Understanding the Causes of Shoulder Pain

If you’re grappling with shoulder pain that’s hindering your daily life, you’re far from alone. Shoulder discomfort is a widespread issue, impacting countless individuals and significantly affecting their well-being. Simple everyday activities can become a struggle when your shoulder isn’t functioning correctly, potentially impacting your mental health and overall quality of life.  

Your shoulder is a marvel of engineering, a complex joint where the clavicle (collarbone), scapula (shoulder blade), and humerus (upper arm bone) meet. The head of the humerus rests within the socket of the scapula, stabilized and protected by a network of muscles and tendons known as the rotator cuff. This intricate structure allows for a wide range of arm movements, making the health of your shoulders crucial for everything from getting dressed to participating in sports.  

How Common is Shoulder Pain?

Shoulder pain is a very common musculoskeletal complaint. As we age, the likelihood of experiencing shoulder pain increases, with various conditions like rotator cuff disorders, tendon injuries, arthritis, frozen shoulder (adhesive capsulitis), and shoulder instability being more prevalent. Pain lasting longer than six months is typically classified as chronic.  

But Is It Really Your Shoulder Causing the Pain?

Interestingly, the pain you feel in your shoulder might not actually originate there. Sometimes, issues in other areas of your body can manifest as referred pain in the shoulder. Problems in your neck or back, such as arthritis or disc herniations, can sometimes mimic shoulder pain.  

Have You Got a Shoulder Injury? Key Indicators

To help determine if your pain stems from a shoulder injury, ask yourself these questions:

• Is your shoulder sore and painful?
• Are you unable to move your shoulder?
• Can you still lift and move your arm despite the pain?
• Is moving your shoulder completely impossible?
• Do you feel pressure on the joint, as if it might “pop” out?

If you answered yes to any of these, it’s likely you’ve injured your shoulder and should consult one of our physical therapists for a thorough evaluation. In the meantime, applying heat or a cold pack might offer some temporary relief. Combining this with rest can help minor injuries improve over time. Depending on the severity, a medical professional might recommend a sling to limit movement and ease the pain.

Warning Signs: When to Seek Immediate Medical Help

Be aware of more severe symptoms that require immediate medical attention:

• Weakness or numbness in your hand or arm.
• Inability to lift or move your shoulder at all.
• Your shoulder joint appears deformed or “out of place.”  
• Sudden, intense pain accompanied by swelling and inflammation.

These signs could indicate a shoulder dislocation or fracture, requiring urgent medical intervention.

What Causes Your Shoulder Pain? The Common Culprits

The reality is that there are numerous causes of shoulder pain. A professional evaluation is crucial for accurate diagnosis and treatment, as self-diagnosis and treatment can potentially worsen the problem. Here’s a rundown of common causes:  

• Fracture: A break or crack in the bones of the shoulder joint (humerus, clavicle, or scapula), often resulting from trauma like a fall or direct impact. Fractures cause significant pain, swelling, and bruising. A broken collarbone might even cause the shoulder to sag. X-rays are needed to confirm a fracture.  
• Frozen Shoulder (Adhesive Capsulitis): A frozen shoulder involves the formation of adhesions within the shoulder joint, restricting movement and causing stiffness and pain. It can sometimes develop after surgery or injury leads to reduced shoulder use.  
• Shoulder Bursitis: Inflammation of the bursa, small fluid-filled sacs that cushion the bones and tendons in your shoulder. Repetitive movements, injuries, or falls can trigger bursitis, which is often aggravated by shoulder movement.
• Shoulder Dislocation: Occurs when the head of the humerus is forced out of the shoulder socket due to excessive rotation or a strong pull. This causes intense pain, numbness, and inflammation. Dislocations can be partial or complete. Repeated dislocations can lead to instability and an increased risk of arthritis.
• Rotator Cuff Tear: Damage to the group of muscles and tendons that stabilize the shoulder joint and enable movement. Tears can result from sudden injuries or gradual wear and tear due to aging or overuse. Symptoms may include a crackling sensation and difficulty with specific movements or lifting.
• Separation: An injury to the acromioclavicular (AC) joint, where the collarbone and shoulder blade meet. It usually happens due to a fall or direct blow that tears the ligaments in this area.
• Cartilage Tear: The cartilage within the shoulder joint can tear due to repetitive motions over time or from a sudden impact. This can restrict movement and cause weakness.  
• Impingement: Occurs when the rotator cuff tendons are compressed by the bones of the shoulder, leading to pain and swelling.  
• Osteoarthritis: A degenerative form of arthritis where the cartilage in the shoulder joint breaks down, causing the bones to rub together, resulting in pain and inflammation.  
• Bone Spurs (Osteophytes): Small bony growths that can develop and cause wear and tear on the rotator cuff, potentially leading to tears or tendonitis and restricting movement.  
• Heart Attack: In rare cases, shoulder pain, particularly if accompanied by chest tightness and difficulty breathing, can be a sign of a heart attack. Seek immediate emergency medical attention if you experience these symptoms.  
• Rheumatoid Arthritis: An autoimmune condition where the body’s immune system attacks the joints, causing inflammation, stiffness, and pain. It often affects the shoulder joints and is usually accompanied by visible swelling.  
• Shoulder Tendinitis: Inflammation of the rotator cuff tendons, often caused by injury or developing gradually over time.  
• Referred Pain: As mentioned earlier, pain felt in the shoulder may originate from another area of the body.  

