Also called shoulder joint pain, shoulder blade pain, chronic shoulder pain. Shoulder pain may arise from the shoulder joint itself or from any of the many surrounding muscles, ligaments or tendons. Shoulder pain that comes from the joint usually worsens with activities or movement of your arm or shoulder.
Various diseases and conditions affecting structures in your chest or abdomen, such as heart disease or gallbladder disease, also can cause shoulder pain. Shoulder pain that arises from another structure is called referred pain. Referred shoulder pain usually doesn’t worsen when you move your shoulder.
Causes
Avascular necrosis (osteonecrosis) – death of bone tissue due to a lack of blood supply.
Brachial plexus injury – The brachial plexus is the network of nerves that sends signals from your spine to your shoulder, arm and hand. A brachial plexus injury occurs when these nerves are stretched, compressed, or in the most serious cases, ripped apart or torn away from the spinal cord.
Broken arm – involves one or more of the three bones in your arm — the ulna, radius and humerus. One of the most common causes of a broken arm is falling onto an outstretched hand.
Broken collarbone – Your collarbone connects the upper part of your breastbone to your shoulder blade. Common causes of a broken collarbone include falls, sports injuries and trauma from traffic accidents.
Bursitis – a painful condition that affects the small, fluid-filled sacs — called bursae (bur-SEE) — that cushion the bones, tendons and muscles near your joints. Bursitis occurs when bursae become inflamed.
Cervical radiculopathy (“pinched nerve”) – occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord. This may cause pain that radiates into the shoulder, as well as muscle weakness and numbness that travels down the arm and into the hand.
Dislocated shoulder – an injury in which your upper arm bone pops out of the cup-shaped socket that’s part of your shoulder blade. The shoulder is the body’s most mobile joint, which makes it susceptible to dislocation.
Frozen shoulder (adhesive capsulitis) – a condition characterized by stiffness and pain in your shoulder joint. Your risk of developing frozen shoulder increases if you’re recovering from a medical condition or procedure that prevents you from moving your arm — such as a stroke or a mastectomy.
Hiatal hernia – occurs when part of your stomach pushes upward through your diaphragm.
Impingement – occurs when tendons or bursa in the shoulder are compressed by bones of the shoulder.
Osteoarthritis – the most common form of arthritis; occurs when the protective cartilage on the ends of your bones wears down over time.
Polymyalgia rheumatica – an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders. Symptoms usually begin quickly and are worse in the morning. Most people who develop polymyalgia rheumatica are older than 65.
Rheumatoid arthritis – occurs when your immune system mistakenly attacks your own body’s tissues. It can affect more than just your joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.
Rotator cuff injury – The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens when you try to sleep on the involved side.
Separated shoulder – an injury to the ligaments that hold your collarbone (clavicle) to your shoulder blade.
Septic arthritis – a painful infection in a joint. The infection can come from germs that travel through your bloodstream from another part of your body. Septic arthritis can also occur when a penetrating injury delivers germs directly into the joint.
Sprains and strains – A sprain is a stretching or tearing of ligaments — the tough bands of fibrous tissue that connect two bones together in your joints. The most common location for a sprain is in your ankle.
A strain is a stretching or tearing of muscle or tendon. A tendon is a fibrous cord of tissue that connects muscles to bones. Strains often occur in the lower back and in the hamstring muscle in the back of your thigh.
Tendinitis – inflammation or irritation of a tendon — any one of the thick fibrous cords that attaches muscle to bone.
Tendon rupture – The forces applied to a tendon may be more than 5 times your body weight. In some rare instances, tendons can snap or rupture. Conditions that make a rupture more likely include the injection of steroids into a tendon, certain diseases (such as gout or hyperparathyroidism), and having type O blood.
Thoracic outlet syndrome – a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed. Common causes include physical trauma from a car accident, repetitive injuries from job- or sports-related activities, certain anatomical defects (such as having an extra rib), and pregnancy.
Torn cartilage – To help make your shoulder more stable, there is a ring of firm tissue, called the labrum, around your shoulder socket. The labrum (LAY-brum) helps keep your arm bone in the shoulder socket.The labrum may fray or tear when you:
- Fall on your outstretched arm.
- Fall on your shoulder.
- Brace yourself with your outstretched arm in a car accident.
- Lift heavy objects repeatedly or too suddenly.
- Do a lot of overhead activities.
When to see a doctor
Shoulder pain accompanied by difficulty breathing or a sense of tightness in the chest may be a symptom of a heart attack and requires immediate medical attention.
Seek immediate medical attention
Ask someone to drive you to urgent care or the emergency room if your shoulder pain is caused by an injury and is accompanied by:
- A joint that appears deformed
- Inability to use the joint or move your arm away from your body
- Intense pain
- Sudden swelling
Schedule an office visit
Make an appointment with your doctor if your shoulder pain is accompanied by:
- Swelling
- Redness
- Tenderness and warmth around the joint
Self-care
To relieve minor shoulder pain you might try:
- Pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) may help.
- Rest. Avoid using your shoulder in ways that cause or worsen pain.
- Ice. Apply an ice pack to your painful shoulder for 15 to 20 minutes a few times each day.
Often, self-care measures and a little time could be all you need to relieve your shoulder pain.
