Shoulder Pain Symptoms and Causes

What is the shoulder?

The shoulder is a highly mobile joint that faces stress from everyday activities such as lifting and reaching, and from high-impact tasks like throwing or swimming

The shoulder is formed by these parts:

• Humerus:Upper arm bone
• Scapula: Shoulder blade
• Clavicle: Collarbone

Each bone end is covered with cartilage that cushions and protects the joint. The shoulder is a ball-and-socket joint held together by muscles, ligaments, and tendons.

Key muscle groups include the rotator cuff muscles, which stabilize and rotate the shoulder, and the deltoid muscle, which lifts the arm. Tendons are strong cords connecting muscles to bones. Ligaments are elastic tissues linking bones, providing stability while allowing a wide range of motion. Some ligaments limit excessive movement to protect the shoulder joint.

What are some common shoulder problems?

Many shoulder problems result from aging and ongoing wear on the shoulder joint, such as arthritis or from injuries due to sudden movements or overuse. Common issues include rotator cuff tears or strains, often caused by repetitive overhead motions or a fall, leading to pain, weakness, or limited motion.

• Rotator cuff tears: Trauma or overuse can tear the rotator cuff, a group of muscles and tendons stabilizing the shoulder. Symptoms include pain, especially at night, and difficulty lifting the arm. Treatment may involve rest, physical therapy, or surgery for severe tears.
• Impingement: Occurs when shoulder tendons or bursa are pinched during arm movements, causing pain and restricted motion. Physical therapy or injections often help, though surgery may be needed.
• Bursitis: Inflammation of the bursa, a fluid-filled sac cushioning the joint, can result from repetitive motions or direct trauma. Symptoms include swelling and pain.
• Tendonitis: Overuse from activities such as throwing, swimming, or painting can inflame shoulder tendons, causing pain during movement. Rest and therapy are common treatments.
• Arthritis: Osteoarthritis, common in middle-aged and older adults, wears down shoulder cartilage, causing stiffness and pain.
• Rheumatoid arthritis: Inflames the joint and damages cartilage. Occurs from repetitive stress, injury, or being overweight, often requiring therapy, medication, or surgery to restore function.

How are shoulder problems diagnosed?

Your health care provider will review your medical history and perform a physical exam to assess your shoulder’s condition. You may also need these tests for shoulder problems:

• X-ray: Uses invisible electromagnetic energy beams to create images of bones and surrounding tissues.
• MRI: Uses large magnets, radio frequencies, and a computer to produce detailed images of shoulder
• CT scan: Combines X-rays and computer technology for detailed images of bones, muscles, and joints, offering more precision than standard X-rays.
• Arthroscopy: A minimally invasive procedure using a small, lighted tube (arthroscope) inserted through a tiny incision to view the shoulder join on a screen, helping diagnose arthritis, rotator cuff tears, or cartilage damage.
• Radionuclide bone scan: Injects a very small amount of radioactive material into the bloodstream, detected by a scanner to assess blood flow and bone activity, identifying causes of pain or inflammation.

Treatment for shoulder problems

With a multidisciplinary approach to the evaluation and management of shoulder conditions, our experienced team of experts provides comprehensive evaluations to determine the extent of a condition as well as the optimal treatment program for each patient. For many, conservative treatment and rehabilitation options are highly successful. Among the nonsurgical procedures performed to relieve pain and improve function is the use of fluoroscopic-guided injections into painful or arthritic joints.

When surgery is recommended, patients benefit from our expertise and excellent outcomes with minimally invasive procedures, including arthroscopic surgery. By using these less-invasive techniques, patients recover faster with less pain and better mobility than with traditional open reconstructive surgery. More significantly, these advanced techniques enable physicians to treat many shoulder disorders that historically led to years of pain and dysfunction.

When necessary, traditional open-surgery procedures can optimize patient recovery and mobility. These procedures can be performed on an outpatient basis. WashU Medicine physicians are experts in both shoulder joint replacement, and in the reconstruction of complex fractures around the shoulder. Computer-assisted shoulder arthroplasty is performed for complex arthritic deformities.

In some cases, fractures can be repaired using less invasive percutaneous fixation techniques, eliminating the need for casting, though a splint is still required. WashU Medicine inpatient and outpatient rehabilitation focuses on rapidly restoring motion, strength, and function.

Next steps

If you or a loved one is interested in taking the first step to living a healthier, pain-free lifestyle, please call (314) 996-8970 or request an appointment online.