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The shoulder is a ball-and-socket joint, which is considered the most movable joint in the body. It is made up of the upper-arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). The shoulder is kept in place by a group of four muscles and tendons, called the rotator cuff, which allows for arm movement. A pulled muscle in the shoulder can cause arm pain, as the rotator cuff is responsible for arm movement. A rotator cuff tear can be caused by overuse, injury, or wear and tear, and can lead to tendinitis, bursitis, or impingement. Treatment for a pulled muscle in the shoulder includes rest, physical therapy, or surgery.
| Characteristics | Values |
|---|---|
| Cause | Muscle, tendon, or ligament damage, nerve damage, heart attack, rotator cuff tear, shoulder impingement syndrome, brachial neuritis, tendonitis, frozen shoulder, overuse, injury, wear and tear, degenerative conditions, dislocation, separation, bone spurs, decreased blood flow, immobilization, nerve injury, trauma, fall, shoulder instability, sprain |
| Symptoms | Pain, fatigue, weakness, numbness, tingling, swelling, bruising, stiffness, soreness, tenderness, difficulty moving arm, difficulty sleeping |
| Treatments | Massage therapy, compression garments, cold-water immersion, pain medication, corticosteroid injections, physical therapy, surgery, sling, ice, pain relievers, exercises, rest, nonsteroidal anti-inflammatory drugs (NSAIDs), reverse shoulder replacement |
| Prevention | Good posture, targeted shoulder exercises, stretching, strengthening exercises |
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What You'll Learn
Rotator cuff injuries
There are two main causes of rotator cuff tears: injury (acute) and wear (degeneration). Acute tears can occur when falling on an outstretched arm or lifting something heavy with a jerking motion. They can also occur with other injuries, such as a broken collarbone or a dislocated shoulder. Degeneration, on the other hand, occurs slowly over time as the tendon wears down due to aging or repetitive movements. Athletes who play sports with repeated shoulder motions, such as tennis, swimming, and baseball, are at an increased risk of rotator cuff tears. Occupations that require frequent overhead reaching or heavy lifting, such as carpentry and construction work, also increase the likelihood of rotator cuff injuries.
The symptoms of a rotator cuff tear include pain and weakness in the shoulder and arm. Pain may be felt when lifting the arm over the head or moving it behind the back. It may also interfere with daily activities such as combing hair or getting dressed. In some cases, there may be no symptoms at all.
Treatment options for rotator cuff injuries depend on the severity and cause of the injury. Non-surgical treatments include pain medication, targeted shoulder exercises, ultrasound therapy, and heat or electrical stimulation of the affected area. Surgery may be considered if the injury is recent, large, or if symptoms persist for an extended period.
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Brachial neuritis
The brachial plexus is a bundle of nerves that runs from the spinal cord to the chest, shoulder, arm, and hand. Brachial neuritis affects the nerves in these areas, causing pain or loss of function. In some cases, the nerves can become stretched, squeezed, or torn away, resulting in a brachial plexus injury. This can cause a numbing feeling or weakness in the arm, as well as a feeling like an electric shock.
The exact cause of brachial neuritis is unknown, but it is believed to be linked to an abnormal immune response from another illness or injury. The condition is often misdiagnosed due to its multifocal symptoms and varied presentations. To make an accurate diagnosis, clinicians must be familiar with the clinical course of the condition and differentiate it from similar neuromuscular disorders. Electromyography (EMG) and nerve conduction studies (NCS) can be performed to confirm the diagnosis and determine the extent of nerve damage.
Treatment for brachial neuritis includes medicines, physical therapy, and relaxation techniques such as yoga. Glucocorticoids (anti-inflammatory steroids) may be given to reduce nerve inflammation, and pain medicines, anti-seizure medicines, and antidepressants may be used to manage nerve-related pain. In some cases, surgical procedures such as neurolysis may be considered. Recovery from brachial neuritis can take anywhere from a few months to a few years.
