Causes of shoulder pain
Medically Reviewed By : Dr Sravya, MBBS, MS
Introduction:
Individuals of all ages and walks of life can be affected by the harmful condition of shoulder pain. Shoulder pain can have a significant impact on your daily activities and general quality of life, regardless of whether you’re an athlete, office worker, or stay-at-home parent. Understanding the causes for shoulder pain is crucial to choosing the right course of action and getting relief. We will examine the typical causes of shoulder pain in this extensive guide, offering in-depth insights into their underlying causes, signs, and treatment alternatives.
Shoulder Pain Causes and Treatment:
1. Rotator Cuff Injuries:
A collection of tendons and muscles called the rotator cuff surrounds the shoulder joint and gives it stability as well as a wide range of motion. These structures are vulnerable to damage, though. Numerous factors, such as overuse, repetitive motions, trauma, or ageing, can lead to rotator cuff injuries.
One or more tendons may be affected by partial or complete rotator cuff tears. They frequently result from repetitive overhead motions that strain the shoulder joint, such as throwing, lifting, or reaching. Experiencing sudden trauma or lifting heavy objects can also result in acute tears. Sharp or aching pain, weakness, and restricted range of motion are all signs of rotator cuff tears.
On the other hand, rotator cuff strains are typically brought on by overuse or repetitive motions. Painting, gardening, or sports that require repeated arm movements can put strain on the rotator cuff’s tendons, resulting in inflammation, pain, and decreased functionality. Symptoms of strains commonly include localised pain, muscle wasting, and difficulty performing particular movements.
2. Frozen Shoulder:
Frozen shoulder, also known as adhesive capsulitis, is a condition that makes the shoulder joint painful and stiff. Although the precise cause of frozen shoulder is unknown, it frequently occurs after a period of immobilisation, an injury, or certain medical conditions like diabetes or thyroid issues.
The three stages of the condition are typically freezing, frozen, and thawing. As the shoulder enters the freezing phase, pain and range of motion gradually worsen. Moving during this stage is painful and difficult due to the ongoing stiffness and pain. The pain finally gradually lessens and range of motion increases during the thawing stage. Reaching, lifting, and even dressing are common activities that people with frozen shoulders find difficult.
3. Shoulder Impingement:
Shoulder injury happens when the tendons of the rotator cuff are irritated or squeezed as they pass through the tiny space between the tip of the shoulder blade (acromion) and the upper arm bone (humerus). Frequently, repetitive overhead movements, structural issues, or muscle imbalances are linked to this condition.
Reaching overhead or performing other repetitive overhead motions, such as throwing a ball, can wear down the tendons and result in inflammation and swelling. Bone spurs and other structural abnormalities, like a hooked acromion, can enlarge the space through which the tendons pass and thereby increase the risk of impingement. The mechanics of the shoulder joint can be altered by muscle imbalances or weaknesses, which raises the risk of impingement.
When performing certain motions, such as reaching overhead or behind the back, shoulder impingement frequently causes pain. Additionally, individuals may feel weak and have restricted range of motion in the affected shoulder. Physical therapy, anti-inflammatory drugs, and in some cases surgery are available treatments for shoulder impingement.
4. Shoulder Dislocation:
When the humerus (bone in the upper arm) slips out of the shoulder socket (glenoid), this is referred to as a shoulder displacement. This injury is frequently brought on by a trauma or forceful impact to the shoulder, like a fall or a sports-related injury.
There are three types of shoulder dislocations: inferior (downward displacement), posterior (backward displacement), and anterior (forward displacement of the humerus). Dislocations result in excruciating pain, oedema, instability, and limited range of motion. However, recurrent dislocations can happen, making the shoulder vulnerable to further episodes. In some cases, the dislocation may spontaneously reduce (go back into place). The relocation of the joint, immobilisation, rehabilitation exercises, and, in some cases, surgery to repair harmed tissues are all part of the treatment for shoulder dislocation.
5. Shoulder Arthritis:
Any joint in the body, including the shoulder, can develop arthritis. The most prevalent type of arthritis is osteoarthritis, which develops when the joint’s protective cartilage deteriorates over time. An autoimmune disease called rheumatoid arthritis can also affect the shoulder joint, causing persistent pain and inflammation.
The shoulder frequently experiences stress and damage brought on by ageing or repetitive use, leading to osteoarthritis. The shoulder joint’s cartilage degenerates over time, leading to pain, stiffness, and a restricted range of motion. On the other hand, rheumatoid arthritis develops when the immune system mistakenly attacks the lining of the joints, causing swelling, pain, and inflammation in the shoulder. Medication, physical therapy, lifestyle changes, and, in severe cases, joint replacement surgery are all possible treatments for shoulder arthritis.
