5 Common Causes of Shoulder Pain

Shoulder pain is a common complaint that can significantly impact daily activities and quality of life. However, determining the underlying cause of shoulder pain can be challenging, as there are several potential sources. In this comprehensive guide, we'll explore the top causes of shoulder pain and provide guidance on how to differentiate between them, empowering you to seek the appropriate treatment and find relief.

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Rotator Cuff Injuries
The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint and facilitate movement. Injuries to the rotator cuff, such as tears or strains, are common causes of shoulder pain, especially in individuals who engage in repetitive overhead motions or activities.

Differentiating Factors:

• Pain that worsens with overhead movements or reaching behind the back.
• Weakness or loss of strength in the shoulder.
• Difficulty lifting or carrying objects

Calcific Tendinopathy of the Rotator Cuff Tendon can cause significant shoulder pain. This condition is treated using needle-based techniques to break up the calcification. 

Images courtesy of Maulik S Patel, Radiopaedia.org

Shoulder Impingement Syndrome
Shoulder impingement occurs when the rotator cuff tendons become irritated or inflamed as they pass through the narrow space between the acromion (a bony projection on the shoulder blade) and the humerus (upper arm bone). This is commonly a precursor to rotator cuff tears.

Differentiating Factors:

• Pain that worsens when raising the arm or reaching overhead.
• Pain that radiates from the front of the shoulder to the side of the arm.
• Weakness or loss of range of motion, especially when lifting objects.

Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder is characterized by stiffness, pain, and limited range of motion in the shoulder joint. It typically develops gradually and progresses through three stages: freezing, frozen, and thawing.

Differentiating Factors:

• Gradual onset of pain and stiffness in the shoulder.
• Difficulty moving the shoulder, especially when reaching behind the back or overhead.
• Pain that worsens at night or during periods of inactivity.

Shoulder Arthritis
Shoulder arthritis is a degenerative condition that occurs when the cartilage lining the shoulder joint wears away, leading to pain, inflammation, and stiffness.

Differentiating Factors:

• Chronic, aching pain in the shoulder joint.
• Stiffness and limited range of motion, particularly in the morning or after periods of inactivity.
• Grating or grinding sensation (crepitus) with movement.

Shoulder Instability
Shoulder instability occurs when the structures that support the shoulder joint, such as ligaments or the labrum, become damaged or stretched, leading to excessive movement or dislocation of the joint.

Differentiating Factors:

• Feeling of instability or "looseness" in the shoulder.
• Recurrent episodes of shoulder dislocation or subluxation (partial dislocation).
• Pain or discomfort during certain activities or movements, such as throwing or reaching.
  
  

Understanding the diverse causes of shoulder pain and their distinctive features is crucial for accurate diagnosis and tailored treatment. If you're grappling with persistent shoulder pain or uncertainty about your shoulder health, consulting a pain specialist is advisable for a comprehensive evaluation and personalized management plan. Remember, your shoulder's well-being is paramount for maintaining an active and fulfilling lifestyle.

Other sites that may be helpful 
1. NHS - Shoulder Pain for Patients 
2. NHS - Shoulder Pain Self-Management
3. Rotator Cuff Tendinoapthy Information
4. Frozen Shoulder Information

​Dr. Christopher Liu is a Singapore-based Pain Specialist with a particular interest in treating musculoskeletal pain. He established an Ultrasound Injection Clinic during his tenure in the public sector, offering minimally invasive treatments for shoulder pain. Dr. Liu conducts regular workshops for doctors on non-surgical techniques for treating shoulder pain and frozen shoulder.