PAIN AND ORTHOPAEDICS · Health guide
What Causes Shoulder Pain? When Should You See a Physician?
Tendon problems, frozen shoulder and referred pain in shoulder pain: restriction of movement, examination and rehabilitation options.
Updated: · General information
Who is affected, and what are the causes?
The shoulder is the most mobile joint in the body and, because it moves in six directions, is vulnerable to injury; it can be affected at any age. In younger people the cause is often impact or trauma, while in older people degenerative (arthritic) causes predominate. It is seen more often in occupations such as carpet weaving and painting and in sports such as tennis and volleyball. Cervical disc herniation, rotator cuff problems (tears, inflammation, impingement), joint osteoarthritis, traumatic dislocation and inflammatory diseases such as rheumatoid arthritis are among the principal causes.
When is further assessment needed?
Further investigation may be needed if the pain does not respond to medication, if its severity is steadily increasing, if it occurs particularly at night, or if it markedly affects daily activities.
Treatment approach
One of the basic principles of treatment is to avoid movements that strain the shoulder; management begins with analgesics and physical therapy. Where indicated, the physician may consider options such as corticosteroid injection, nerve block, PRP or prolotherapy. Avoiding lying on the painful side, supporting the arms when seated, limiting lifting the arm above shoulder level, not carrying heavy loads and exercising on medical advice can all help with prevention.
Tell us which movements you find difficult
Pain when raising the arm, reaching behind the back, dressing or lying on the shoulder can occur in a range of shoulder conditions. The examination compares movements the person performs themselves with movements performed with assistance. Symptoms radiating from the neck are also investigated; not every shoulder pain means a tendon tear.
How are loading and recovery monitored?
Overhead movements at work or in sport, the loads carried and night pain all guide the programme. The aim is not merely to reduce pain but to increase everyday use of the arm. If, after a fall, the arm cannot be raised, there is a deformity or a sudden loss of strength, assessment for injury must come first.
Your questions
Patient information
Are frozen shoulder and a muscle strain the same?
In frozen shoulder, joint movement can be markedly restricted. The diagnosis is based not on the severity of pain alone but on the movement characteristics found at examination.
Can shoulder pain be related to the heart?
If shoulder or arm pain is accompanied by pressure in the chest, breathlessness or cold sweating, it should not be assumed to be muscular pain; emergency services must be called.
