Shoulder Pain Causes

By Matthew Nugent, MD

Q. I have an ache in my shoulder that’s getting worse over time. Why does it hurt, and when should I see a medical professional?
A. You’re not alone. An estimated seven out of ten people will experience some sort of shoulder pain in their lifetime. Let’s examine the common causes of shoulder pain, and what to do about them.

Arthritis is a condition in which the body’s cartilage breaks down. In some cases arthritis is genetic, but for most people it’s caused by wear and tear. Think of your cartilage like the tread on a tire; when the tread is worn out, the tire (i.e., your joints) can’t handle friction as well. Anybody can develop arthritis, but it’s especially typical in older patients.

Bursitis and bicep tendonitis are both inflammation injuries. Bursitis is inflammation of the bursa, which is a sac of lubricating fluid that cushions the shoulder joints. Bicep tendonitis is inflammation of the tendon connecting the bicep muscle to the shoulder. Both conditions can be caused by over-use or lack of use. They’re often seen in middle-age and older patients.

Pain from instability develops when shoulders are dislocating or moving too much. This is usually found in younger patients, athletes, or people who’ve experienced a traumatic shoulder injury.

How can you find relief?

Start with home remedies, such as ice and over-the counter anti-inflammatory medications. If those don’t ease the pain, it’s time to see an orthopedic physician.

In my office, we conduct a thorough exam to diagnose the source of your pain. This includes an X-ray and possibly a cortisone injection, which not only gives you fast relief but also enables me to detect the cause of your shoulder trouble.

In most cases, conservative treatment does the trick. This may involve a series of physical therapy sessions, once or twice a week for six weeks. These will help heal and strengthen your shoulder so you can return to normal activities, pain-free.

For more serious injuries, however, we might need to continue with further testing, such as an MRI. This could lead to surgery to repair the source of your pain.

What can you do to prevent shoulder pain?

Of course the best way to treat shoulder pain is to avoid it in the first place! Whether you are active at work or in sports, or if you engage in very little physical activity at all, you can prevent shoulder injuries by maintaining motion in your shoulders. Choose some targeted exercises to strengthen your rotator cuff muscles and biceps, which will make your body less susceptible to shoulder injuries.