Friday, July 29, 2022

What Causes Severe Shoulder Pain

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Symptoms Of Shoulder Pain

There are many causes of shoulder pain, and they all have their own unique set of symptoms.

Depending on the cause of your shoulder pain you may experience:

  • pain deep in the shoulder joint, in the back or the front of the shoulder and the upper part of the arm. Sometimes the pain in the shoulder can be described as a catching pain. The location and type of pain is likely to relate to the structure causing the pain
  • reduced movement, and pain when moving your shoulder.
  • weakness of the shoulder/upper arm. 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
  • sensations of pins and needles 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. This 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.

What Are The Symptoms Of Shoulder Bursitis

Shoulder pain from bursitis can come on suddenly or gradually. You may experience a dull ache, sharp pain or mild tenderness.

Other signs of shoulder bursitis include:

  • Shoulder stiffness or a feeling of swelling.
  • Painful range of motion.
  • Nighttime pain when lying on the affected side.
  • Sharp or pinching pain with overhead shoulder motions.

Anatomy Of The Shoulder

Your shoulder is a complex structure comprising of tendons, muscles, your shoulder blade , collarbone , and upper arm bone . Dr. Stephen Kishner, a specialist in physical medicine and rehabilitation, says that the shoulder joint has a wide range of motion. Because of the complexity and function of the shoulder joint, it is quite unstable and prone to injury.

Dr. Kishner explains that one common injury affecting the shoulder blade is to the rotator cuff a group of muscles and tendons that give strength to the shoulder. A torn or tendon inflammation can cause intense pain and can be a major reason for shoulder pain after sleeping.

What Did The Pain Mapping Study Involve

The new pain mapping study included a total of 21,500 people who had attended the severe pain management clinics at the University of Pittsburgh. A computer clustering analysis was carried out on patient body maps to determine patterns of pain distribution.

The results showed there were nine clear types of chronic pain a patient could experience. The researchers believe the identified patterns of pain distribution could help to predict pain impact, severity, physical function, and predicted outcomes.

So, what did it find in relation to those experiencing shoulder pain? Unfortunately, it wasnt great news

Most Shoulder Injuries Are Caused By Sports Weightlifting Strenuous Exercise Or Lifting Heavy Objects

Shoulder Pain: Causes, Treatment, and When to See a Doctor

But where do we draw the line between common shoulder injuries and what could be a more serious cause of pain in the shoulder? In this guide, well explore several different shoulder pain causes, starting with the most common, low-risk causes and working our up to serious conditions that require you to seek medical attention.

Whether youre dealing with shoulder pain for the first time or seeking shoulder pain relief for a chronic issue, this guide should help you determine the cause of your shoulder and arm pain and point you in the right direction as far as shoulder pain treatment and prevention. But first, lets look at the anatomy of the shoulder, which will help you pinpoint the exact cause of your pain as well as help you describe it to a physician.

What Causes Shoulder Pain

Several factors and conditions can contribute to shoulder pain. The most prevalent cause is rotator cuff tendinitis.

This is a condition characterized by swollen tendons. Another common cause of shoulder pain is impingement syndrome where the rotator cuff gets caught between the acromium and humeral head .

Sometimes shoulder pain is the result of injury to another location in your body, usually the neck or biceps. This is known as referred pain. Referred pain generally doesnt get worse when you move your shoulder.

Other causes of shoulder pain include:

What Are The Symptoms Of A Frozen Shoulder

You become aware of a frozen shoulder when it begins to hurt. The pain then causes you to limit your movement. Moving the shoulder less and less increases its stiffness. Before long, you find that you cant move your shoulder as you once did. Reaching for an item on a high shelf becomes difficult, if not impossible. When its severe, you might not be able to do everyday tasks that involve shoulder movement such as dressing.

Outside Of The Shoulder

Several issues can cause pain on the outside of the shoulder, and the most common cause is a rotator cuff tear.

