Shoulder Pain

When you have shoulder pain, it’s difficult to focus on much else in your daily routine. When there is ongoing discomfort, we realize that the mobility of our shoulders is required for almost all tasks. Many times, shoulder pain can be caused by several poor habits that contribute to a tear, nerve pain, or impingement. These can include normal everyday movements such as typing on your laptop with poor posture and then doing planks and pushups during a workout without stretching. There is even a new diagnosis called smartphone tendonitis, which normally effects the hands, but can cause neck and shoulder pain as well. Over time, injuries will likely take place and increase. 

Often neck and shoulder pain are experienced together, and whether the pain stems from the right, left, front, shoulder blade, or rotator cuff, the entire region can feel affected due to muscle tension and permeating pain that can run down the arm, elbow, and hand. Along with affecting your daily routine, many individuals find it difficult to fall asleep with shoulder pain due to the burning or stabbing sensations that often coincide.

Continue reading for an overview of shoulder pain diagnosis, procedures, protocols, and frequently asked questions.

The shoulder is a complex and intricate area of the body due to its incredible ability to move and rotate in numerous ways. Three bones make up the shoulder. These include the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle).

The humerus bone has a ball at the top that securely fits in the rounded glenoid socket.  Surrounding soft tissue such as tendons, ligaments, and muscles keeps the joint and bones attached and creates stability.  Several muscles and tendons protect and encapsulate the shoulder; these are known as the rotator cuff.

Shoulder Pain Causes, Treatments, and Diagnosis:

Often, shoulder pain is due to small tears that occur in the rotator cuff. These tears can progress and may require conservative or surgical treatment. Other issues with shoulder pain stem from overuse or injury that might dislocate the humerus bone from the socket. Fractures or hairline fractures can occur in the bones that make up the shoulder. These will typically need to be stabilized in order to heal correctly. Aging also contributes to common shoulder pain, which may or may not be attributed to arthritis.

If you have shoulder pain, it’s imperative to see a surgeon that is board certified, and fellowship trained with extensive experience.  

The causes of shoulder pain will need to be determined with a thorough medical evaluation, and in many cases, imaging will be necessary to better understand the soft tissue damage and bone degeneration or fractures that may be causing the injury and pain. A physical examination will allow the surgeon to understand your shoulder pain by performing a few tests and qualifying your pain level. It is imperative to have diagnostic imaging for a thorough evaluation and diagnosis.  These include x-ray, CT scan, ultrasound, or MRI.  Having a clear understanding of bone and soft tissue damage is critical for proper diagnosis and treatment planning.

The specialists at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine will determine the cause of your pain and explain your treatment options in full detail. Some of the common causes of shoulder pain are the following:

Once the cause is determined, treatment will depend on the patients’ overall health and medical history, the severity of the injury, and the root cause. Many times, surgery may not be necessary. Physical therapy is usually very helpful in the case of any injury and can teach patients proper stretching and exercise routines to perform at home, which will help the shoulder heal and maximize the range of motion and function.

Physical Therapy

Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine has a group of elite physical therapists on-site, making our treatment patient care and communication convenient for patients and ideal for our practitioners.

Regenerative Medicine

Add-on treatments may also help stimulate the healing process. Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine are experts in biologic and regenerative medicine. Regenerative medicine is a remarkable way to treat damaged tissues directly within the joint. This is a safe and natural alternative to surgery and has helped numerous people find relief and treat the root cause of their condition.

Anatomy of Shoulder 

Four joints make up the shoulder, and it’s one of the most complex areas of the body. The AC joint or acromioclavicular joint is where the clavicle and the acromion bones meet. 

The upper arm bone fits snuggly into the glenoid socket, and the labrum acts as a cushion to protect and stabilize the joint. The labrum is a strong fibrous ring that stabilizes many ligaments and the bicep tendon. The shoulder joint is protected and stabilized by a group of muscles that form tendons, known as the rotator cuff. The humerus bone is encapsulated and protected by the rotator cuff as it wraps from the humerus bone to the scapular or shoulder blade.

shoulder-major-components-of-the-joint

Causes – Tendon inflammation (bursitis or tendinitis) 

Tendonitis usually happens when a tendon is pinched. This often occurs when repetitive overhead movements are in a person’s regular routine, such as painters, construction workers, and sports like tennis, racquetball, basketball, and swimming, to name a few. These same situations can lead to tendon tears, which usually start our tiny and progress to complete or multipole tears with time (if left untreated). 

Bursitis is often also caused by overuse and injury. Bursae are tiny, fluid-filled sacs found throughout the joints. These sacs act as cushions between bones and the overlying soft tissues and help make gliding motions and reduce friction. It’s not uncommon that bursitis and tendonitis to occur together, making it difficult to move the shoulder and causing severe pain. Both tendonitis and bursitis require medical treatment.

  • Instability— Instability Often causes weakness, swelling, and loss of strength and mobility.
  • Arthritis—Cartilage begins to wear down, the bones will rub against each other, cause pain, and limit the range of motion. Bone degeneration is progressive.
  • Fracture (broken bone)—Shoulder fractures are usually the result of an accident or injury.  Fractures include three types: clavicle fracture, proximal humerus fracture (humeral head), and scapula fracture (comminuted scapula).


How can I get immediate relief from shoulder pain? 

Getting immediate relief from shoulder pain depends greatly on the area, cause, and severity of the injury.  If the shoulder pain is acute and less severe, ibuprofen, icing and rest will most likely relieve your pain. If your shoulder is dislocated, immediate relief is possible, but you will need an orthopedic surgeon to put your shoulder back in place. If you are experiencing nerve pain, medications like gabapentin are often prescribed to relieve the discomfort and inflammation.

Shoulder Pain Prevention:

  • Before exercise, warm-up and stretch the shoulder
  • Eat a healthy diet
  • Be cautious about overtraining
  • Strengthen the shoulder by performing exercises such as resistance bands, weight-bearing, and internal and external rotations.


Shoulder Pain Home Remedies:

If you have pain, it’s important to rest your shoulder. Don’t overdo it because this can cause further damage, which may require surgical treatment. Many people find relief with ice on for 15 minutes and ice off for 15 minutes, a few times throughout the day. At night, when you’re preparing to sleep, make sure that your shoulder is relaxed with no added pressure. When sleeping, many people find relief by lying on their back and hanging their arm gently off the side of the bed or supporting it on a pillow. Bracing the area or using kinesiology tape can be helpful to eliminate too much movement. Over-the-counter pain relievers or certain supplements can also be beneficial. However, seeking medical care to get an accurate diagnosis is essential. If you don’t find relief over a few weeks (one to three), you must see an orthopedic surgeon.

Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine put their patient’s needs first above all else. Isn’t it time you placed your health in the hands of the experts?

 With decades of experience, the board-certified, fellowship-trained surgeons at Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine offer you the best treatment options and care.

Our commitment to our patients is to provide excellent medical care in a warm and caring environment. Most importantly, allowing time with the doctor to have questions and concerns addressed.   Let us get you back in your game.