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The shoulder is one of the most mobile joints in the human body with ability to flex, extend, and rotate. However, mobility has its price making the joint very susceptible to wear and tear and injury, It may lead to increasing problems with instability or impingement of soft tissue resulting in pain. You may feel pain only when the shoulder is moved, or pain may be present all of the time. This article explains some of the common causes of, and treatments for, shoulder pain, and how you can prevent it. For this article I have interviewed Dr. Lance Estrada an orthopedic surgeon who specializes in shoulder injuries.

The most common causes of shoulder pain include bursitis/tendonitis, biceps tendonitis, arthritis, and rotator cuff tears

Most shoulder problems involve the soft tissues, muscles, ligaments, and tendons, rather than bones. And most of these problems fall into three major categories: tendonitis/bursitis, injury/instability, arthritis, and rotator cuff tears.


A tendon is a cord which connects muscle to bone or other tissue. Most tendonitis is a result of the wearing process that takes place over a period of years, much like the wearing process on the sole of a shoe which eventually splits from overuse. Generally, tendonitis is one of several types: acute tendonitis following some overuse problem such as excessive ball throwing and other sports- or work-related activities, chronic tendonitis resulting from degenerative disease or repetitive wear and tear due to age, and the splitting and tearing of tendons which may result from acute injury or degenerative changes in the tendons due to advancing age. Rotator cuff injuries are among the most common of these disorders. The rotator cuff is the arrangement of muscles and their tendons which provides shoulder motion and stability.


Sometimes, excessive use of the shoulder leads to inflammation and swelling of a bursa or sacs which are fluid-filled sacs located around the joints which lessen the friction caused by movement of the shoulder. Bursitis often occurs in association with rotator cuff tendonitis. Sometimes the many tissues in the shoulder become inflamed and painful, limiting the use of the shoulder. Classically bursitis is characterized by pain with overhead activity and pain at night. The pain may start without any trauma or increased activity. If bursitis is left untreated, many progress to rotator cuff tears.


Sometimes the bones in one of the shoulder joints move (or, in an injury, are forced) out of their normal position. This condition, instability, can result in dislocation of one of the joints in the shoulder. Recurring dislocations, which may be partial or complete, cause pain and unsteadiness when you raise your arm or move it away from your body.


Shoulder pain can also result from arthritis. There are many types of arthritis, but generally it involves wear and tear changes with inflammation of the joint, causing swelling, pain and stiffness. Arthritis may be related to sports or work injuries.

Many patients ignore temporary minimal shoulder symptoms with few bad effects. If the pain is less not severe, it may be safe to wait a few days to see if time will alleviate the problem. If symptoms persist, you should see a physician to obtain a diagnosis and treatment.

Rotator Cuff Tear

If the rotator cuff is involved, the pain is usually in the front or outside of the shoulder. This pain is usually worse when you raise your arm or lift something above your head. The pain can be bad enough to keep you from doing even the simplest tasks. Pain at night is common, and it may be bad enough to wake you.


Determining the source of the problem in the shoulder is essential to recommending the right method of treatment. Therefore, a comprehensive examination will be required to find the causes of your shoulder pain.

X-ray studies may be required to look closely at the bones and joints in your shoulder. Other diagnostic techniques that may be used include CT scan (computed tomography), which provides a more detailed view of the shoulder area; MRI (magnetic resonance imaging) and ultrasound are other valuable diagnostic tools, because they provide images of the soft tissues without using radiation. Arthroscopy is a surgical procedure which looks inside the joint with a lighted telescope. It is sometimes used to diagnose causes of shoulder pain.

Treatment generally involves altering activities, rest and physical therapy to help you improve shoulder strength and flexibility. Anti-inflammatory medication may be prescribed to reduce inflammation and reduce pain. Injections of drugs such as steroids may also be used to treat pain.

Surgery may be required to resolve shoulder problems; however, 90 percent of patients with shoulder pain will respond to simple treatment methods such as altering activities, rest, exercise and medication. Certain types of shoulder problems, such as recurring dislocation and some rotator cuff tears may require surgery. Surgery is usually now done as an outpatient. Most surgery can be accomplished arthroscopically with very small incisions which decreases the post-operative pain and discomfort.


Common sense solutions such as avoiding overexertion or overdoing activities in which you normally don't participate can help to prevent shoulder pain. If you have had shoulder pain in the past, use ice and ibuprofen after exercising. Learn proper exercises to stretch and strengthen your rotator cuff tendons and shoulder muscles. A doctor or physical therapist can help. In sports-related activities, learn proper technique to prevent painful and expensive shoulder problems.