Rotator Cuff Problem

There are four rotator cuff muscles that move your shoulder, including your deltoid muscle.

There are three main types of rotator cuff problems

  • Tendonitis: Inflammation of the tendons
  • Bursitis: Inflammation of the bursa
  • Rotator cuff tear: The tendons of the rotator cuff become damaged at their insertion to the bone.
  • Rotator cuff problems cause pain, especially with activities like reaching or throwing. The deep, aching shoulder pain tends to worsen or flare up at night, and it can wake you up from sleep or make it difficult to fall asleep.

    Rotator cuff problems can be associated with a limited active range of motion. Since it’s hard to voluntarily move your injured or inflamed muscle, your shoulder may feel stiff. But if someone does the work for you by lifting your arm , your shoulder will likely move normally.

    Frozen Shoulder

    Also called adhesive capsulitis, frozen shoulder is a common condition that leads to joint stiffness and pain, which can be constant. While many shoulder conditions, including rotator cuff tendinitis, can be associated with frozen shoulder, the cause is often unknown.

    With a frozen shoulder, there is a decrease of both active and passive range of motion.

    Calcific Tendonitis

    If You Have To Go To The Doctor

    If you talk with your doctor about right shoulder and arm pain, they may recommend the following, depending on the severity of your condition.

    • Immobilization: In some cases, limiting the movement of your shoulder or arm may help it heal. This is often achieved using a sling, brace, or cast. Your doctor will let you know when it can be removed.
    • Corticosteroid injections: This is a type of medication that your doctor can inject into the affected area to help reduce inflammation.
    • Prescription medications: Prescription pain medications may be given for severe pain. Oral corticosteroids can help ease inflammation. If you have RA, your doctor will likely prescribe a disease-modifying drug.
    • Physical therapy: Your doctor may give you a list of exercises to do that can help you regain strength, flexibility, and range of motion. In some cases, they may recommend that you work with a physical therapist.
    • Surgery: Surgery may be recommended when other treatments havent been effective or when damage is severe. The specific procedure thats used can depend on whats causing your condition.

    Pinched Nerve In The Neck

    A pinched nerve in the neck is also called cervical radiculopathy. It means that a nerve in the neck, at a point where it branches off from the spinal cord, is being compressed by the surrounding bones, muscles, or other tissues.

    It can be caused by a traumatic injury, such as from sports or an automobile accident, especially if the injury results in a herniated disk. It may also arise from the normal wear and tear of aging.

    Symptoms include sharp, burning pain with numbness and tingling from the neck to the shoulder, as well as weakness and numbness into the arm and hand.

    Diagnosis is made through patient history, physical examination, and simple neurological tests to check the reflexes. Imaging such as x-ray, CT scan, or MRI may be done, as well as electromyography to measure nerve impulses in the muscles.

    A pinched nerve in the neck often improves with simply a few days or weeks of rest. Physical therapy, nonsteroidal anti-inflammatory drugs, and steroid injections into the spine can all be very helpful.

    Rarity: Common

    Top Symptoms: pain in one shoulder, spontaneous shoulder pain, pain that radiates down arm, pain in the back of the neck, severe shoulder pain

    Urgency: Primary care doctor

    Causes Of Frozen Shoulder

    The condition generally affects adults ages 40 to 60 and can be caused by diseases such as diabetes, hypothyroidism, hyperthyroidism, Parkinsons, or cardiac disease. It can also result from immobilizing the shoulder too long after an injury, which is why a vital part of any recovery is physical therapy.

    How Airrosti Can Help: Shoulder Pain Diagnosis Treatment And Pain Relief

    Airrosti providers aim to diagnose and treat pain at the source with hands-on manual therapy, combined with targeted active rehab exercises to restore shoulder strength and function. We also give you the tools and resources to address pain as it appears, leaving you to focus on doing the things you love most.

    If youre experiencing shoulder pain, dont wait. We offer both in-office and telehealth appointments to best suit your needs. Call us at 404-6050 and schedule your appointment today.

