When to seek care for shoulder pain

Overview

Shoulder pain is pain or discomfort in or around the shoulder joint. It can come from the muscles, tendons, ligaments, or bones that make up the shoulder.

Yes, shoulder pain is very common. About two out of three people will have shoulder pain at some point in their lives.

It can affect people of all ages, but it is more common in adults over 50 and in people who do repetitive overhead work or sports.

Symptoms

Common symptoms

• Pain in the shoulder joint that may spread down the arm
• Stiffness or difficulty moving the shoulder
• Weakness in the arm or hand
• Aching or sharp pain when lifting or reaching
• Swelling or tenderness around the shoulder

Symptoms in children

• Pain after a sports injury or fall
• Refusing to move the arm or shoulder
• Swelling or bruising around the shoulder

Symptoms in older adults

• Gradual onset of stiffness and pain, often worse at night
• Difficulty reaching behind the back or overhead
• Pain that may come with normal activities like dressing

Causes

Main causes

• Muscle strain or overuse from repetitive activities or heavy lifting
• Inflammation of the tendons (tendinitis) or bursa (bursitis)
• Torn rotator cuff – the group of muscles and tendons that hold the shoulder in place
• Frozen shoulder (adhesive capsulitis) – stiffness that builds over time
• Arthritis of the shoulder joint
• Direct injury like a fall or collision

Risk factors

• Age over 40
• Doing sports that involve overhead movements, like swimming or tennis
• Jobs that require repeated lifting or reaching overhead
• Previous shoulder injury
• Diabetes or thyroid conditions, which can raise the risk of frozen shoulder

When to see a doctor

See a doctor urgently if:

• If you have a sudden injury and cannot move your arm at all
• If your shoulder looks deformed or out of place
• If you have severe pain that does not improve with rest
• If you have a fever or signs of infection like redness and warmth

Book a routine appointment if:

• If shoulder pain lasts more than two weeks despite rest and gentle activity
• If pain interferes with your sleep or daily activities
• If you have had a previous shoulder problem that is getting worse
• If you notice weakness or numbness in your arm or hand

Diagnosis

A doctor will ask about your symptoms and how the pain started, then examine your shoulder. They will check for tenderness, swelling, and how well you can move the joint.

Tests that may be done

• Physical examination of the shoulder and arm
• Imaging tests like X-rays (to see bones) or ultrasound/MRI (to see soft tissues) – only if needed
• Sometimes a local anaesthetic injection to help pinpoint the source of pain

What to expect at your appointment

You will be asked about your medical history, any recent injuries, and what makes the pain better or worse. The doctor may ask you to perform simple movements. Most people do not need special tests – the diagnosis is often clear from the examination.

Treatment

Treatment depends on the cause and severity of your shoulder pain. Most cases improve with simple measures. More serious problems may require physical therapy or other medical treatments.

Self-care at home

• Rest the shoulder for a day or two, but try to move it gently to prevent stiffness
• Apply ice packs for 15 minutes several times a day during the first 48 hours
• After that, try gentle heat to relax muscles
• Over-the-counter pain relief (like paracetamol or ibuprofen) can help – always follow the package instructions

Medical treatments

If self-care is not enough, a doctor may suggest physical therapy to strengthen and stretch the shoulder. They may also discuss anti-inflammatory medicines, steroid injections into the joint, or other treatments tailored to your condition. Always follow your doctor’s advice on any treatment.

When is surgery considered?

Surgery is rarely needed for shoulder pain. It may be considered if there is a large rotator cuff tear, a dislocated shoulder that keeps happening, or if other treatments haven’t helped after several months.

Living with this condition

Living with shoulder pain can be frustrating, but most people can manage it with simple changes. Avoid activities that trigger pain, but keep the shoulder moving gently to stay flexible.

Lifestyle tips

• Use proper posture when sitting and standing
• Take breaks if you do repetitive overhead work
• Sleep with a pillow supporting your arm if lying on your side
• Avoid carrying heavy bags on the painful side

Diet and exercise

A balanced diet helps keep your muscles and joints healthy. Gentle exercises like shoulder rolls, pendulum swings, and stretches recommended by a physical therapist can improve strength and range of motion. Stop any exercise that makes pain worse.

Mental health and emotional wellbeing

Chronic shoulder pain can affect your mood and sleep, and may cause frustration or anxiety. It is normal to feel this way. Talk to your doctor if pain is affecting your mental well-being.

Prevention

You can reduce your risk of shoulder pain by staying active, warming up before exercise, and using proper technique when lifting or playing sports. Listen to your body and avoid pushing through sharp pain.

Complications

If left untreated

• Chronic pain that lasts for months or years
• Loss of motion in the shoulder (frozen shoulder)
• Muscle weakness that may become permanent if a tear is not repaired
• Difficulty doing everyday tasks like dressing, bathing, or driving

Long-term outlook

The outlook for shoulder pain is generally good. Most people get better with simple care. Even if the problem is more serious, treatments like physical therapy or injections work well for many. Surgery may be an option if needed. With the right care, most people can return to their normal activities.

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