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Shoulder impingement syndrome
The primary symptom of shoulder impingement syndrome is pain at the top and outer part of the shoulder, which may radiate to the side of the arm. This pain is typically worse when lifting the arm, especially above the head, and it may also disturb sleep, particularly at night. The pain may come on suddenly or gradually, and it can be severe enough to interfere with basic activities such as getting dressed, putting on a seatbelt, or washing hair.
The diagnosis of shoulder impingement syndrome is made through a patient's history and physical examination. Treatment focuses on early identification, physical therapy exercises to strengthen the shoulder girdle, and pharmacological interventions to reduce inflammation. Physiotherapists play a crucial role in suggesting exercises to improve the range of motion and reduce pain. In cases where rest and exercises are ineffective, steroid injections may be considered to alleviate pain. Surgery may also be an option to widen the space around the tendon and prevent further impingement.
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Tendonitis
A pulled muscle in the shoulder can cause arm pain. Shoulder pain can be caused by muscle, tendon, or ligament damage, or nerve damage. Nerve damage can cause numbness and tingling in the arm. Brachial neuritis, for example, causes pain and weakness in the shoulder and arm, usually on the dominant side.
The symptoms of tendonitis can range from mild to severe and usually include pain during movement, especially when raising or moving the arm. Other symptoms include weak muscles and, in some cases, numbness and tingling in the arm. Tendonitis is often treated with rest, ice, anti-inflammatory medication, and stretching and strengthening exercises. In more severe cases, corticosteroid injections or surgery may be required.
To diagnose tendonitis, a healthcare professional will take a health history, perform a physical examination, and may use diagnostic tests such as X-rays or MRIs. It is important to seek medical advice if you are experiencing shoulder or arm pain, as it can sometimes be a sign of a more serious underlying condition, such as a heart attack or gallbladder disease.
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Heart attack
A pulled muscle in the shoulder can cause arm pain. Shoulder pain is any type of pain or discomfort felt in the shoulder. It can be caused by muscle, tendon, or ligament damage, or nerve damage. In some cases, it could be a sign of a heart attack.
Other symptoms of a heart attack include:
- Chest pain or discomfort, which may feel like pressure, burning, tightness, or sharpness
- Pain in the back, neck, or jaw
- Shortness of breath
- Fatigue
- Sweating
- Dizziness
- Nausea
- Anxiety
If you or someone else is experiencing symptoms of a heart attack, it is crucial to call emergency services immediately. While waiting for the ambulance, rest and avoid any unnecessary strain on the heart. If aspirin is available and you are not allergic, slowly chew and swallow an adult-sized tablet (300mg).
To treat a pulled muscle in the shoulder, immobilization using a sling can help relieve pain by keeping the weight of the arm from pulling on the shoulder. However, it is important not to keep the arm immobile for too long without medical advice as it can cause complications like muscle weakness. Exercises and physical therapy can help ease stiffness and pain, but it is essential to check with a doctor or physical therapist first as, depending on the injury, exercise could make it worse.
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Frequently asked questions
Symptoms of a pulled muscle in the shoulder can include soreness, tenderness, and pain in the shoulder, as well as weakness and difficulty moving the arm.
A pulled muscle in the shoulder can be caused by overuse, repetitive movements, or stress on the tendons and muscles. It can also be caused by a sudden injury, accident, or fall.
Treatment for a pulled muscle in the shoulder may include rest, ice, compression, and elevation (RICE). Physical therapy and exercises to improve range of motion and strengthen the shoulder muscles may also be recommended. In some cases, stronger painkillers or steroid injections may be prescribed.
Yes, a pulled muscle in the shoulder can cause pain that radiates down the arm, up towards the neck, or across the back. This is known as subacromial pain syndrome.
If the pain is severe, if there is swelling or bruising, or if you are unable to move your arm, it is recommended to seek medical advice. Additionally, if the pain is accompanied by other symptoms such as chest pain or tightness, difficulty breathing, or numbness and tingling in the arm, it could indicate a more serious condition and immediate medical attention should be sought.