    What Is Acupuncture How Does It Works

    Severe Shoulder Pain After Waking Up: Causes, Relief ...

    How National Health Service describes:

    Acupuncture involves stimulating sensory nerves under the skin and in the muscles of the body. This results in the body producing natural substances, such as pain-relieving endorphins. Its believed that these naturally released substances are responsible for the beneficial effects experienced with acupuncture. A course of acupuncture usually creates longer lasting pain relief than when a single treatment is used.


    Causes Of Shoulder Pain

    There are many causes of shoulder pain and not all of them are due to problems of the shoulder joints or associated structures.

    Osteoarthritis: cartilage is a smooth, cushiony tissue that covers the ends of your 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.

    Inflammation of the shoulder capsule

    • Synovitis is when your synovial membrane becomes inflamed. It can occur as a result of another condition or it may happen as a result of an injury. Or the cause may be unknown.
    • Frozen shoulder is a condition that occurs when your shoulder capsule thickens and becomes inflamed and tight. There may also be less synovial fluid to lubricate the joint. As a result your shoulder becomes difficult to move. Frozen shoulder may occur as a result of another condition , if the shoulder has been immobilised , or the cause may not be known.

    Inflamed bursa: pain associated with an inflamed bursa is also common in the shoulder. A bursa is a small fluid-filled sac that reduces friction between two structures, such as bone, muscle and tendons. In your shoulder the bursa that sits between the rotator cuff tendon and the bony tip of the shoulder can become inflamed, most commonly with repetitive movements.

    Injuries and sprains

    Referred pain: shoulder pain may also be caused by problems affecting your abdomen , heart and lungs .

    Signs And Symptoms Of Shoulder Pain

    There may be many causes of shoulder pain. They all have their own unique set of symptoms. 

    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. Sometimes the pain in the shoulder can be described as a catching pain. 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. A feeling of weakness of the shoulder/upper arm is also common. 

    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 . Some people may experience sensations of pins and needles 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.

    Shoulder Pain In The Morning Only

    Morning is a time when you should be feeling at your body best, not budgeting extra time to pull your shirt on or wash your hair because your stiff, sore shoulders havent warmed up yet.

    When you wake up with shoulder pain that gradually dissipates throughout the day, only to flare up again next morning, you may need to look no further than your bed for the reason and the solution.

    Start with simple changes and monitor shoulder pain each morning as you work your way through this list of shoulder pain relief techniques.

  • Switch your sleep position. Try sleeping on your back or on the other side not your stomach.
  • Remove some pillows. We often sleep propped up to improve breathing and digestion, but having too many pillows can lead to over-pronation of the head, which stretches the muscles and ligaments in the neck and can cause morning shoulder pain.
  • Add some pillows. If you arent using one at all, or just a single flat pillow, try sleeping elevated to take some pressure off your shoulders.
  • Dont sleep with your arm under the pillow or your elbow over your head; this squeezes the tendons and can lead to weakness in the arm.
  • Switch to a cervical support pillow or tear drop shaped specially designed to support the neck during side-sleeping.
  • Buy a new mattress if you have had yours for many years. Mattresses tend to sag in the middle over time, which puts undue pressure on all the muscles.
  • Adhesive Capsulitis Of Shoulder

    Adhesive capsulitis of shoulder is more commonly known as frozen shoulder. The exact cause of frozen shoulder is not fully understood but there are several factors that might play a hand in its development. Individuals with diabetes have a higher risk of developing frozen shoulder, along with those who have been diagnosed with hypothyroidism, hyperthyroidism, cardiac disease, and Parkinsons disease. It is also thought that immobilization of the shoulder for prolonged periods can lead to a frozen shoulder.

    With adhesive capsulitis, the pain is usually dull and located in the outer shoulder area and upper arm. If you would describe your pain as either right shoulder blade pain or left shoulder blade pain, a frozen shoulder could be the problem. X-rays are sometimes used to diagnose the condition. Treatment focuses on pain management, as a frozen shoulder condition usually resolves on its own. But for some individuals, the condition can persist for years. Steroid injections can be administered for serious cases and shoulder exercises are always recommended.

