You reach up to get something off the top shelf in the closet and suddenly ouch! Or you start to take a grocery bag out of the back of the car and ouch again! Maybe it happens when you’re swinging a tennis racquet or a golf club, maybe you first feel it when all you’re doing is scratching your back or tying your shoes. It’s your shoulder, and it hurts.
What causes shoulder pain and how can you treat it? Let’s find out…
First, the Basics
What you call your shoulder is actually comprised of three bones: the humerus (the long bone in your upper arm), the scapula (your shoulder blade) and the clavicle (your collarbone).
The head of your upper arm bone fits into a rounded socket in your shoulder blade, and it’s centered and kept in place by a combination of four muscles and some tendons that together are called the rotator cuff. This cuff covers the head of your upper arm bone and attaches it to your shoulder blade.
Two joints work together to allow arm movement. These are the glenohumeral (the shoulder joint) and the acromioclavular (AC).
The shoulder joint is like a ball-and-socket, and it’s what allows the arm to rotate in a circular motion as well as toward and away from your body. The ball is the top, rounded part of the upper arm bone and the socket is the glenoid, the bowl-shaped part of the shoulder blade. They’re cushioned by a piece of cartilage called the labrum.
The AC is a gliding joint formed between the collarbone and the acromion, the projection of your collarbone that forms the point of the shoulder. This joint lets us raise our arms up above our heads.
Lubricating and helping to reduce friction between the moving parts of the shoulder are fluid-filled structures called bursae.
Causes and Symptoms of Shoulder Pain
The shoulder is one of the most flexible joints in your body. Imagine trying to do any normal activity like turning on a faucet or combing your hair without using your shoulder and you quickly realize that it’s called upon to be in motion almost all the time.
Pain caused by overdoing simple everyday activities like gardening or tossing a ball around with your kids will usually dissipate within a few days. But here are some of the conditions that require more examination:
- Rotator cuff tendinitis: Tendinitis is the inflammation and soreness that typically develops after repetitive stress on the shoulder. It’s common in athletes and in people whose jobs involve heavy lifting or reaching over their heads. People over 40 are most likely to have rotator cuff problems in general, and genes are thought to have an effect on your susceptibility to the issue as well.
- Bursitis: Bursitis often accompanies tendinitis, when the fluid-filled bursae become inflamed and painful. You might feel it if you’ve had a sudden traumatic injury to your shoulder or have been hard at work doing something like shoveling snow.
- Arthritis: Osteoarthritis is caused by the deterioration of joint cartilage, often with age, while rheumatoid arthritis occurs when the body’s own immune system attacks the joints. Both can affect the shoulder with pain, stiffness and mobility limitations.
- Pinched nerve: A pinched nerve in your shoulder or neck can cause pain, numbness and a “pins and needles” tingling in the shoulders, arms and hands. This happens when nerve roots extending from the spinal cord become compressed, usually by a herniated disc, osteoporosis fractures or other conditions. The sensation isn’t affected when you move your shoulders because the pain is being generated by a different part of the body.
How to Deal With Shoulder Pain
Treatment options vary with the cause. If symptoms persist, it’s time to see a professional and have the problem diagnosed and treated.
- Medication: No medication cures shoulder pain, but relieving that pain in the short term makes it more tolerable while you recover.
- Physical therapy: An experienced physical therapist can put together a plan designed to alleviate pain, improve mobility and strengthen muscles surrounding the shoulders. Therapy may include heat and ice, massage, stretching, exercise or ultrasound.
- Interventional treatments: Many find relief from the pain with corticosteroid Trigger point injections may be given near the shoulder joint or, in the case of a pinched nerve, specially guided injections near certain discs in the upper spine.
- Surgery: Most shoulder problems don’t require surgery, while herniated discs and some other issues may be corrected with minor outpatient procedures. In extreme cases, major surgery may be required to stabilize the shoulder joint, repair the rotator cuff or, in the case of advanced arthritis, partially or completely replace the joint.