Broken Collarbone
Collarbones are long and thin, connecting the upper chest to the shoulder. A broken collarbone or broken clavicle is a common sports injury, and it can also occur as a result of a fall or car accident when an outside force causes it to snap in one place or into several pieces.
Pain from a broken collarbone is often sharp and worsens with movement. This injury can also result in difficulty moving the arm or bruising, tenderness, or swelling.
Heart Attack
Heart attacks have many symptoms. Most people know they can cause chest pain, shortness of breath, sweating, and heart palpitation. Shoulder pain can also be a symptom of a heart attack, and it is often overlooked or misunderstood.
Pain from a heart attack may start in the chest and spread out to one or both shoulders. While this can happen to anyone, women are more likely to experience shoulder pain during a heart attack.
Thoracic Outlet Syndrome
Thoracic outlet syndrome (TOS) is an all-inclusive term for several uncommon conditions that compress the brachial plexus, leading to shoulder pain and neck pain, among other symptoms.
There are three types of TOS. Neurogenic TOS is the most common and results from tears in the muscles on the sides of the neck leading to muscle spasms that irritate the brachial plexus. Arterial TOS is caused by an extra rib near the neck that compresses the artery running to the arm. Venous TOS occurs when the vein running between the collar bone and the first rib is injured.
Sprains
A shoulder sprain happens when the ligaments in the shoulder are stretched or torn, and it can cause significant shoulder pain. Shoulder sprains are more common in the ligament between the acromion, a small bony process on the shoulder blade, and the collar bone.
Pain from a sprained shoulder can spread from the shoulder down the arm or even to the midline of the chest.
Avascular Necrosis
Avascular necrosis can happen to any bone and occurs when the blood supply to the bone is lost, whether temporarily or permanently. If avascular necrosis happens near a joint like the shoulder, the joint's surface may collapse.
This condition results from many things, including fractures, injuries, blood vessel damage, and long-term use of some medications. If avascular necrosis occurs in the humerus, the long bone in the upper arm, shoulder pain may be minimal at first, but it increases significantly as the joint and bone sustain more damage from lack of blood flow.
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