    What Causes Shoulder Bursitis

    Bursitis most commonly affects the shoulder, but it can develop in any joint. Shoulder bursitis is often the result of overuse or repetitive shoulder movements.

    Overhead activities increase friction between bones and tissues. This ongoing friction can inflame and irritate bursae. When fluid builds up in the bursa sacs, you have bursitis.

    Shoulder Pain From Sleeping On The Side

    Your shoulder may hurt when your sleep on one side just because of your sleeping position.

    Although overuse injuries and damage to your rotator cuff are common causes of night shoulder pain, its not true in every case. For example, researchers have found that not everyone who wakens in the night with shoulder pain has an injury-related cause.

    The journal Medical Hypotheses reported that shoulder pain can be directly connected with sleeping position. Sleeping on one side can cause pain in that shoulder due to the weight of the body on the shoulder joint. Shoulder pain from sleeping on one side can also occur if a person doesnt change their position at all while sleeping.

    How To Choose The Best Pillow For Shoulder Pain

    According to the journal Physiotherapy Canada, having a good-quality and comfortable pillow is essential for a good nights sleep. Researchers found that a low pillow, a feather pillow, and uncomfortable pillow can greatly increase incidences of shoulder pain and neck stiffness.

    How can you choose the best pillow for shoulder pain? Here are some helpful tips:

    Support. A pillow should support your head and neck well and not go flat during the night. The pillow should be firm enough to keep your neck at a good angle while you sleep. Memory foam pillows are good for supporting your neck.

    Height. You should also avoid a pillow that is too high because it can strain your neck and cause shoulder pain while you are sleeping. If you tend to sleep on your back, then the pillow height should be lower than if your sleeping position is on your side.

    Fill material. According to the study mentioned above, while there was no significant difference in sleep quality scores for the different pillow types, it was found that the feather-pillow users consistently rated their sleep quality and pillow comfort low.

    Exercise Dos And Donts

    Q and A On Causes of Shoulder Pain: 13 Major Medical ...

    During your recovery from shoulder impingement, you should avoid any activities that involve throwing, especially with your arms overheard, such as tennis, baseball, and softball. You should also avoid certain types of weightlifting, such as overhead presses or pull downs. If youre a swimmer, you should take some time off from training to allow the recovery process to progress.

    While its important to rest your shoulder, you can do some light exercising to strengthen your rotator cuff and stretch the muscles in your arm, shoulder, and chest.

    Try these exercises:

    • Stand with your arms at your sides and your palms facing forward. Squeeze your shoulder blades together and hold for five to ten seconds. Repeat a few times.
    • Stretch your arm straight in front of you and move it forward using only your shoulder. Then move your shoulder as far back as you can without moving your neck or back, or bending your arm.
    • Lie on your unaffected side and bend your top arm in a 90-degree angle. Keep your elbow on your hip and rotate your lower arm up toward the ceiling. Repeat 10 to 20 times.
    • Stand in a doorway, holding the side of the frame with your arm slightly below shoulder height. Turn your upper body away from that arm until you feel a slight stretch, and hold.

    If any of these exercises cause pain, stop doing them or try holding them for a shorter period of time.

    Injury To The Shoulder Joint

    Shoulder pain can sometimes occur due to a dislocation, a fracture, or another acute injury to the shoulder joint.


    Treatment for an acute shoulder injury varies depending on the type of injury and its severity.

    Some injuries heal on their own. However, surgery may be necessary if the damage is significant or there are torn ligaments that require repair.

    Shoulder Pain While Sleeping During Pregnancy

    During your third trimester, you may suffer from a sore shoulder while sleeping on one side. Some of the reasons for night-time shoulder pain during pregnancy could be that extra weight causes sore back muscles.

    Try to change you sleeping position several times during the night to reduce pressure on the shoulder.

