Shoulder pain: causes, symptoms and treatment
Updated: December 2018
Shoulder pain is a very common reason for consulting a doctor. The shoulder is the most mobile of all our joints, and also the most used since it forms the connection between three different bones — the scapula, humerus and clavicle. It is involved in a number of ordinary, everyday movements such as combing your hair, drinking a coffee and driving a car, and these repetitive movements can weaken the shoulder. The shoulder is also a highly complex joint as it is made up of several articulations, muscles and tendons. Shoulder pain can therefore have a number of causes, which will determine how the pain should be treated. For this reason, it is important to consult a doctor if you have persistent shoulder pain.
Causes of shoulder pain
Due to the complexity of the shoulder’s anatomical structure, shoulder pain could come from a number of sources, such as the joints, tendons, muscles, nerves, or bones. In the vast majority of cases, it is caused by shoulder tendinitis, an inflammation in the muscle tendons that allow the shoulder to move (called “rotator cuffs”), which can be due to either the natural wear and tear that comes with ageing, an acute pull or strain injury, or repetitive strain (for example, from work-related activity or exercise involving repetitive movements).
A painful shoulder may also be linked to conditions such as bursitis or bone calcification, an injury (i.e. muscle and tendon tears, sprains, or dislocations, or humerus, shoulder blade or collar bone fractures) or inflammatory disorders such as arthritis.
However, the pain can sometimes be due to a non-musculoskeletal cause that is unrelated to the shoulder, such as an infectious or neurological condition, or heart or lung problem, all of which can manifest as shoulder pain. This is why it’s important to talk to a doctor as soon as possible if you have persistent shoulder pain — he or she will be able to
Symptoms of shoulder pain
Shoulder pain can manifest itself in a number of ways:
- A pain in the shoulder that varies in intensity, which may or may not be present when you are resting, and that worsens during strenuous activity
- A pain that radiates down your arm, sometimes as far as your hand
- Shoulder stiffness
- Swelling or oedema (build-up of fluid)
- Reduction or loss of shoulder mobility
- Reduced function in your shoulder, arm, and/or hand
- A clicking or snapping sensation in your shoulder
Given its impact on everyday movements, shoulder pain can quickly become disabling so it’s important to get it seen quickly.
Diagnosing shoulder pain
A painful shoulder should be treated according to its cause. However, since there are so many possible causes of shoulder pain it can be difficult to diagnose. Your doctor will first have to work out whether the pain is linked to the shoulder itself, or whether it is a symptom of another problem elsewhere in your body that has spread to your shoulder.
Most of the time, muscle tests can identify the muscle or tendon that is causing the pain, but other information about you such as your job, activities and previous injuries, in addition to the location of the pain and the symptoms associated with it, can help the doctor to make a diagnosis. If the pain does not seem to be musculoskeletal in origin, some more advanced tests will need be carried out. Ultrasound scans can often diagnose whether the symptoms are linked to a cardiovascular, lung, gastrointestinal or neurological problem, for example.
Treating shoulder pain
Once the doctor has made a diagnosis, they can start treating your shoulder pain. Most of the time, if the problem is caused by the shoulder itself, painkillers (such as paracetamol) and/or anti-inflammatory drugs may be prescribed to treat the pain, alongside a course of physiotherapy. If the pain is severe, cortisone injections may also be prescribed. In rare cases surgery may be recommended, mainly for acute rotator cuff tears resulting from an accident or injury.
There are also other solutions that help reduce shoulder pain, drug-free. This is where OMRON’s range of pain relievers come in — using Transcutaneous Electrical Nerve Stimulation (TENS) to help you to relieve your muscle and joint pain.
Finally, there are also some precautions you can take in order to limit the pain in your everyday life. You should of course avoid any activity that causes pain, never force a movement that hurts you, keep your elbows close to your body if you have to exert effort from your shoulders, and if you work at a desk, ensure that you keep your elbows at a 45-degree angle from your body.
PassportSanté (2015). Shoulder pain. Retrieved from www.passeportsante.net/fr/Maux/Symptomes/Fiche.aspx?doc=douleurs-epaule-symptome
Wisard, S. (2014). Healing a painful shoulder requires patience. Retrieved from www.planetesante.ch/Magazine/Medicaments-examens-et-traitements/Anti-inflammatoires/Guerir-d-une-epaule-douloureuse-demande-de-la-patience