6. Bursitis:
Small sacs filled with fluid called bursae act as cushions between bones, tendons, and muscles. Bursitis develops when the bursa in the shoulder becomes inflamed as a result of repetitive motions, trauma, or underlying medical conditions like arthritis. Localised pain, swelling, and tenderness in the shoulder joint are signs of bursitis.
Inflammation of the bursa can result from repetitive motions involving frequent overhead movements or excessive pressure on the shoulder. Painting, carpentry, or swimming are a few examples of professions or sports that increase the risk of developing bursitis. In addition, underlying illnesses like arthritis can aggravate shoulder bursitis. Rest, ice, anti-inflammatory drugs, physical therapy, and, in some circumstances, bursa aspiration or injection are all possible treatments for shoulder bursitis.
7. Tendinitis:
Tendons, which are strong cords, attach muscles to bones. Tendonitis is an inflammation of the tendon that is frequently brought on by overuse or repetitive motions. Tendinitis in the shoulder can cause discomfort, edema, and limited motion.
Biceps tendinitis and supraspinatus tendinitis are two common types of shoulder tendinitis. The long head of the biceps tendon becomes inflamed, resulting in biceps tendinitis, which hurts the front of the shoulder and upper arm. One of the rotator cuff tendons, the supraspinatus tendon, is impacted by supraspinatus tendinitis, which results in pain on top of the shoulder and restricted range of motion.
Repetitive overhead motions, such as weightlifting or throwing repeatedly, or working with heavy objects, can put strain on the tendons in the shoulder and cause tendinitis. Tendinitis can also develop as a result of poor shoulder mechanics and ageing-related degeneration. Rest, physical therapy, anti-inflammatory drugs, and in some cases corticosteroid injections are all possible treatments for shoulder tendinitis.
8. Fractures and Sprains:
Falls, accidents, or sports-related injuries can cause fractures or breaks in the shoulder’s bones, such as the humerus and collarbone (clavicle). Intense pain, swelling, deformity, and difficulty moving the arm are symptoms of shoulder fractures.
Conversely, sprains involve stretched or torn ligaments. Ligaments are tenacious tissue bands that connect bones and stabilise joints. Sudden falls, hard impacts, or excessive ligament stretching can all result in shoulder sprains. Pain, bruising, swelling, and instability in the shoulder joint are some symptoms.
Physical therapy, pain management, immobilisation with a cast or sling, and, in severe cases, surgical intervention may all be used as treatments for shoulder fractures and sprains.
Back Shoulder Pain Causes:
Back shoulder pain, often referred to as posterior shoulder pain, can stem from various causes. Here are some common causes and their associated treatments:
1. Muscle Strain or Overuse:
- Cause: Excessive use or strain on the muscles in the back of the shoulder.
- Treatment: Rest, ice, gentle stretching, and avoiding activities that aggravate the pain. Gradual return to normal activity as the pain improves.
2. Posture-related Issues:
- Cause: Poor posture, such as rounded shoulders, can strain the muscles and lead to pain.
- Treatment: Focus on improving posture through ergonomic adjustments, exercises to strengthen back muscles, and awareness of proper alignment.
3. Thoracic Outlet Syndrome:
- Cause: Compression of nerves or blood vessels between the collarbone and rib cage.
- Treatment: Physical therapy to improve posture, stretching exercises, and sometimes surgical intervention to relieve compression.
4. Scapular Dyskinesis:
- Cause: Abnormal movement of the shoulder blade (scapula), leading to pain.
- Treatment: Physical therapy to correct muscle imbalances and improve scapular movement.
Causes of Pain in Shoulder Joint:
Pain in the shoulder joint can result from various causes. Here are some common causes and their associated treatments:
1. Labral Tears:
A labral tear is when the cartilage ring (labrum) in your shoulder joint gets damaged or torn. This can happen from injuries, repetitive movements, or wear and tear.
- Cause: Tears in the labrum (cartilage rim) of the shoulder joint.
- Treatment: Rest, physical therapy to strengthen surrounding muscles, pain management, and surgical repair for severe tears.
2. Nerve Compression:
- Cause: Compression of nerves around the shoulder joint.
- Treatment: Rest, physical therapy, and addressing the underlying cause, such as correcting posture or treating herniated discs.
3. Referred Pain:
- Cause: Pain originating from another area of the body, such as the neck or upper back, can be felt in the shoulder joint.
- Treatment: Addressing the underlying cause of referred pain through medical evaluation and appropriate treatment.
Conclusion:
There are many different reasons why shoulders hurt, from accidents and overuse to illnesses and structural problems. For a precise diagnosis and the best course of treatment, it is essential to comprehend the underlying causes of shoulder pain. It is advised to seek medical attention if you have persistent or severe shoulder pain so that you can receive a full assessment and specialised care.
Many shoulder conditions can be effectively managed with the right diagnosis and care, enabling patients to regain pain-free movement and carry on with their daily activities. To prevent long-term complications and achieve optimal shoulder health, keep in mind that early intervention and appropriate care are essential.