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What’s Causing My Shoulder Pain?

A healthy shoulder moves easily, allowing a full range of motion. When it hurts, it’s natural to wonder why. Here are a few reasons you may have shoulder pain, but remember… only a doctor can properly diagnose the cause of your pain.

When your shoulder is healthy and functioning properly, it has the largest range of motion of any joint in your body and moves without pain. When you experience pain or limited function, it’s natural to wonder why.

How the shoulder works

The shoulder is a ball-and-socket joint that’s composed of 3 bones: the ball (humerus), the socket (scapula), and the collarbone (clavicle). When you raise your arm, the ball glides and rotates within the socket. A complex interaction between muscles, tendons, ligaments, cartilage, as well as bones allows our shoulders to have tremendous motion as well as strength.

The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) that attach on the upper part of the humerus and help stabilize your shoulder as well as provide strength. There’s also an important muscle outside your rotator cuff called the deltoid that’s imperative for powering the shoulder joint. This is the muscle that you can feel underneath your skin on the outer part of your shoulder. 

In a healthy shoulder joint, the bone’s surface, where the ball and socket rub together, is covered with a smooth, tough protective tissue called cartilage. Arthritis causes damage to this area of the bone’s surface and cartilage. These damaged surfaces eventually become painful as they rub together.

As you might expect, there are a number of reasons why you might be feeling pain in your shoulder including arthritis, rotator cuff tear, dislocation, and more.

3 Common types of shoulder arthritis conditions

1. Osteoarthritis

A common cause of shoulder pain is osteoarthritis,1-2 a degenerative joint disease that causes the cartilage in your shoulder to break down. When that layer of cartilage—which is meant to cushion the joint and protect the surface of the bones—is damaged or worn away, your shoulder bones come in direct contact with each other, and that contact hurts. You can feel it when lifting groceries, reaching for something, or simply raising your arms to brush your teeth or hair. It may even keep you up at night.

Managing Arthritis: Frequently Asked Questions

It can be hard to know where to start when diagnosed with a disease like arthritis. Click here for a free copy of frequently asked questions about managing arthritis.

 

2. Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disorder in which the lining of the joint (synovium) becomes inflamed. This inflammation causes pain, swelling, and can eventually erode or deform the joint.

3. Rotator cuff arthropathy

This is a condition when someone has both arthritis in the shoulder and a large rotator cuff tear.

Injury

Rotator cuff disorders

Inflammation or tearing of the rotator cuff is a very common problem. There’s a wide spectrum of rotator cuff disease from inflammation to partial tears to full thickness tears. Inflammation and partial thickness rotator cuff tears can typically be treated with non-surgical options.  Surgery is traditionally indicated for full thickness tears that occur with a sudden injury. In addition, partial or full thickness tears that don’t respond to non-surgical measures may be candidates for repair. Among patients with a massive or non-repairable rotator cuff tear, shoulder replacement surgery may also be an option.

Dislocation: When the rounded head of the upper arm bone (humerus) comes out of the socket portion of the shoulder blade (scapula), it’s called a dislocation. This usually occurs as a result of a specific injury such as a fall.

Separation: A shoulder separation describes when the collar bone (clavicle) slips from the acromion (part of the scapula). This is usually due to a specific injury such as falling.

Fracture: The humeral bone and collar bone are some of the most frequently fractured bones in the body.3

Infection: Although less common, infection can occur in the shoulder.  This usually results in pain, swelling, and redness.

Understanding Shoulder Pain and Shoulder Replacement Surgery

Want to learn more about your options for shoulder pain? Click on this image for a free downloadable brochure.

While this is not an exhaustive list of all the possible reasons for shoulder joint pain, the good news is that most of these are treatable. Arthritis is a disease that typically worsens over the years, so it is common for treatment to involve more than one approach and to change over time. For some people, nonsurgical treatments such as lifestyle changes, medications, and physical therapy help alleviate the pain. For others, shoulder replacement surgery may be a long-term solution. Together, you and your doctor can determine the best treatment options for you.

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References
  1. Sources of Arthritis Pain (2019). Arthritis Foundation. https://www.arthritis.org/health-wellness/healthy-living/managing-pain/understanding-pain/sources-of-arthritis-pain
  2. Waiter, JM. (2013, Jan). Arthritis of the Shoulder. OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-shoulder
  3. Williamson, L. (2019, Aug 15). The most common broken bones in the body: the top 10. Enable Law. https://www.enablelaw.com/news/expert-opinion/most-common-broken-bones-top-10/