The shoulder joint has the greatest range of motion, but is frequently affected by either acute traumatic injuries or chronic overuse injuries. Shoulder pain affects 18-26% of adults at any point in time and can significantly limit occupational, recreational, and athletic activities.1
The 6 leading causes of shoulder pain include:
- The Rotator Cuff:
Almost 2 million Americans suffer from rotator cuff problems every year.2 The rotator cuff consists of a group of tendons and muscles that surround and stabilize the shoulder joint. This allows for a wide range of movement across multiple planes. Irritation, inflammation, or injury to the tendons or tissues can result in rotator cuff pain.
- Shoulder Impingement:
Shoulder Impingement is caused by excessive rubbing of the shoulder muscles against the top part of the shoulder blade. Shoulder impingement is usually seen in young and middle-aged patients, who engage sports that require repeated overhead arm movement. In some circumstances, a partial tear of the rotator cuff may cause impingement pain. Medical care should be sought immediately for inflammation in the shoulder because it could eventually lead to a more serious injury.
Shoulder fractures can involve the upper arm bone called the humerus, the shoulder blade known as the scapula, and collarbone called the clavicle. A shoulder fracture in older patients is usually the result of a fall. In younger patients, shoulder fractures occur from a sports injury or vehicular accident. Fractures cause severe pain, bruising, and swelling.
- SLAP Tears and Biceps Pathology:
SLAP (Superior Labrum from Anterior to Posterior)tears or called labrum tears, account for 4-8% of all shoulder injuries.3 SLAP tears are commonly seen as a sports injury but can also occur with age. Symptoms of a SLAP tear include a persistent dull ache or a sharp pain deep in your shoulder. Left untreated, SLAP tear symptoms may get worse, causing chronic shoulder pain and decreasing your ability to use your arm and shoulder. A Biceps tear or tendonitis can also happen at the shoulder causing pain. Tendonitis is caused from inflammation around the long head of the biceps muscle due to wear and tear and is normally associated with other shoulder injuries. A tear is usually indicated by sudden, severe pain in the upper part of your arm.
- Shoulder Instability or Dislocation:
Shoulder instability typically happens as a result of a sudden injury like a fall or accident. It occurs when the head of the upper arm bone is forced out of the shoulder socket. Once a shoulder has dislocated, it is vulnerable to repeat episodes. When the shoulder is loose and slips out of place repeatedly, it is called chronic shoulder instability.
Osteoarthritis (OA) wears away the smooth cartilage in the joint over time causing your bones to rub against each other. Rheumatoid arthritis (RA) is an autoimmune disorder and impacts the synovium that lubricates the joint so it can move easier. The proportion of cartilage damage and synovial inflammation varies with the type and stage of arthritis. Usually the pain early on is due to inflammation. In the later stages, when the cartilage is worn away, most of the pain comes from the mechanical friction of raw bones rubbing on each other.
Shoulder pain is a common condition among people of all ages. The underlying reason for shoulder pain can vary significantly from rotator cuff issues to fractures to arthritis. It is imperative to have your shoulder pain evaluated rather than pushing through the pain. When treated early, most shoulder pain can be resolved with conservative methods, but waiting to seek treatment can lead to further injury.
If you are suffering from shoulder pain, make an appointment today to have your shoulder evaluated to get you on the road to healing.
Anup Shah, MD, MBA, is a board-certified, fellowship-trained Sports Medicine Orthopedic surgeon specializing in Knee and Shoulder Surgery in Phoenix, Arizona at Banner Health. Dr. Shah uses a patient-centric and an evidence-based approach to help his patients achieve their desired goals.