Treatment for shoulder pain causes (fractures,tissue inflammation,ligament instability) will vary, too.
These treatment options may includerest, medication, and physical therapy.
In some serious cases, such as arotator cuff tear, surgery may be recommended.
Illustration by Alexandra Gordon for Verywell Health
This article explains some of these shoulder pain causes.
The location of your shoulder pain can help your healthcare provider understand which part of the shoulder is affected.
Pain Outside of the Shoulder
Several issues can cause pain on the outside of the shoulder.
The most common cause is a tear in the rotator cuff, which helps lift and rotate your arm.
Rotator Cuff Problem
Fourrotator cuff musclesmove your shoulder, including thedeltoid muscle.
The deep, aching shoulder pain tends to worsen or flare up at night.
It can easily wake you up from sleep or make it difficult to fall asleep.
Rotator cuff problems can be associated with a limited active range of motion.
Since it’s hard to voluntarily move your injured orinflamed muscle, your shoulder may feel stiff.
Why Does My Shoulder Hurt at Night?
Some shoulder issues get worse at night because the area is more compressed when you lie down.
It’s common for pain from tendonitis, bursitis, and rotator cuff tears to flare up at night.
There is also a decrease in both active and passive range of motion.
Some people develop a chronic case of this form of tendonitis.
Many others find that the symptoms resolve on their own with rest, physical therapy and pain management.
This key in of fracture may occur when you fall on your shoulder onto an outstretched arm.
It can intensify at night.
Problems with the biceps tendon may also cause a clicking sound when the shoulder is rotated in an arc.
Biceps Tendon Rupture
A biceps tendon rupture may occur if the biceps muscle breaks free near the joint.
One common cause is a fall on an outstretched hand.
There is generally a decrease in both active and passive range of motion.
When severe, it may be treated with joint replacement surgery.
Pinched nervesare also associated with this punch in of wear and tear arthritis.
This can lead to additional symptoms such as armnumbness.
Fractured Clavicle
A fracturedclaviclemay cause pain in the front of the shoulder.
Your clavicle is also called your collarbone.
When you break this bone, you may experience sharp pain in the front of your shoulder.
Distal Clavicle Osteolysis
Distal clavicle osteolysis causes sharp or aching pain at the end of the collarbone.
It most commonly affects weightlifters or others who repeatedly lift or carry heavy objects.
The clavicle provides support to the scapula, allowing the arm to move freely.
A problem with any part of this architecture can cause pain, weakness, or instability in the shoulder.
If these tissues become loose or torn, shoulder instability ordislocationmay occur.
Shoulder Instability
As the name suggests, instability causes loosening of the joint.
It can be resulting from a traumatic injury (dislocation) or from overuse.
Shoulders that feelunstablemay feel as though they will pop out of the joint.
The sensation is often described as a “dead arm” with excessive shoulder range of motion.
If someone hasdislocated their shoulder, the normal ligaments that hold the shoulder in position may be damaged.
The shoulder is then more likely to pop out of the joint again.
They will press on different areas of your shoulder to evaluate it for tenderness or deformity.
They will also test your arm strength and your shoulder range of motion.
In rare cases, shoulder pain can be a symptom of bleeding from the liver or spleen.
For example, anelectrocardiogram(ECG) may be ordered for a suspected heart attack.
Anabdominal ultrasoundmay be ordered for suspected gallbladder disease.
Treatment
The treatment of shoulder pain depends entirely on the cause of the problem.
It’s vital that you seek expert medical advice before embarking on a treatment program.
Not all treatments listed here are appropriate for every condition.
But, some may help relieve shoulder pain given your situation.
In some cases, the shoulder may be immobilized.
Use caution when resting the joint; prolonged rest can lead to joint stiffness.
Sit straight in your chair and see to it your head is aligned with your screen.
attempt to correct your posture whenever you notice you are slouching.
In these cases, the ice is applied right after the overhead activity to minimize the onset of inflammation.
Heat pads are also used to treat chronic shoulder conditions, but generally,beforethe overhead activity is performed.
Heat can relax the muscles, ease stiffness, and reduce pain.
Before applying ice or heat, talk with your healthcare provider or physical therapist.
Developing a specific plan for the timing and duration of each treatment is important so that you heal properly.
Physical Therapy
Physical therapyplays an important role in shoulder pain treatment.
Stretching
Stretching exercises can help relieve pain while you are at home.
Hold for 30 seconds, then switch arms.
These exercises also may follow surgery, if needed to repair your shoulder.
These are commonly used to treat shoulder problems like arthritis, bursitis, and tendonitis.
An injection can help reduce pain and help you engage in physical therapy sessions more easily.
Prevention
Shoulder pain can sometimes be prevented by making a few changes at home.
They include reducing the risk of trips and falls by making sure floors are uncluttered and rugs are safe.
2023 May 25;11(11):1555. doi:10.3390/healthcare11111555.
2021 Aug 31;22(1):749. doi:10.1186/s12891-021-04634-6.
2023 Feb;17(1):150-159. doi:10.1007/s11764-021-00995-y.
2020;15(1):e0227688.
2021 May 11;8:663703. doi:10.3389/fmed.2021.663703.
2023 Dec 16:S1888-4415(23)00263-1.
American Academy of Orthopaedic Surgeons.Shoulder trauma (fractures and dislocations).
2017;9(6):2668-2683.
2018;108:71-76. doi:10.1016/j.maturitas.2017.11.013
American Academy of Orthopaedic Surgeons.Cervical radiculopathy (pinched nerve).
2017;11:919-933. doi:10.2174/1874325001711010919
Duke University Health System.Know When to See a Doctor for Shoulder Pain.
University of Michigan Health.Referred shoulder pain.
Centers for Disease Control and Prevention.Heart attack symptoms, risks, and recovery.
American Heart Association.Angina in women can be different than men.
doi:10.1136/bcr-2019-230243
Breast Cancer Now.Secondary breast cancer in the liver.
Merck Manual.Overview of Dislocations.
2020 Oct 29;26:e925758.
2023 Dec;32(12):2599-2612. doi:10.1016/j.jse.2023.07.002.
Harvard Health Publishing.Two common shoulder injuries and how to avoid them.
