Understanding shoulder pain and the common causes of it

Our shoulders are our most mobile and probably our hardest working joint. From playing tennis and carrying a bag of groceries to lifting a child, they get used and abused a lot, making them prone to injury. Even though back injuries are the most frequently reported on-the-job injury, shoulder injuries keep people out of work the longest – 30 days compared to the back – 12 days 

About 1.2 million Americans annually visit the emergency room for acute shoulder pain. Most pain in the shoulders can be remedied with rest and rehabilitation at home. But if the injury is that of a broken or dislocated shoulder, it will need to be examined by a physician.

The composition of our shoulders

The anatomy of our shoulders is complex. It is composed of three joints making it our most mobile joint with the ability to move up, down, forward, and back, and for those who are double-jointed, it can be twisted and contorted in unusual ways.  

Three bones make up our shoulder – the clavicle or collarbone, the shoulder blade or scapula, and the humerus, the bone of the upper arm that fits into the other two. Unlike the tight-fitting ball and socket joint of our hips, the bones of our shoulders do not fit tightly but are stabilized by various muscles, tendons, and ligaments.

Common causes of shoulder pain

• Rotator cuff

This part of the shoulder comprises four muscle and their tendons giving us mobility and strength and keeping the arm bone in place. Unfortunately, it can also be a common site causing shoulder pain. Conditions such as tendonitis and bursitis can arise when the tendons are overused, trapped between the shoulder bones, or the bursa gets inflamed. The tendons and muscles of the rotator cuff can also tear, limiting the shoulder’s range of motion. Aging can be one cause of the pain, or an injury such as falling onto your shoulder can be a factor.

• Frozen shoulder or adhesive capsulitis

A frozen shoulder is when the joint loses part of its range of motion. An injury could cause it, aging – it is most common after age 40 – and women are far more prone to this than men. Individuals with diabetes, thyroid problems, and heart disease also have this condition more often, with about one-third who have one frozen shoulder will most likely get the condition in the other shoulder eventually.

• Arthritis

Because the shoulder is a joint, it is also prone to arthritis, usually due to cartilage cushioning the joint wearing down, causing the bones to rub together. In addition, the autoimmune disease of rheumatoid arthritis can also cause painful swelling in the joint linings.

• Acute injury

Any sudden, unexpected injury to the shoulder, such as a broken collarbone, a separated shoulder (ligaments connecting the collarbone and shoulder blade get stretched or torn), or a dislocated shoulder (where the arm bone is pulled out of place in the socket), will be felt and noticed right away and will need medical treatment as soon as possible.

• Treating shoulder pain

If shoulder pain is due to an acute injury, this will necessitate immediate medical intervention by visiting a doctor or going to an emergency room.  

For all other shoulder pain generally developing over time, resting the shoulder, avoiding painful movements, using ice, and taking an over-the-counter pain reliever can often solve and remedy the pain. Even wearing a sling anchoring the shoulder to prevent movement will keep it stabilized and rested while relieving pain.  

If the pain persists or worsens after just a few days, see your orthopedic or orthopedic doctor. They will perform tests such as X-rays, ultrasounds, or MRIs to determine the cause of pain and how to treat it. Treatment often involves physical therapy that teaches proper stretches and exercises to build shoulder muscles. Other options may be a cortisone shot or surgery as a last resort.  

Exercises preventing shoulder pain

Keeping the shoulder muscles toned and in shape is an important part of any exercise program. It is well worth the time and effort put into it to prevent future problems. In addition, regularly performing movements to strengthen the shoulders will make it much easier to do everyday tasks and improve posture.  

This website offers good tips on preventing shoulder and rotator cuff injuries. Another website with good information is the American Academy of Orthopaedic Surgeons, offering a set of 13 exercises using small hand weights to free this area of your body from pain and injury.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.