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Shoulder Pain Explained: Causes and Treatments

Jun 23, 2022

One of the biggest problems in explaining shoulder pain lies in the fact that (anatomically) the shoulder is an area and not an organ or a limb. It’s an area consisting of:

  • Bones
  • Joints
  • Cartilage
  • Tendons
  • Muscles
  • Membrane (synovium) and its own coating fluid (synovial fluid)

This means that the sensation of pain that you’re experiencing may come from so many different sources. However, for a layman (or even someone vaguely familiar with the anatomy of the shoulder) it’s just simpler, cleaner, and more accurate to classify it all as shoulder pain.

Nonetheless, when looking for reasons for shoulder pain, it’s vital that you get a bit more specific. With all of this in mind and without further ado, here are some reasons why you may be experiencing shoulder pain and what you can/should do about it.

Shoulder Pain Location 

In order to make a proper diagnosis, it’s first important to identify the exact area from which the pain is originating (relative to your shoulder).

Both of your shoulders are identical, which means that whether you’re experiencing left shoulder pain or right shoulder pain, it does not always change the situation. However, the anatomy of each individual shoulder is quite complex, which is why there’s quite the difference when it comes to whether the pain originates from the front or the back. This is a great place to start when trying to determine the causes of shoulder pain.

Front Shoulder Pain

The front of your shoulder is usually associated with the bicep tendon, which is why two main causes of front shoulder pain are:

  • Bicep tendonitis: This is a condition that causes gradual pain. Now, while we’ve classified this as passive pain, it gets worse with each activity. It is also noticed that it may get worse depending on the time of day, seeing as how it has a tendency of intensifying late in the evening. It gets even worse, seeing as how it may be coupled with elbow tendonitis pain, as well, making the situation unbearable in that entire region.
  • Bicep tendon rupture: This is a condition that happens when there’s a tear near the joint. This is somewhat easier to identify, seeing as how the exact moment gets accompanied by both sharp pain and there’s swelling, bruising, or even a visible lump in the aftermath.

Other possible culprits are:

  • SLAP tear: The SLAP is short for superior labrum anterior-posterior and it is a common problem in athletes. This is because one of its main causes comes from repeatedly doing overhead activities with your arms (like throwing).
  • Shoulder osteoarthritis: Shoulder pain caused by this condition will also be accompanied by a decrease in the range of motion. This is why it’s one of the conditions that affect your quality of life the most. Moreover, it’s usually a result of an injury to this general area.

Finally, it’s worth mentioning that while these four are the major reasons why your front shoulder hurts, they’re not the only possible explanations out there. Most commonly (at least in the past few years) people have experienced shoulder pain after the COVID vaccine. The main reason why this is not such a big issue is that, like an injury, it’s a problem that you can easily track back to its source.

Back shoulder pain

Back shoulder pain or the shoulder blade pain may just be one of the most common shoulder problems out there. One reason why it’s particularly troublesome is due to the fact that it may make it difficult to sleep on your back or even on your side.

The number of causes for this type of pain is virtually endless. This pain is usually musculoskeletal or bone and joint-related, however, due to pain projection to different body parts, it’s also possible that various heart, lung, chest, or even pelvic problems may project themselves as back shoulder pain.

When talking about bone and joint shoulder pain reasons there are three major culprits:

  • Osteoporosis: Although asymptomatic, shoulder fractures are very common in patients with osteoporosis. This is a disease that weakens your bones to the point where they may become incredibly brittle. While this can happen to virtually any bone in your body, the spine, hip bones, and wrist bones are the most susceptible. 
  • Arthritis: Seeing as how swelling and tenderness of the joints known as arthritis can be quite painful, it’s no surprise that it’s a common reason for shoulder pain. After all, there are two joints in the shoulder (acromioclavicular and glenohumeral) and each of them is susceptible.
  • Compressed nerves: Pressure on the nerve in the neck may cause pain in your shoulder area. This often happens with collapsed or displaced discs, as well as spinal stenosis.

Now, this list is far from complete. People can also suffer from shoulder blade pain due to a heart attack, aortic dissection, or pericarditis. Pulmonary embolism and pneumothorax may also project the pain to a shoulder blade.

One interesting thing is that right back shoulder pain may be caused by gallstones, peptic ulcer disease, acid reflux, and liver disease. This is one of the main reasons why physicians often start by asking which shoulder hurts.

