Shoulder Pain: Top 6 Causes & What to Do

Shoulder pain can occur due to natural joint breakdown due to aging. It can also be a sign of bursitis, tendinitis, arthritis or frozen shoulder. 

Although it can occur at any age, shoulder pain is most frequent in people who frequently use this joint, like tennis players or gymnasts. 

Usually, shoulder pain is temporary and resolves within 3 to 5 days with rest and ice. However, if pain persists for longer, or if the pain is very intense and accompanied by other symptoms, you should consult a doctor for assessment and treatment. 

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Common causes

The most common causes of shoulder pain include:  

1. Joint breakdown

The shoulder joint undergoes natural breakdown with normal aging. This can lead to shoulder pain and difficulty moving the arm.

How to treat: It is important to keep the shoulder moving so that it does not become stiff. You should continue to exercise regularly, although it may be beneficial to incorporate physiotherapy-focused exercises into your routine. 

2. Bursitis

Bursitis is an inflammation of the bursa, a padded, fluid-filled structure that reduces friction between tendons and muscles. This inflammation is more common in people who repetitively move the shoulder, and is common in swimmers and weight lifters. 

Shoulder pain from bursitis is usually acute, and worsens when moving the arm to complete certain movements, like brushing your hair or getting dressed. 

How to treat: Apply ice to the affected area for 20 minutes, 2 to 3 times per day. You should avoid using the shoulder for activities of daily living for a few days to help relieve inflammation. If pain does not improve within 2 to 3 days, you should consult a doctor, as anti-inflammatories (like diclofenac) or physiotherapy may be needed. 

3. Tendinitis

Tendinitis is a condition similar to bursitis, although it affects the tendons instead of the bursae. It is associated with the same underlying causes (ie. repetitive movements), and both tendons and bursae can be affected at the same time.

With this condition, pain is felt at the front of the shoulder, particularly when the arm is raised above the head or in front of the body. 

How to treat: In cases of tendinitis, it is very important to complete physiotherapy to treat tendon inflammation. You should apply cold compresses and anti-inflammatory ointments to help relieve pain.

4. Arthritis

Although it is more common in older adults, arthritis can also occur in younger adults, particularly those who frequently use the shoulder. In addition to shoulder pain, it is common for the shoulder to become swollen, making movement more difficult. Arthritis is not a temporary condition and tends to worsen over time. 

How to treat: Treatment shoulder be oriented by an orthopedist surgeon, who will typically prescribe anti-inflammatories (like ibuprofen) to relieve pain. Physiotherapy may be recommended to strengthen the joint and reduce inflammation to improve shoulder movement. 

5. Frozen shoulder

Frozen shoulder, or adhesive capsulitis, is a chronic shoulder inflammation that can make movement in this joint very difficulty. Frozen shoulder is more common in women over 40 who have had their arms immobilized for over 2 months. 

In addition to shoulder pain, this condition also causes immense difficulty with movement, which is gradually recovered with the right treatment. 

How to treat: Physiotherapy is recommended to mobilize the shoulder and relax the shoulder muscles. In very severe cases, surgery may be advised to repair any injuries within the shoulder. 

6. Fractures

Although they are typically easy to identify, fractures usually cause minimal symptoms other than pain, especially if the fractures are small or incomplete. The most common type of fracture that causes shoulder pain is a clavicle bone fracture or humerus bone fracture, which can occur from a fall or accident.

Generally, fractures cause intense pain, swelling and bruising. However, very small fractures cause a slight pain that increases over time and interferes with normal movement. 

How to treat: You should proceed immediately to the hospital for diagnosis. The doctor may realign the bone and immobilize the affected arm to promote healing. 

How shoulder pain is diagnosed 

Shoulder pain should be assessed by an orthopedic surgeon. The doctor will evaluate all the structures associated with the shoulder, as well as the characteristics of pain, such as the intensity, location, worsening factors and frequency. 

You should also inform your doctor about your lifestyle habits, and when the shoulder pain started, like whether it is associated with certain movements from work, incorrect posture, swelling or inflammation. 

To help the diagnosis, the doctor may prescribe imaging tests, like x-ray, ultrasound, CT or mri, which will help to identify the underlying cause and extent of injury. The doctor may also recommend an arthroscopy, which is a diagnostic method that involves visualization of the shoulder with a camera, through small incisions in the skin.