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Shoulder pain is a common symptom with several possible causes. The shoulder is the most movable joint in the body, but this makes it unstable and susceptible to injury. The shoulder is a ball-and-socket joint made up of several joints, tendons, muscles, and ligaments that combine to allow a wide range of motion in the arm. Due to the complexity of the shoulder, pain can arise from issues with any of its constituent parts. This article will discuss how to determine which shoulder muscle is causing pain.
| Characteristics | Values |
|---|---|
| Cause of pain | Traumatic injuries, repetitive motion injuries, long-term wear and tear, tissue disorders, arthritis, dislocation, muscle strain, overuse, underuse, degenerative conditions, referred pain, frozen shoulder, bone spurs, impingement syndrome, tendinosis, rotator cuff tear, clavicle fracture, shoulder arthritis, shoulder separation, shoulder impingement, tendonitis, myofascial pain syndrome, muscle strain, or poor posture |
| Symptoms | Pain, swelling, inability to move the shoulder, arm numbness, weakness, visibly out-of-place shoulder, sudden swelling or visible deformity, numbness or tingling in the arm or hand, pain when reaching over the head, shoulder weakness, catching, locking, grinding, crackling sound when moving the shoulder, pain when lifting things, pain at night, difficulty moving the arm, difficulty performing daily tasks |
| Diagnosis | X-ray, magnetic resonance imaging (MRI), computed tomography (CT) scan, physical examination, medical history, shoulder injury diagnosis tool |
| Treatment | Rest, medication, surgery, physical therapy, anti-inflammatory medications, corticosteroid injections, arthroscopic surgery, joint replacement, massage therapy, targeted stretching and strengthening exercises |
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Rotator cuff injuries
The rotator cuff is a group of four muscles and tendons that cover the head of the upper arm bone, keeping it in the shoulder socket. It provides stability and support to the shoulder, allowing the arm to reach above the head, pick up heavy objects, or rotate. Rotator cuff injuries are common and can be caused by repetitive overhead arm actions, such as painting, swimming, or throwing a ball. They can also be caused by a sudden traumatic event, such as a fall or accident.
The main symptoms of a rotator cuff injury are pain and discomfort in the top and side of the shoulder, which can spread down towards the elbow. The pain can be a dull ache or severe and sudden, and it may be worse at night, especially if sleeping on the injured shoulder. Other symptoms include weakness in the arm, a crackling sound when moving the shoulder, and difficulty lifting things or reaching overhead.
If you suspect a rotator cuff injury, it is important to see a doctor or physiotherapist for a diagnosis. They will ask about your symptoms, examine your shoulder, and may perform imaging tests such as X-rays or MRIs to confirm the diagnosis.
Treatment for rotator cuff injuries depends on the severity, your age, and your activity level. Non-surgical treatments, such as rest, ultrasound therapy, and electrical stimulation, can often be effective in relieving pain and improving strength. However, in some cases, surgery may be recommended, especially for extensive tears or if non-surgical treatments are unsuccessful.
It is important to seek early treatment for a rotator cuff injury to prevent it from becoming more serious and affecting your daily activities.
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Poor posture
The shoulder is made up of three different bones: the humerus (upper arm bone), the clavicle (collarbone), and the scapula (shoulder blade). There are two joints in the shoulder: the acromioclavicular joint, where the shoulder blade and collarbone meet, and the glenohumeral joint, where the ball of the upper arm and the socket meet. The shoulder is the most movable joint in the body, but this comes at the expense of stability. The shoulder joint is susceptible to injury and dislocation due to its range of motion.
The rotator cuff, composed of tendons from different muscles, connects all these bones and joints together, keeping the shoulder's parts attached and working fluidly. The supraspinatus tendon runs through a space at the top of the shoulder bone called the subacromial space. The rotator cuff tendons may press on the coracoacromial arch of the shoulder, causing pain with reaching movements, lying on the involved side, and changes in the motion of the shoulder.
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Shoulder dislocation
The shoulder is a complex joint with many parts, which means there are many reasons why you might experience shoulder pain. The shoulder is the most movable joint in the body, but this advantage comes at the expense of stability. The shoulder joint is also the most frequently dislocated major joint in the body.
A shoulder dislocation is an injury that occurs when the ball and socket connection between your bones is separated. This can damage the tissue around the shoulder joint, including blood vessels. Dislocations can be complete or partial, and they usually occur after a trauma such as a fall, sports injury, or motor vehicle collision. In a complete dislocation, the joint surfaces are completely separated, and the shoulder may look deformed and not move normally. In a partial dislocation, or subluxation, the joint surfaces are only partially separated, and the joint may appear fairly normal with a good range of motion. However, there may still be pain, and partial dislocations can continue to happen over time if the ligaments never heal.
