Roughly half of all adults will experience shoulder pain at some point in their lives.1 The shoulder’s exceptional mobility and high usage makes it particularly vulnerable to injury. Do not let the common nature of these problems fool you. Shoulder problems can be serious. They often result in surgery or life-long loss of function. Knowing the source of your shoulder pain and addressing it early can prevent worsening and help avoid surgery.
Most Common Causes of Shoulder Pain
- Adhesive Capsulitis: Frozen shoulder. When the connective tissue encapsulating the shoulder thickens and tightens too much.
- Shoulder Impingement: Swimmer’s shoulder. Commonly described as misalignment causing a tendon to rub on bone, but more cases are likely just inadequate healing responses to repeated stress on tendons.
- Osteoarthritis: When the protective cartilage on bones in joints wears down.
- Rotator Cuff Injury: A tearing or fibrosis of the muscles and tendons that encapsulate the shoulder joint. It’s often a dull ache that prevents sleeping on the involved side. It’s more prevalent among people who perform overhead motions in their jobs (painters, drywall installers), baseball players, and tennis players.
- Other Sprains: A stretching or tearing of ligaments
- Other Tendinosis: A failed healing response where the body is not healing a tendon as quickly as it is being damaged by small, normal, but recurring activity.
- Bursitis: Inflammation of a fluid-filled sac responsible for joint lubrication.
- Cervical Radiculopathy: A malfunctioning nerve in the neck causing pain, numbness, and/or weakness radiating into the arm.
Shoulder pain is rarely an inflammation that simply needs to be treated with oral or injectable anti-inflammatories. In some cases, anti-inflammatories worsen long-term outcomes. The optimal strategy is to have a healthcare professional highly trained in joint function and pathology assess the condition. A physical therapy assessment can identify and help correct the biomechanical mechanisms contributing to shoulder pain.
When to Seek Immediate Medical Attention from 911 or the Emergency Department
- Shoulder pain accompanied by difficulty breathing or tightness in the chest suggests a heart attack.
- The joint appears deformed.
- Inability to move the arm
- Sudden swelling
- Intense pain
- Over-the-counter pain relievers used for short-term, non-recurring pain: Repeated use or a need to use more or longer than indicated on the packaging is a sign that a physical therapy appointment would be warranted.
- Rest: Avoid aggravating activities for a few days and give mild irritations a chance to heal. However, if there is an injury in an acute phase that will need physical therapy, getting that physical therapy during the acute phase improves outcomes. Often times, “waiting to see if you need physical therapy” causes people to need more physical therapy or end up settling for lesser outcomes. Try not to rely on pain not going away as a sign that physical therapy is needed.
- Ice: An icepack for 15 to 20 minutes a few times per day.
When to Seek a Physical Therapy Assessment
Here are signs that you have a condition that does not get better quickly or with potential for gradual worsening leading to possible surgery if not addressed. These are signs of different conditions, so they would not necessarily appear together.
- Loss of range of motion
- Muscle weakness or losing muscle
- Feeling like tendons are rubbing. They are probably not, but this sensation suggests a need for targeted interventions.
- Heat or swelling with the pain
- Pain or joint tightness that gets progressively worse over months or a year
- Consistent pain that increases with lifting or reaching and that interferes with rest, athletics, or work
- Pain around the outside or tip of the shoulder
Want to learn more about the benefits of physical therapy for shoulder pain? Contact Us Today at Step Ahead Physical Therapy for more information and be sure to schedule an initial consultation.
- Luime JJ, Koes BW, Hendriksen IJ, Burdorf A, Verhagen AP, Miedema HS, Verhaar JA. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scandinavian Journal of Rheumatology. 2004 Mar 1;33(2):73-81.