Why Does My Shoulder Hurt When Lifting My Arm?

The most common cause for your shoulder to hurt when you lift your arm is a rotator cuff injury or inflammation. While it is common to see this as a result of an incident, this is not always the case. If the bursa (the part that serves as cushioning between the bones and tendons) becomes inflamed, chances are that you’ll experience pain every time you try lifting that arm.

One of the main reasons why this happens is the overuse of the arm in question. People who keep their arms in the overhead position a lot (like house painters) are especially prone to this type of injury. The same goes for athletes who endure this same problem due to overuse. This is especially true for tennis players, seeing as how they repeatedly swing.

Some of the most common shoulder injuries are a result of lifting heavy objects or just using poor technique while lifting weights. Lastly, a fall or a blow to your shoulder (as well as its dislocation), may lead to a labral tear or even a fracture of the glenoid (socket) or the humeral head (ball). Nonetheless, this too can happen as a result of the majority of situations listed above (weightlifting, overuse, sports that involve a lot of swinging and throwing).

How to Relieve Shoulder Pain?

Your ability to relieve shoulder pain depends on the source and the nature of the injury. In general, putting ice on the shoulder for 15 minutes (3-4 times per day) could be quite helpful.

Also, you might want to rest the shoulder for at least a couple of days after an injury (or a particularly painful period). Once it’s time for you to return to your regular activities, it might be best to do so slowly and gradually. In fact, it might be best to look for some effective shoulder stretch exercises to help you get back into the game. Some of the best ones are:

  • Lowering your chin toward your chest
  • Gently tilting your head to one side and then to another
  • Chest expansion
  • Eagle arms spinal rolls
  • Seated twist
  • Shoulder circles

The majority of these stretches are low-intensity and are, therefore, safe to start with. You can also back down as soon as the pain appears (or becomes a bit more intense than you believe you can take).

Other than this, non-steroidal, anti-inflammatory medications (NSAIDs) can also be of great help. For instance, you can try taking ibuprofen or acetaminophen in order to reduce your shoulder pain.

How to Get Rid of Shoulder Pain?

Living with pain is never healthy, for either your psyche or your body. Now, previously, we’ve discussed various ways in which you can alleviate pain or relieve some of the pain. However, what if this doesn’t give you the desired results?

One of the most efficient shoulder pain treatment methods is definitely a cortisone injection. This, however, is something that you should never do without a doctor’s advice. The injection will give effects in up to 48 hours (sometimes even as early as 20 minutes later). These effects can last up to several months.

Physical therapy for shoulder pain is the most effective non-surgical method. Now, the treatment is usually custom-designed and depends on the type of the injury. It is made to help you regain mobility and, when completely successful, could eliminate the need for surgery. This, however, doesn’t mean that it’s an alternative to surgery. Even in a scenario where surgery is unavoidable, you can use physical therapy to facilitate the recovery process both before and after surgery. 

If nothing else works and you decide to go for a more invasive method, you can always go for shoulder surgery. Depending on the source of the problem, or how serious things are, you have to undergo:

  • Arthroscopy for frozen shoulder
  • Arthroscopy for impingement syndrome
  • Total shoulder replacement
  • Acromioclavicular joint debridement
  • Rotator cuff repair (open or arthroscopic)

While surgery may sound scary, this may be the only way for you to get rid of shoulder pain for good. It should also improve your function. Living with pain will seriously diminish your quality of life and cause all sorts of problems (both physical and mental). When performed by professionals (and proscribed by trusted specialists) these procedures are quite safe.

Wrap Up

Getting rid of shoulder pain should always be a priority, seeing as how the pain of any kind is either an inconvenience, a distraction, or a problem that you can’t afford to ignore. Over the course of time, if not treated and tended to, the pain will become more extreme. In some cases, the swelling and crippling pain may restrict your motion, thus making you incapable of handling even some of the simplest tasks. In addition, it may be more difficult to treat. 

All of this can be avoided by taking shoulder pain seriously. Sure, it’s possible that you’ve just bruised the tissue a bit and that it will pass after some icing and rest.

  • However, what if this doesn’t turn out to be the case?
  • What if it’s not just something that occurred due to your bad posture while sleeping
  • What if things progressively get worse?

The only way to know for sure is to get examined by a medical professional. Therefore, just in order to stay on the safe side, you should consult with an expert shoulder specialist at the Orthopedic Institute of NJ.

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