There are two joints in the shoulder:. Strong connective tissue forms the shoulder capsule. This keeps the head of the humerus in place in the joint socket. The joint capsule is lined with a synovial membrane. It produces synovial fluid which lubricates and nourishes the joint. There are many causes of shoulder pain and not all of these are due to problems of the shoulder joints or associated structures.
Cartilage is a smooth, cushiony tissue that covers the ends of bones where they meet in a joint. Healthy cartilage helps your joints move smoothly. Over time cartilage can become worn, or it may become damaged due to injury or an accident, leading to the development of osteoarthritis. The synovial membrane of the shoulder may become inflamed — this is called 'synovitis'. Synovitis may occur as a result of another condition for example, rheumatoid arthritis or it may happen as a result of an injury, or the cause may be unknown.
Frozen shoulder 'adhesive capsulitis' is a condition that occurs when the shoulder capsule thickens and becomes inflamed and tight. There may also be less synovial fluid to lubricate the joint. As a result, the shoulder becomes difficult to move. Frozen shoulder may occur as a result of another condition if the shoulder has been immobilised for example, due to surgery or injury.
Sometimes the cause of shoulder pain may not be known. A bursa is a small fluid-filled sac that reduces friction between two structures, such as bone, muscle and tendons. In the shoulder, the bursa that sits between the rotator cuff tendon and the bony tip of the shoulder acromion can become inflamed, most commonly with repetitive movements. Ligaments are soft tissues that connect bones to bones.
If ligaments are injured or sprained, it can cause short term pain. This may be the result of the humerus coming partially out of the joint socket subluxation or if the humerus comes completely out dislocation. The flexible tissue that helps keep the shoulder joint in place labrum can become torn. This is called a 'labral tear'.
This can occur as a result of an injury for example, falling onto your outstretched arm or repetitive actions for example, due to playing sports that involve throwing, such as cricket.
A direct blow to the shoulder can result in acromioclavicular joint 'AC joint' being sprained. This type of injury often occurs in people participating in contact sports such as football who take a blow to the shoulder. It can also occur as a result of a fall. The group of tendons and muscles that keeps the shoulder stable and positioned correctly for the shoulder and arm to move is called the rotator cuff. Tears to rotator cuff tendons may occur as a result of an injury for example, a fall or broken collarbone or happen over a period of time as we age.
Problems with the joints and associated nerves of the neck and upper back can also be a source of shoulder pain. The pain from the neck and upper back is often felt at the back of the shoulder joint and through to the outside of the upper arm.
This nerve can be injured as a result of a shoulder dislocation or fractured humerus, and cause weakness in moving the arm outwardly away from the body. Shoulder pain may also be caused by problems affecting the abdomen for example, gallstones , heart for example, angina or heart attack and lungs for example, pneumonia. People with shoulder pain can experience pain deep in the shoulder joint, in the back or the front of the shoulder and the upper part of the arm.
The location and type of pain is likely to relate to the structure causing the pain. In some conditions there may be reduced movement, and moving the shoulder may cause you to feel pain. Depending on the condition, there may be a sensation of the joint slipping out and back in to the joint socket, or the shoulder can become completely dislodged dislocated.
Some people may experience sensations of pins and needles tingling and burning pain. This is more likely to be associated with nerves from the neck than the shoulder joint itself. Lack of movement after a shoulder dislocation is usually due to pain.
Complete rotator cuff tears and injury to the axillary nerve both cause weakness in moving the arm away from the body. These problems require close clinical examination. Health practitioners who treat shoulder pain are trained to investigate and identify the exact cause of the condition or injury causing the pain. They will do this by:. From this information they can work out the likelihood of particular structures in the shoulder region being involved.
