Shoulder pain can be a result of injury or disease of the shoulder joint. Injury can affect any of the ligaments, bursae, or tendons surrounding the shoulder joint. Injury can also affect the ligaments, cartilage, menisci (plural for meniscus), and bones of the joint. The design of the shoulder joint is such that it sacrifices stability for mobility. As an extremely mobile joint that plays a central role in the action of a major extremity, the shoulder is at risk for injury. Common injuries of the shoulder can lead to inflammation of the bursae (bursitis) or tendons (tendonitis or tendinitis) and result in a torn rotator cuff with dysfunction, impingement, as well as instability and frozen shoulder. Labral tears can be from torn cartilage. Fracture of the bones of the shoulder (such as from biking falls) can cause intense shoulder pain.
Pain can also occur in the shoulder from diseases or conditions that involve the shoulder joint (including arthritis such as osteoarthritis or degenerative arthritis with bone spurs), the soft tissues and bones surrounding the shoulder, or the nerves that supply sensation to the shoulder area. Occasionally, shoulder pain can be a result of a heart attack. It is unusual for cancer to cause shoulder pain.
Other causes of shoulder pain
- Bone Tumor
- Brachial Plexus Injury
- Cartilage Tear (Usually Labrum Tear)
- Irritation Under Diaphragm
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Causes of Shoulder Pain
Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
A broken bone is a fracture. There are different types of fractures, such as: compressed, open, stress, greenstick, spiral, vertebral compression, compound, and comminuted. Symptoms of a broken bone include pain at the site of injury, swelling, and bruising around the area of injury. Treatment of a fracture depends on the type and location of the injury.
A bursa is a fluid-filled sac found in the joints that cushions them. Bursitis is an inflammation of the bursae, most commonly caused by repetitive motion. Bursitis can be caused by a bacterial infection and should be treated with antibiotics. Doctors also recommend icing and resting the joint.
Calcific bursitis is the calcification of the bursa caused by chronic inflammation of the bursa. Calcific bursitis most commonly occurs in the shoulder. Calcific bursitis treatment includes medication for inflammation, ice, immobilization, cortisone injections, and occasionally surgical removal of the inflamed bursa.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
The shoulder is the most often dislocated joint in the body due to its mobility. Dislocation occurs when the head of the humerus is dislocated from its socket. Symptoms and signs of a shoulder dislocation include nausea and vomiting, lightheadedness, weakness, and sweating. There are various methods of reducing a dislocation and returning the humeral head to its normal place. The method for reduction of a shoulder dislocation depends upon the type of dislocation, the patient, the situation, and the clinician's experience. Intravenous narcotics and muscle relaxants are often administered to relax the muscles and relieve pain.
Fibromyalgia is a chronic pain condition characterized by symptoms such as fatigue, sleep disturbances, and tender points. Stress reduction, exercise, and medication are the standard treatments for fibromyalgia.
A frozen shoulder (adhesive capsulitis) is when the shoulder joint experiences a significant loss in its range of motion due to inflammation, scarring, or injury. Treatment involves anti-inflammatory medication, cortisone injections, and physical therapy.
Head and Neck Cancer
Head and neck cancer is cancer of the oral cavity, salivary glands, paranasal sinuses and nasal cavity, pharynx, larynx, or lymph nodes in the upper part of the neck. These cancers account for 3% to 5% of cancers in the U.S. Tobacco and alcohol use are important risk factors. Treatment may involve surgery, radiation therapy, and/or chemotherapy.
A heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
Lung cancer kills more men and women than any other form of cancer. Eight out of 10 lung cancers are due to tobacco smoke. Lung cancers are classified as either small-cell or non-small-cell lung cancers.
Myofascial Pain Syndrome
Myofascial pain syndrome is muscle pain in the body's soft tissues due to injury or strain. Symptoms include muscle pain with tender points and fatigue. Treatment usually involves physical therapy, massage therapy, or trigger point injection.
Neck Pain (Cervical Pain)
Neck pain (cervical pain) may be caused by any number of disorders and diseases. Tenderness is another symptom of neck pain. Though treatment for neck pain really depends upon the cause, treatment typically may involve heat/ice application, traction, physical therapy, cortisone injection, topical anesthetic creams, and muscle relaxants.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of cartilage in the joints. Also known as degenerative arthritis, osteoarthritis can be caused by aging, heredity, and injury from trauma or disease.
Radiculopathy, a condition in which a nerve or nerves along the spine are compressed causing pain, numbness, weakenss, and tingling along the nerve(s). Some causes of radiculopathy include bone spurs, disc hernation, osteoarthritis, tumors, infection, and neuropathy. There are many types of radiculopathy, including cervical radiculopathy, lumbar radiculopathy, and thoracic radiculopathy. Treatment depends on the are of nerve compression. Surgery is generally not required.
Rotator Cuff Disease
Rotator cuff disease is damage to any of the four tendons that stabilize the shoulder joint. Shoulder pain and tenderness are common symptoms. Rotator cuff disease treatment depends on the severity of the shoulder injury.
Shoulder bursitis is inflammation of the shoulder bursa. Bursitis may be caused by injury, infection, or a rheumatic condition. Symptoms include pain, swelling, tenderness, and pain with movement of the shoulder joint. Treatment may involve ice compresses, rest, and anti-inflammatory medications and depends on whether there is an infection.
Sprains and Strains
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms and signs include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
Temporomandibular Joint Syndrome (TMJ)
Temporomandibular joint (TMJ) syndrome is a disorder that causes symptoms like pain, clicking, and popping of the jaw. TMJ is caused by injury to the temporomandibular joint. Stress, poor posture, jaw trauma, genetic predisposition, and inflammatory disorders are risk factors for the condition. A variety of self-care measures (application of ice, use of over-the-counter pain medication, massage, relaxation techniques) and medical treatment options (dental splint, Botox, prescription medications, surgery) are available to manage TMJ. The prognosis of TMJ is good with proper treatment.
Thoracic Outlet Syndrome (TOS)
Thoracic outlet syndrome is a condition where symptoms are produced from compression of nerves or blood vessels because the passageway through the neck and armpit is inadequate. Symptoms of thoracic outlet syndrome include neck, shoulder, and arm pain, and numbness or impaired circulation to the extremities.
Examples of Medications for Shoulder Pain
- acetaminophen (Tylenol, Tylenol Arthritis Pain, Tylenol Ext, Little Fevers Children's Fever/Pain)
- aspirin (acetylsalicylic acid, Bayer, Ecotrin, and others)
- celecoxib (Celebrex)
- ibuprofen (Advil, Motrin, Nuprin)
- Ketorolac vs. diclofenac
- Ketorolac vs. ibuprofen (Advil)
- Ketorolac vs. naproxen (Aleve)
- naproxen (Aleve, Anaprox, Naprelan, Naprosyn)
- Nonsteroidal Antiinflammatory Drugs (NSAIDs)
- OTC Pain Relievers and Fever Reducers
- rofecoxib, Vioxx
- valdecoxib, Bextra