October 1, 2023

The shoulder handles the broadest range of motion in the body. Any problems with the soft tissue or bony structures can lead to severe pain in the shoulder. The pain can radiate to the upper arm, elbow, and neck. This shoulder pain can appear with movement. It can be temporary or persist all the time.

Different types of shoulder pain

Here are some most common types of shoulder pain.

  1. Shoulder aches: Accidents or traumatic brain injuries can cause achy shoulder pain. It is dull or deep pain and is difficult to pinpoint. Some examples of shoulder aches include the following. 
  • Rotator cuff tears: It leads to dull, achy shoulder pain. A traumatic event causes tears and severe pain due to wear of tendons over some time or traumatic injury.  
  • SLAP tear: Another cause of achy shoulder pain is SLAP tear. It is a tear to the cartilage that surrounds the socket of the shoulder. SLAP tears may develop over time or may result from an acute injury. 
  • Frozen shoulder: This condition also causes achy shoulder pain and may sometimes affect the upper arm. This type of shoulder pain increases in the initial phase and decreases in later phases.  
  • Glenohumeral osteoarthritis: It is arthritis of the shoulder joint. Glenohumeral osteoarthritis causes deep, achy pain in the joint and at the back of the shoulder. It is a degenerative condition, observed in adults over 50 years old and with people with a dislocated shoulder or fracture.
  1. Radiating pain: Traumatic brain injuries or sometimes, shoulder injuries can radiate pain. It can extend in the neck or arm. It includes arthritis in the joint at the top of your shoulder, rotator cuff tendonitis, etc.
  2. Burning pain: When there is inflammation or irritation in the shoulder, it causes burning shoulder pain or a dull ache. Subacromial bursitis is a condition in which a bursa, a fluid-filled sac in the shoulder, is inflamed or irritated. The burning sensation is mainly associated with another shoulder injury, like a rotator cuff tear. 
  3. Dislocation: Shoulder dislocation happens when the shoulder is pulled back too hard or is rotated too far. This causes displacement of the top of the arm from its socket. The pain is extreme, and dislocation can lead to swelling, numbness, and bruising.

Causes of shoulder pain
In most cases, shoulder problems only affect a small area, and the pain lasts for a relatively short time. Sometimes, shoulder pain can be part of a long-term condition like osteoarthritis or polymyalgia rheumatica. Some other causes of shoulder pain are as follows. 

  • Fracture where a shoulder bone can break or crack because of accident or fall and result in shoulder pain. This can lead to severe pain and bruises. 
  • Inflammation. In this, the shoulder becomes red, hot, swollen, and painful.  
  • Damage to the shoulder muscles and tendons. 
  • Muscle tension between the shoulder and the neck. 
  • Damage to the shoulder bones and cartilage because of the heterotopic ossification (HO) caused due to traumatic brain injury (TBI).

Diagnosis of shoulder pain
As there are many potential causes of shoulder pain, the doctor will review the symptoms and start with a physical exam. The doctor will check for any structural problems, evaluate tenderness or deformity, and rule out anything that might involve the neck or spine. Also, the doctor will test arm strength and flexibility of the shoulder. Your doctor can recommend one or more imaging tests:

  • X-rays: This imaging test can help find bone spurs, arthritis, and other bone-related problems causing shoulder pain. For a closer look and better details, the doctor can ask for an arthrogram, which involves a shot of dye.
  • Magnetic resonance imaging (MRI) scan: Radio waves and a powerful magnet used in this technique offer detailed shoulder images.
  • Computerized tomography (CT) scan: It uses a series of rotating X-rays taken and a computer to give a better picture of shoulder anatomy, including ligaments, tendons, and cartilage. It may show tears to the rotator cuff or abnormalities with bursae.
  • Electromyography (EMG): This measures the electrical activity in the shoulder muscles. EMG offers insights related to any problems with the nerves.
  • Arthroscopy: It is a surgical procedure that uses a tiny fiber-optic camera. Arthroscopy shows high-definition images of the shoulder, and sometimes, it enables the treatment of the problem during the procedure.

Treatment of shoulder pain
Shoulder pain treatment depends on the cause of the problem. For most common types of shoulder pain, the best treatment is to rest the shoulder. This allows any acute inflammation to subside. In case of swelling and pain, ice packs are helpful. To treat chronic conditions, heat pads offer relief. It relaxes the shoulder muscles and eases stiffness. However, it is best to consult with the doctor before using ice or heat pads.

  • Physical therapy: It is helpful in case of shoulder pain.  
  • Medications: To reduce pain and swelling, steroid injections and non-steroidal anti-inflammatories are used.  
  • Surgery: If conservative measures are not giving any positive results, or the injury is severe, surgery can help. 

Shoulder injuries can happen after a traumatic event and can cause immediate, severe pain. Proper diagnosis and treatment of shoulder pain are necessary as if it is left untreated, it can cause prolonged immobilization and stiffness.