Finding the Root Cause: The Role of a Physical Therapist

When you consult a physical therapist for shoulder pain, they will conduct a comprehensive physical examination. This includes assessing your range of motion, strength, and flexibility, and checking for any structural issues or problems in your back or spine that might be contributing to your pain. They may ask you to perform specific arm movements to evaluate your condition.  

In some cases, additional medical tests may be necessary for an accurate diagnosis:

• Arthroscopy: A minimally invasive surgical procedure where a tiny camera is inserted into the shoulder to visualize the inside of the joint. Sometimes, the issue can be treated during this procedure.
• MRI Scan: Uses powerful magnets and radio waves to create detailed images of the soft tissues within the shoulder joint.  
• CT Scan: Combines multiple X-ray images taken from different angles to provide a more comprehensive view of the shoulder’s condition.  
• X-rays: Help identify structural issues like arthritis, bone spurs, or fractures. An arthrogram, where dye is injected before the X-ray, might be recommended for better detail.  
• EMG (Electromyography): Measures the electrical activity of the muscles and nerves in the shoulder to identify any nerve or muscle dysfunction.  

Treating Shoulder Pain: The Importance of Professional Guidance

Generally, attempting to self-treat significant shoulder pain is not advisable. Fractures, separations, and dislocations require medical intervention to reset the bones or provide appropriate support for healing. Doctors may also prescribe pain medication and anti-inflammatory drugs, such as corticosteroid injections, to reduce swelling and pain. In severe cases, surgery might be the most effective solution.  

However, for chronic pain or minor injuries not resulting from severe trauma, physical therapy can be highly beneficial.

How a Physical Therapist Can Help

A physical therapist can play a crucial role in your recovery. They will:

• Assess your range of motion and functional abilities.
• Develop a personalized treatment plan tailored to your specific needs and goals.
• Implement strategies to restore your mobility and help you return to your desired activities.
• Guide you through strengthening and stretching exercises to improve muscle function and flexibility.
• Work to stabilize your shoulder joint.
• Provide advice on ergonomics for your work, home life, and hobbies to prevent further issues.
• Offer guidance on proper sleeping positions to minimize discomfort.

By combining hands-on therapy with expert advice, physical therapists aim to alleviate your pain, improve your function, and prevent future problems.  

Intecore Physical Therapy: Our Philosophy

At Intecore Physical Therapy, we are guided by principles of integrity of care and core rehabilitation values. We focus on providing a thorough evaluation to identify the underlying cause of your pain, allowing us to create a personalized and hands-on treatment program. Our goal is to deliver lasting relief and help you return to a more enjoyable and fulfilling life. We offer pre-operative, post-operative, and non-operative therapy, emphasizing manual therapy techniques, therapeutic exercise, patient education, and individualized care to enhance your quality of life. We focus on you, the individual, not just the pain.  

If you’re struggling with shoulder pain, reaching out to a physical therapist can be a significant step towards finding relief and regaining your functionality