The shoulder supports a wide range of movements, so when something is wrong with your shoulder, it hinders free movement and causes a lot of discomfort and pain. The shoulder is a ball-and-socket joint with three major bones:
A layer of cartilage cushions these bones, and the two main shoulder joints include:
The shoulder joint allows the highest movement in the body. It can move backwards and forward, allowing the arms to move away from the body, up and in a circular motion.
The shoulders get their wide range of movement from the rotator cuff. The rotator cuff consists of four tendons. The tendons are tissues connecting muscles to bone. Lifting your arm over your head may be difficult or painful if the bones or tendons around your rotator cuff are swollen or damaged.
Repetitive movement, playing sports or carrying out manual labour can injure your shoulder. Some diseases also cause pain that affects the should. These diseases include liver, gallbladder, heart disease, or cervical spine (neck) disease.
The chances of having problems with your shoulder are higher as you grow older, especially after age 60. This is because the soft tissues surrounding your shoulder often degenerate with age.
Most times, you can treat shoulder pain at home, but surgery, medications or physical therapy may also be necessary.
Many conditions and factors may contribute to shoulder pain, but the most common is rotator cuff tendinitis, which causes swollen tendons.
Impingement syndrome is another cause of shoulder pain. In this condition, the rotator cuff becomes stuck between the humeral head (the ball part of the humerus) and the acromium (the scapular area covering the ball).
In some cases, shoulder pain results from an injury in another part of the body, usually the biceps or neck. This is called referred pain which generally doesn’t worsen when moving your shoulder.
Other conditions that may cause shoulder pain are:
Ensure you contact your doctor if you experience lasting bruising, tenderness around the joint, heat, fever, inability to move your shoulder, or pain that remains after a few weeks of home treatment.
If your shoulder pain is sudden and unrelated to an injury, seek emergency care, as this may indicate a sight of a heart attack. Other signs of a heart attack are:
Ensure you visit the emergency room immediately if you have an injected shoulder that is swollen, bleeding or showing tissues.
A doctor will need to determine the cause of your shoulder pain. The doctor will request your medical history and carry out a physical exam.
Your doctor will check for swelling and tenderness and assess your joint stability and range of motion. Imaging tests like an MRI or X-ray can give a detailed image of your shoulder to help with an accurate diagnosis.
Your doctor may ask these questions to determine the cause of your shoulder pain.
After determining the cause of the pain, your doctor will begin with a physical exam to check for any structural problems and rule out any issue that may involve the neck or spine.
The next step is checking your range of movement to see how flexible and strong your shoulder is, which involves moving your arms in different ways, like across your body, behind you, above your head and rotating it 180 or 90 degrees.
Your doctor may recommend one or several imaging tests for a closer look at the shoulder, such as:
The shoulder pain treatments often depend on the severity and cause of the pain. Some treatments include occupational or physical therapy, surgery, a shoulder immobiliser or a sling.
Your doctor may prescribe medication such as corticosteroids or NSAIDs (nonsteroidal anti-inflammatory medications). Corticosteroids are highly effective anti-inflammatory medications taken orally, or the doctor can inject them into the shoulder. If you had shoulder surgery, ensure you follow after-care instructions carefully.
Some minor shoulder pains are treatable at home. You can place ice on the shoulder for 15 – 20 minutes 3 – 4 times daily for several days to help reduce the pain. Wrap the ice in a towel or use an ice bag because putting ice directly on your skin can burn your skin or cause frostbite.
Resting the shoulder for some days before resuming your normal activities and avoiding any movement that may cause pain can help. Limit your overhead activities or work.
Other home treatments for shoulder pain include using over-the-counter nonsteroidal anti-inflammatory medication to reduce inflammation and pain and compressing the area using an elastic band to reduce swelling.
The following home care tips can help relieve shoulder pain.
You can perform simple shoulder exercises to strengthen and stretch your rotator cuff tendons and muscles. An occupational therapist or physical therapist can show you to do these exercises correctly.
If you have previous shoulder problems, use ice for 15 minutes after you exercise to prevent future injuries. After tendinitis or bursitis, perform simple range-of-motion exercises daily to prevent a frozen shoulder.
Pain in your shoulder and neck can also cause pain in your arms. In some cases, problems in the shoulder are due to neck problems. This may occur even if you don’t feel pain in your neck. People with this kind of problem usually describe the pain as needles and pins, burning, sharp or hot pain.
You can engage in an aerobic exercise program to aid better blood flow to your bursa and tendons. The improved blood flow will help reduce soreness. If you smoke, consider quitting to allow more oxygen to reach your injured tendon and aid in faster healing.
The exercises below can help improve shoulder pain. Ensure you ask your doctor if you can do other exercises.
The following are rotator cuff exercises
Stand up, lean over to face the floor, and let the sore arm dangle down. Try drawing small circles in the air using the sore arm. Ensure you start with smaller circles and gradually draw bigger circles. You can repeat these exercises 5 – 10 times a day. If you feel pain in the shoulder, stop and try again later.
A good shoulder posture can help prevent pain in your shoulder. Many people with shoulder pain usually hunch their shoulder forward or lift it. Work on making your posture better if you hunch or slump.
During the day, focus on bringing your shoulder blade or shoulder down and holding it in that position. You can also stand against a wall with the back of your heels, legs, shoulder and head touching the wall. Check if your shoulder blade does not touch the wall completely, and keep trying the position throughout the day.
As the pain subsides, consider including a general upper-body weight-lifting exercise in your program with free weights or weight machines. Lie on your side and place your left arm on your side. With the weight in your left hand and your forearm placed across your stomach, raise your forearm and keep your elbow close to your side.
If you feel a sudden pull or fall, do not wait a few days before visiting your doctor because you may have a torn tendon. Inform your doctor if the pain persists despite a good treatment program or if certain arm motions are weak. You have a torn rotator cuff which may need surgery.
You can ask the doctor the following questions during your appointment.
Shoulder pain is quite common and has several causes. While home remedies are available to reduce shoulder pain, you may have to visit your doctor for testing to determine its cause and get a suitable treatment program to reduce the pain and prevents its recurrence.