Are you struggling to dress for work every morning due to shoulder pain? This blog educates you about causes, diagnosis, treatments, and preventive measures of shoulder pain. Read till the end to get every detail.
Why Does My Shoulder Hurt?
Your shoulder can hurt due to a couple of reasons.
- As an athlete, your shoulder can hurt when you perform the same exercises or stretch daily.
- Your shoulder can hurt when you engage in gardening activities like digging, where you move your shoulders repeatedly.
- Your shoulder can hurt due to underlying issues such as arthritis.
Seek medical advice immediately if you notice persistent shoulder pain.
What Causes Shoulder Pain?
Degenerative Causes(Arthritis)
Shoulder arthritis is the swelling in your shoulder joint that causes pain when lifting items with your arms.
Shoulder arthritis may occur either at the glenohumeral joint or the acromioclavicular joint. With time, arthritis causes the loss of cartilage, a tissue that prevents shoulder bones from grinding against each other.
2 types of degenerative arthritis cause shoulder pain: Osteoarthritis and Rheumatoid arthritis.
Osteoarthritis occurs when the cartilage wears down, causing the bones to rub against each other when you move your joints. You will know you have osteoarthritis if you feel pain in the joint, have a joint deformity, a swollen joint, or stiffness.
Rheumatoid arthritis is an autoimmune disease where your immune system attacks the healthy tissues. This attack causes pain, inflammation, and stiffness in the lining of your joints. You will know you have rheumatoid arthritis if you feel pain in your joints, fatigue, fever, weakness, or swelling of the joints.
Injuries
Overuse injury or repetitive use injury happens when you move in the same direction repeatedly. You can experience repetitive movements while gardening, swimming, playing tennis, painting, or cleaning.
A cartilage tear is when the rubber pad that surrounds your joints is torn. This causes pain when you stretch your arm to pick something up. Rotator cuff tear happens due to overuse or age. As you approach 60, your rotator cuff tends to tear. You know you have a rotator cuff tear when you feel pain while lifting your arm overhead and hear a crackling sound when you move your arm.
Inflammation
Tendonitis occurs when the muscles in the shoulders swell to the point that the rotator cuff cannot comfortably fit between the bones. This condition, also known as shoulder impingement, causes the shoulder bones to grind against each other or pinch the rotator cuff.
Also Read: Patellar Tendinitis: Causes, Symptoms, Treatment, & More
You know you have rotator cuff tendinitis if the pain extends to the other side of the arm or when you struggle to sleep or lift your arm.
Shoulder bursitis is the swelling of the bursa or bursae due to overuse, injury, or infection. Bursa is a fluid-filled sac that cushions the spaces between your bones and the connective tissues. You know you have bursitis if your shoulder feels tender with a light touch, swollen, and warm to the touch.
Referred Pain
Referred shoulder pain is where pain originates from other parts of the body, such as the heart and gallbladder.
A heart attack can cause shoulder pain which is one of the more common reason for referred shoulder pain.
Removal of the gall bladder can cause shoulder pain. Belly surgery or laparoscopic surgery makes your body hang on the carbon dioxide in your stomach area. This irritates your nerves and spine, therefore causing shoulder pain.
If you have a pinched nerve or nerve compression, you may have shoulder pain. A pinched nerve sends pain signals to your body, and this may trigger shoulder pain.
Lung problems, such as pneumonia or lung cancer, can cause shoulder pain.
How Is the Cause of Shoulder Pain Diagnosed?
Diagnosis helps in finding out the root cause of your shoulder pain. Below are some tests your doctor may use to diagnose shoulder pain.
Physical Examination
Physical examination involves assessing your range of motion, joint stability, and the physical structure of your shoulders.
To test your range of motion, your doctor may ask you to move your arms in various directions, such as above and below your head or across your body. Rotating your hands either 90 or 180 degrees tests for joint stability.
To test for structural problems, your doctor may identify if you have a swollen or tender shoulder. Warmth also shows underlying shoulder problems.
Imaging Tests
X-ray, CT scan, and MRI are imaging tests. During X-rays, the doctor looks for bone issues causing shoulder pain, such as bone spurs or arthritis.
An MRI scan is used for complex shoulder issues. A physiotherapist uses radio waves that build images, showing what is happening in your bones, tendons, muscles, and soft tissues..
A CT scan is a combination of multiple X-rays to find the root cause of your shoulder pain. The X-rays are done at different angles and then combined as one image.
Blood tests are not common for diagnosing shoulder pain, however, it is used to identify arthritis or infections in your shoulder.
Electromyography (Nerve Damage)
Electromyography identifies nerve problems. This is how Electromyography is done:
- A small needle is inserted through your skin into the muscle.
- The electrode picks up radioactivity and displays it on the oscilloscope.
- The doctor may use an audio amplifier to listen to the activities.
- You may be told to change activities, such as resting, engage in forceful contraction of the shoulder, or even a slight contraction. This helps measure the electrical activity of your muscles.
When Should I Seek Medical Help? (Red Flags)
Mild shoulder pains can be treated at home; however, when you notice severe symptoms, consult a doctor. Seek medical help if you notice:
- Sudden swelling of the shoulder
- A deformed shoulder joint
- Uncontrollable pain
- Inability to move your arm or shoulder
Also Read: How to Choose the Right Physiotherapist for Your Needs
What are the Treatment Options for Shoulder Pain?
