Pain in the shoulder can result from several different reasons and can be triggered by trauma or a chronic underlining condition. The shoulder is a highly versatile ball-and-socket joint and its great ability of movement is also its greatest weakness. This makes it, in fact prone to instability that can lead to pain and dysfunction. To make it even more complicate there is a second small joint, the acomio-clavicular joint (ACJ) that can be affected and cause pain.
The shoulder is often injured during sport but also during manual labour, especially if this involves repetitive movements. Shoulder pain may affect young people as well as the elderly.
Causes of pain within the shoulder
What causes shoulder pain?
Pain in the shoulder can be caused by many conditions within and outside the shoulder itself. In fact shoulder pain can be the result of injury to another location in the body, usually the neck or bicep. This type of pain is called referred pain.
Osteoarthritis is the most common joint disorder in the world and affects something like 9-10 million British. In western countries it is one of the most frequent causes of pain, disability and loss of function in adults. Osteoarthritis is mainly characterized by cartilage breakdown within the joint. As cartilage wears and tear, bones begin to rub against one another and cause pain. Osteoarthritis can also occur due to trauma. This condition, when at a late stage, is treated with a shoulder replacement.
Rheumatoid arthritis is a chronic condition that affects multiple joints. Joint disruption is one of the main features of this condition. When at a late stage, this condition, is treated with a shoulder replacement.
Other less common forms of arthritis
Septic arthritis is a severe infection affecting a joint and a medical emergency.
Bursitis is an inflammation of the bursa on the top of the shoulder that can lead to severe pain. This can often need an injection to have a good and permanent relief.
Tendonitis is an inflammation of the one or more tendons, which causes severe pain and often needs an injection or even a surgical procedure. In fact the most prevalent cause of shoulder pain is rotator cuff tendinitis that is a condition where the tendons are inflamed. The inflammation can also lead to calcifications in the tendons. They sometimes need a surgical procedure to remove the calcification if the pain is severe and persistent.
Torn rotator cuff
The rotator cuff is a structure which surrounds the shoulder and which is made by the tendons that operates the shoulder and stabilize it. If torn can cause pain and loss of function. The tear can be often fixed with surgery leading to a better function and relief from pain.
Impingement syndrome is a condition that occurs when the tendons of the rotator cuff impinge on the bonny structures of the top of the shoulder causing pain, inflammation, and eventually rupture of the rotator cuff which leads to weakness and loss of function. Impingement syndrome is often treated with injections or even surgery with the aim to reduces the pain and avoid further damage to the rotator cuff.
Pain in the shoulder can be caused by pinched nerves at the neck or around the shoulder itself.
Fractures are a direct cause of trauma but can also occur in absence of trauma if there is an underlining pathology that makes you prone to have this.
Frozen shoulder is also known as capsulitis and is a condition in which tendons, ligaments, and muscles stiffen up and become painful and difficult or sometimes impossible to move
Causes of pain outside the shoulder
A shoulder dislocation occurs when the head of the humerus (ball) is pulled out of the Glenaoid (shoulder socket). This can be recurrent and lead to pain and severe malfunction of the shoulder.
A trapped nerve can cause pain in the shoulder. Trapped nerve can be in the neck and around the shoulder.
A hearth attack can cause pain in the shoulder. This kind of pain is often accompanied with shortness of breath and other typical symptoms. A hearth attack needs urgent medical care.