What Causes Shoulder Pain?

Understand shoulder pain, symptoms and treatment options.

There are many different causes of shoulder pain. Acute shoulder injuries often occur during sports, while general wear and tear over time can result in chronic shoulder problems. Examples of chronic problems include adhesive capsulitis (frozen shoulder), shoulder impingement syndrome and osteoarthritis.

Symptoms

Shoulder pain is often worse when lifting the arms or at night or when lying on the affected shoulder. In addition, symptoms may include tenderness, stiffness, swelling or a decreased ability to move the shoulder. The symptoms will vary depending on the cause.

Adhesive capsulitis (or frozen shoulder), can cause pain and a significant loss of shoulder movement. There’s a progressive loss of shoulder movement (freezing), which lasts for several months, followed by a gradual improvement in shoulder movement (thawing), which returns to near normal without treatment within one to two years after the onset of symptoms.
Chronic shoulder instability can cause a feeling of shoulder instability or weakness, or “giving out” of the shoulder.
Labral tear can cause shoulder pain with overhead activities, a feeling of shoulder instability or a catching sensation.
Osteoarthritis can cause joint stiffness, especially in the morning and after periods of inactivity, generally lasting longer than a few minutes, as well as joint swelling, warmth and tenderness. The pain typically increases with activity and is relieved by rest.
Rheumatoid arthritis can cause joint stiffness, especially in the morning and after periods of inactivity, generally lasting longer than one hour, as well as joint pain, tenderness and swelling.
Rotator cuff tear can cause shoulder pain; difficulty in reaching or with overhead activities; and progressive weakness.
Shoulder impingement syndrome can cause shoulder pain that occurs when lifting the arm or from other movements that are at or above shoulder level; loss of shoulder motion; pain when reaching backward; and progressive weakness.

Treatment options

Initial treatment decisions are often based on your medical history, current symptoms and physical examination of the shoulder. Diagnostic tests or procedures should only be done if the results will be helpful in determining your treatment. Unnecessary testing may expose you to risks or additional cost, without benefit.

Conservative treatment. About 90 percent of people with shoulder pain will respond to conservative treatment and never need shoulder surgery. Conservative treatment options include:

Activity modification
Heat/cold applications
Exercise/physical therapy
If the above treatments aren’t successful, your doctor may recommend adding oral medications or shoulder injections.

Surgery. Conservative treatments should be tried extensively (depending on the cause) before thinking about surgery. Surgery may be recommended for certain types of injuries, or if you continue to have severe symptoms that interfere significantly with your daily life.

By Optum Contributing Writer

American Academy of Orthopaedic Surgeons. Shoulder and Elbow. Accessed September 27, 2107.
American Physical Therapy Association. Shoulder. Accessed November 11, 2017.
Anderson BC. Glenohumeral osteoarthritis. UpToDate. Accessed September 9, 2017.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Questions and answers about shoulder problems. Accessed September 26, 2017.

Last Updated: October 19, 2017