After diagnosis, your physical therapist determines the treatment for your shoulder pain. Your doctor may recommend any of the following treatment options:
Homecare
At home, you can treat shoulder pain through the RICE method.
- Rest. Rest from physical activities that keep your arm in motion, for example, swimming, playing tennis, and other similar activities.
- Ice. Apply an ice pack to your inflamed shoulder for 15 minutes or every 4 hours. If you do not have an ice pack, wrap ice in a towel and place it on the area of treatment. Applying ice directly can cause skin burn.
- Compress: Compressing is gently putting pressure on the area of treatment with an elastic bandage to reduce inflammation.
- Elevating the level or supporting your shoulder improves blood circulation and promotes a fast recovery.
Medications
Non-steroidal anti-inflammatory treatments relieve pain and inflammation. Aspirin and Ibuprofen are NSAIDs used to reduce swelling and pain.
Your healthcare provider may recommend corticosteroids to reduce inflammation. Corticosteroids can be taken orally or by injection, where the treatment is injected in your shoulder.
Therapy
Physical therapy exercises by a chiropractor align and improve flexibility.
If you have a dislocated shoulder, your doctor may suggest a closed reduction procedure. In close reduction, your doctor gives you sedation since it’s a painful procedure. This treatment cannot be done by one doctor, so your doctor may call another doctor to place your shoulder and arm back into position.
A physiotherapist can suggest the best exercises to reduce shoulder pain at home. The exercises are mainly for strengthening and improving the range of motion.
Surgery
Surgery is recommended if your shoulder pain lasts for more than 4 weeks. Reverse shoulder replacement is done if you have severe arthritis or an irreparable rotator cuff.
Arthroscopy is performed on a damaged rotator cuff. A subacromial balloon spacer is placed in the space area of the damaged rotator cuff, then it is inflated with saline to cushion and stabilize the joint.
How Can I Prevent Shoulder Pain?
You can prevent shoulder pain by practicing the following habits.
- Use the correct form and techniques during exercises.
- Maintaining good posture while standing or sitting.
- Take a rest from activities that cause shoulder pain to help your muscles recover.
- Take care of how you carry out your body, at work or at home. This may include how you lean or bend.
- Avoid carrying heavy objects to minimize discomfort.
Practice good posture to avoid shoulder pain. Below are ways to practice good posture:
- While driving, sit with your spine straight and support your lower back with a small pillow.
- While working on a computer, support your lower back with a pillow, sit upright, and ensure that your hips, head, and spine are in alignment.
- Stand tall, pull in your belly, push your shoulders back, hold your head high, tuck in your chin, and ensure your spine is upright.
- While using your phone, hold it at eye level to view your screen.
Focus on strengthening your muscles and increasing mobility. Strengthening exercises are also recommended during resting periods to enhance recovery. Examples of strengthening exercises include:
- Shoulder stretch
- Cross-body stretch
- Arm circles
- Chest stretch
Another way to prevent shoulder pain is to warm up before sports. Warm-ups activate your shoulder muscles, enhance blood circulation, and improve flexibility. Tight shoulders may cause shoulder pain while playing; warm up to enhance flexibility.
Ergonomic workstation setup helps prevent shoulder pain. How you sit on a chair in the office determines whether you are stressing or relaxing your shoulders. This is how you should set up your office chair to prevent shoulder pain:
- Choose the right chair for your spine.
- Adjust your chair to rest your feet on the floor. If you have footrests, use them to ensure your thighs are parallel to the floor.
- Rest your arms on the armrests with your elbows close to your body.
If you are using a keyboard, always ensure your keyboard is in front while your wrists and forearms are in line with your shoulders.
Can Stress Cause Shoulder Pain?
Yes, anxiety and stress can cause chronic pain in your shoulders. When you are stressed or anxious, your body responds by contracting your muscles. If the stressful situation lasts for a long time, it causes continuous muscle tightness that may lead to serious shoulder pain.
To avoid stress:
- Exercise to stay active
- Practice breathing exercises
- Practice mindfulness
- Get enough sleep
Is Shoulder Pain a Sign of Cancer?
Shoulder pain can be a sign of lung cancer or an underlying health condition such as arthritis. Lung tumors may cause pressure on a nerve connected to your shoulder, or lung cancer may spread to your bones, including the shoulders. Shoulder pain can be a sign of lung cancer.
Cancer-related shoulder pain can be accompanied by numbness in the fingers, pain in the arms, and hands.
Common symptoms of lung cancer include:
- Coughing blood
- Breathing difficulties
- Wheezing
- Fatigue
- Chest pain
- Recurring respiratory infections such as bronchitis and pneumonia
Below are the types of lung cancer with shoulder pain symptoms:
- Mesothelioma
- Pancoast lung cancer tumors
- Metastatic lung cancer
How Do I Sleep With Shoulder Pain?
Bad sleeping positions can add stress and strain on your shoulders, leading to pain. The best sleeping positions for shoulder pain are the ones that do not put too much pressure on your shoulder. You can try the following sleeping positions.
- Rest your arm on a low-lying pillow or folded cloth to support your shoulder.
- Lie on your side with the hurt arm facing upwards to avoid stress on your joints.