Sometimes they will suggest that investigations or tests may be needed. An experienced health practitioner can help you to understand the difference. X-rays provide images of the bones and joints. They can show any changes caused by arthritis in the shoulder joint for example, bone spurs or narrowed joint space or fractures. However x-rays do not show any changes or problems with the soft tissues such as muscles and tendons. Ultrasounds are typically used to investigate the rotator cuff tendon for inflammation, tears or rupture.
If an ultrasound is ordered, then an x-ray will also be arranged. Both tests together will provide more complete information about the state of the joints and the tendon. Other interventions include nonsteroidal anti-inflammatory drugs, corticosteroid injections, or, in some cases, surgery.
When people think of osteoarthritis , they may think of the knee and the hip, which are common sites for arthritis pain. But while osteoarthritis affects the shoulder less often, it's not uncommon, says Dr.
The condition develops when cartilage cushions between the bones in the shoulder erode, causing the bones to rub against one another. There are numerous treatments for osteoarthritis, including rest, modifications to activities, anti-inflammatory drugs, corticosteroid injections, and surgery in some cases, says Dr. While you may be tempted to stop moving when you experience pain from osteoarthritis, doing so can actually make the problem worse because it allows the muscles to stiffen and shorten.
This may ultimately make it even harder for you to move the way you want to. Performing simple stretches two to three days a week see "Simple shoulder stretch exercises" can help keep your muscles flexible and reduce pain, provided your doctor approves. Starting position: Sit up straight on a chair.
Put your left hand on your right shoulder. Cup your left elbow with your right hand. Movement: Roll your shoulders down and back, then gently pull your left elbow across your chest as you extend your left arm.
Feel the stretch in your left shoulder. Return to the starting position, then repeat on the opposite side. This is one rep. Starting position: Sit up straight. Place your right hand on your right shoulder. Clasp your right elbow with your left hand. Movement: Keeping your shoulders down and back, lift your right elbow up toward the ceiling to the point of tightness.
Feel the stretch in the back of your upper right arm and shoulder. Return to the starting position. Repeat on the other side. Movement: Roll your shoulders down and back. Clasp your hands behind you, intertwining your fingers so your palms face you. Gently lift your hands toward the ceiling to the point of tightness. Feel the stretch in the front of your shoulders and across your chest.
Slowly return to the starting position. As a service to our readers, Harvard Health Publishing provides access to our library of archived content.
Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Thanks for visiting. Don't miss your FREE gift. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health , plus the latest advances in preventative medicine, diet and exercise , pain relief, blood pressure and cholesterol management, and more.
Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss Stay on top of latest health news from Harvard Medical School. Repeat these exercises 5 to 10 times during the day.
If you have pain, stop. You can try again later. Having good shoulder posture can help prevent shoulder pain. Many people with shoulder pain often lift up or hunch their shoulder forward. Work on improving your posture if you find yourself slumping or hunching.
Throughout the day, focus on bringing your shoulder or shoulder blade down and holding there. Another exercise is to stand against the wall with the back of your head, shoulders, legs, and heels touching the wall. Keep trying that position throughout the day. As your pain goes away, try adding a general upper body weight-lifting program using weight machines or free weights. Lie on your right side with your left arm at your side. With a weight in your left hand and your forearm across your tummy, raise your forearm.
An aerobic exercise program will help improve the blood flow to the tendon or bursa. The blood flow will help reduce soreness.
Smokers should quit smoking so more oxygen reaches the injured tendon. This will help the injury heal faster. It often takes a shoulder a long time to heal. The earlier you address the pain, the better. Depending on your injury, you should be able to make a full recovery. However, many people complain that even with a full recovery, their shoulder is not as strong as before. Tell your doctor if your pain goes on in spite of a good treatment program.
Or when there is weakness in certain motions of the arm. You may have torn your rotator cuff. This type of injury may need surgery. Last Updated: August 31, This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject. Opioids are powerful medicines that treat pain.
However, they can be addictive. Your doctor may be able to help…. An ACL injury is the overstretching or tearing of the anterior cruciate ligament in your knee. It is a….
0コメント