    Diagnosis Of Shoulder Pain

    We can often recognize the minor shoulder pain as it happens due to overexerting arms or sleeping in the wrong position. But when the pain is sudden without any reason, you need to call for medical assessment.

    The physician will examine you by asking medical history, family history especially for diseases like diabetes, arthritis, and thyroid.

    Diagnostic test like X-ray can be performed to detect the fracture, bone abnormalities, bone separation, or arthritis. Advanced tests like ultrasound and MRI give a clearer picture if the cause of pain is not detected.

    An arthrogram is an advanced test used to detect structural problems in muscles and tendons. Blood tests are also used where necessary.

    Causes Of Chronic Shoulder Pain

    Why Diagnosis is key.

    Believe it or not, chronic shoulder pain is quite common at my back pain clinic. The Chronic part refers to a pain or movement problem that has been present for more than six weeks – and I find that this is the most useful definition to start with.

    However, there are various degrees of chronic associated with shoulder pain. These degrees vary according to the length of time a problem has been active in conjunction with the severity of your symptoms and the constancy of your pain. Lets have a look at this in more detail.

    When I see Shoulder Pain become Chronic Shoulder pain, it is usually down to one of the following reasons:

  • Failure to remove the underlying cause: For example, if your chronic shoulder pain is coming from a pinched nerve in your neck then treatment must be directed towards your neck pain primarily and not your shoulder.

    Another example: If the cause of your chronic shoulder pain is due to a poor sitting posture, or your work station is incorrect for you – then treatment is required for both posture correction and to modify your work station. Without correcting these underlying causes of shoulder pain, then all the shoulder treatments in the world will not relieve you permanently from your pain.

    These are just two common examples of treatment errors that I see in my clinic.

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    When Should I Seek Medical Help

    You should contact your doctor if you experience fever, inability to move your shoulder, lasting bruising, heat and tenderness around the joint, or pain that persists beyond a few weeks of home treatment.

    If your shoulder pain is sudden and not related to an injury, call 911 immediately. It may be a sign of a heart attack. Other signs of a heart attack include:

    • trouble breathing

    What Is The Cervical Spine

    The cervical spine is the neck region of your spinal column. It’s made up of seven small, highly mobile bones, and their associated ligaments, muscles, and shock-absorbing discs.

    Anything that aggravates or comes into contact with your spinal nerve roots can lead to radiculopathy, and that includes several common conditions in which growths or abnormalities cause something to invade the space of the nerve root.

    • Herniated disc: The shock-absorbing discs between vertebrae can become damaged and may develop a bulge and/or leak fluid.
    • Synovial cyst: These lumps are caused by a buildup of joint fluid that forms a sac.
    • Bone spur: An extra bit of bone forms in response to damage or chronic inflammation.
    • Cervical spondylosis : This condition involves the formation of bone spurs in the neck.
    • Spinal stenosis: An advanced stage of spinal arthritis, stenosis occurs when the spaces in the spine become narrowed, usually due to excess bone growth.
    • Degenerative disc disease : Discs between vertebrae erode and fray over time, which may cause a herniated disc. In cases of severe degeneration, bone-on-bone contact can cause bone spurs in the joint.

    What To Do If Your Shoulder Hurts

    If you do experience shoulder pain, it’s not always possible to figure out the cause. Sometimes problems in other parts of the body are actually the source of the pain, which then radiates to your shoulder. This can happen with certain neck problems, including arthritis and disc herniations, says Dr. Arun Ramappa, associate professor of orthopedic surgery at Harvard Medical School.

    In general, if you are experiencing a lot of pain or know you injured yourself, it’s best to see a doctor right away to have your shoulder condition diagnosed.

    But if you have general, mild shoulder pain, try adjusting your activities, taking nonsteroidal anti-inflammatory drugs, and performing mild stretches to see if the pain improves on its own. However, if the pain doesn’t go away after a few weeks, you should consult your doctor.

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