If you think you have a dislocated shoulder, it is important to go to the emergency room right away. Do not try to force your shoulder back into place on your own, as this can make the injury worse and damage the tissue around it. Instead, try to hold your shoulder as still as possible and keep your arm close to your side. A healthcare provider will diagnose a dislocated shoulder with a physical exam, looking at your shoulder and the rest of your arm. They may also need imaging tests such as an X-ray, MRI, or CT scan to diagnose damage inside the body after a dislocation.
After a dislocation, immobilization is important to help the shoulder heal. You will need to wear a splint or sling to hold your injured shoulder in place and take the stress off it. Your provider may also recommend icing your shoulder a few times a day and doing light exercises to prevent the shoulder from tightening or freezing.
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Tendonitis
Shoulder pain can be caused by several factors, such as injury, overuse, underuse, degenerative conditions, or referred pain from problems in other parts of the body. The shoulder is a complex joint made up of ligaments, bones, tendons, and muscles, all of which can be a source of pain.
One common cause of shoulder pain is tendonitis, an inflammation of the rotator cuff or biceps tendon. Tendonitis can occur when the tendon is irritated, inflamed, or partially torn due to repetitive stress or overuse. This can lead to symptoms such as pain during movement, soreness, and weakness in the joint.
To determine if tendonitis is the cause of your shoulder pain, a specialist will typically start with a physical examination and discuss your medical history, including any recent injuries. They may also evaluate your range of motion and the location and level of pain. From there, additional tests may be required, such as:
- X-ray: This diagnostic test uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs.
- Ultrasonography: This test uses high-frequency sound waves to create images of the internal soft tissues and organs.
- MRI: Magnetic resonance imaging uses large magnets and radio waves to generate detailed images of internal organs, tissues, ligaments, and muscles, helping to identify any damage or disease.
Treatment for tendonitis will depend on the severity of the condition and may include rest, anti-inflammatory medications, strengthening exercises, ultrasound therapy, corticosteroid injections, or, in severe cases, surgery.
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Frozen shoulder
The shoulder is a highly mobile ball-and-socket joint that allows for a wide range of motion in the arm. However, this mobility comes at the cost of stability, making the shoulder susceptible to various problems and injuries.
One such condition is a frozen shoulder, which is characterised by severe pain and stiffness in the shoulder, leading to a significant loss of mobility. This condition typically develops in three stages: the "freezing" stage, the "frozen" stage, and the "thawing" stage. During the freezing stage, individuals experience a gradual increase in pain and a loss of range of motion, which can last anywhere from 6 weeks to 9 months. The frozen stage is marked by persistent pain and stiffness, making daily activities challenging, and usually lasts for about 4 to 6 months. Finally, during the thawing stage, shoulder motion gradually improves, but it can take anywhere from 6 months to 2 years to regain normal or near-normal strength and motion.
The underlying cause of a frozen shoulder is often inflammation of the capsule, the tissue surrounding the shoulder joint. This inflammation results in scarring, leading to the formation of abnormal bands of tissue called adhesions. These adhesions restrict movement and cause pain, as the capsule becomes tight and less flexible. While the exact causes of this condition are not fully understood, certain factors have been identified that increase the risk of developing a frozen shoulder. These include immobilization of the shoulder due to surgery, fracture, or other injuries, underlying medical conditions such as diabetes, hypothyroidism, hyperthyroidism, Parkinson's disease, and cardiac disease, and age, with individuals between 40 and 60 being more susceptible.
Diagnosing a frozen shoulder typically involves a physical examination by a doctor, who will carefully move the shoulder in all directions to assess the range of motion and the presence of pain. Additional tests, such as X-rays or magnetic resonance imaging (MRI), may be required to rule out other potential causes of the symptoms. Treatment options include physical therapy, with a focus on shoulder flexibility, and anti-inflammatory medications to reduce pain and inflammation. In rare cases, surgery may be considered if non-operative treatments have not been successful in improving range of motion and pain management.
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Frequently asked questions
If your pain is localized to a specific muscle or tendon and improves with rest or stretching, it is likely muscular. Unlike joint pain, muscle-related discomfort does not typically worsen with shoulder movement.
Shoulder pain can be caused by traumatic injuries, repetitive motion injuries, long-term wear and tear, or tissue disorders. It can also be caused by problems in other parts of your body, referred to as referred pain.
If your shoulder pain persists for more than a few weeks or worsens over time, it’s important to seek medical attention. Some warning signs of a more serious issue include persistent pain that does not improve with rest, difficulty moving the arm or performing daily tasks, and sudden swelling or visible deformity.
