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What Is Causing Pain In My Shoulder?

Man in pain due to shoulder

Is shoulder pain keeping you awake at night?

The shoulder joint has an extensive range of motion. You can move it up, down, back, forwards, and around in a 360-degree circle if you want to.

However, when an injury or damage to the bones or the surrounding muscles, ligaments, or connective tissue encases the joint occurs, it can impede the shoulder’s usual free movement and cause discomfort and pain.

But the “shoulder” isn't just one joint or bone. It's actually a ball and socket joint that is made up of three major bones a) the clavicle, b) the scapula, and c) the humerus – with an inner layer of cartilage.

Two primary joints connect these bones: the acromioclavicular joint and the glenohumeral joint (also referred to as the shoulder joint). The latter is exceptionally mobile and helps the shoulder move back and forth.

It also allows you to move your arm around in a circle and away from the body.

The “rotator cuff” – the group of muscles and four tendons surrounding the shoulder – is responsible for the shoulder’s impressive range of motion. The rotator cuff tendons attach the muscles to the bones. 

But when these tendons suffer damage or inflammation, it can be challenging to move your arm. 

The shoulder can suffer injury or damage through repetitive movement, sports, and manual labor.

In addition, many medical conditions can lead to pain in the shoulder. These include gallbladder disease, cervical spine issues, and heart and liver disease, to name but a few.

Generally, as we age, there is a greater risk of developing problems with the shoulder, especially after 60 years of age.

The main reason for this increased risk is due to the aging process, where wear and tear causes the shoulder’s soft tissues to "wear and tear."

While in most cases, you can reduce the level of degeneration inside the shoulder with a healthy, active lifestyle.

Occasionally, arthritis can develop in the bones and joints inside the shoulder, which may require pain medication or surgery (in severe cases).

However, in our experience, regular physical therapy is the best way to prevent and treat arthritis.

There are many different causes of shoulder pain. This blog looks at prevention, diagnosis, causes, and how best to treat shoulder pain.

What Causes Shoulder Pain?

older man with shoulder pain

Many medical conditions and different causative factors to do with your job or lifestyle can lead to shoulder pain. 

Of these, the most common cause of shoulder pain that we see in the Apex Physical Therapy clinic is rotator cuff tendinitis.

When you suffer from rotator cuff tendinitis, the rotator cuff tendons surrounding and supporting the shoulder become swollen and inflamed. 

Another reason for the shoulder pain we see regularly is "impingement syndrome," where the rotator cuff gets stuck between the acromion and humeral head (shoulder bones). 

But it's not always just the shoulder joint. In some cases, shoulder pain can result from injury to another part of the body, like the biceps, neck, and cervical spine. We call this type of pain referred pain.

However, an excellent well to tell the difference is that referred pain is unlikely to worsen when you move the shoulder. 

Some other reasons for shoulder pain are:

  • A torn or injured rotator cuff
  • A pinched nerve in the shoulder or neck
  • Rheumatoid arthritis or osteoarthritis
  • Any torn cartilage inside the shoulder capsule
  • A dislocated shoulder
  • Swollen bursa sacs or tendons
  • A broken arm or shoulder bone
  • Muscle strains and sprains
  • A ruptured tendon
  • Injury due to repetitive use or overuse of the shoulder
  • A condition called “frozen shoulder"
  • Septic or psoriatic arthritis
  • An injury to the spinal cord
  • Development of bone spurs
  • Thoracic outlet syndrome
  • In rare cases, a heart attack

How We Diagnose Shoulder Pain 

shoulder pain in older man getting diagnosed by physical therapist

As physical therapists, we always determine the root cause of your pain rather than just treating symptoms. To do this, we evaluate your medical history and conduct a physical exam.

Depending on your symptoms, we'll look for any swelling, tenderness, and other signs of inflammation. In addition, we check the stability of your joints and range of motion.

We may also recommend specific imaging tests like an MRI, Cat Scan, or X-ray to confirm what we suspect is causing your pain. 

Some of the questions we may ask you at the initial exam include:

  • Is it a dull ache or sharp, intense pain? 
  • Does the pain increase when you move your hand in particular ways?
  • Do you feel pain in one or both of your shoulders?
  • Can you point out the exact spot where you feel the pain?
  • Did the pain occur all of a sudden, and what were you doing at that time?
  • Do you feel any pain when you’re still and not moving?
  • Can you feel the pain radiate to other areas of the body?
  • Does the pain keep you awake at night?
  • Are there specific movements that increase or decrease the pain?
  •  Have you had to stop certain activities because of the pain?
  • Do you have swelling, warmth, and inflammation in the affected area? 

The Best Treatments For Shoulder Pain

Woman with shoulder pain

The treatment for shoulder pain depends on the severity and the root cause of the pain. But various treatment options are available to treat shoulder pain, including occupational therapy, physical therapy, and wearing supportive devices like a sling or shoulder strap.

If your shoulder pain is mild. You can usually manage it at home – with adequate rest, avoiding strenuous movements, and using heat/cold therapy to relieve pain and reduce inflammation. However, never apply heat or ice directly to your skin. Instead, use a towel or an ice bag.

Surgery is only ever necessary in really severe cases, where the pain is chronic, affects your quality of life, and has not responded to more conservative treatment. 

Doctors usually prescribe medications like corticosteroids or non-steroid anti-inflammatories (NSAIDs). But we would urge you to avoid these and only take them if it is absolutely necessary due to the long-term health effects.

Physical therapy and lifestyle changes effectively take the place of these drugs. 

But regardless of whether your shoulder pain is mild, moderate, or severe. We always recommend that you come and see us for a proper diagnosis rather than ignoring it and hoping it'll go away.

Things can and do get a lot worse if you don't seek treatment for chronic pain. On the other hand, if we catch it early enough – before any permanent damage occurs.

We can prevent things from getting much more painful, so it's not worth taking the risk and hoping for the best.

In most cases, there is a simple reason why you have shoulder pain that we can fix in a few sessions and educate you on how to prevent it from reoccurring. Hence, you never have to suffer from shoulder pain again. 

How To Prevent Shoulder Pain

Man doing physical therapy exercise with doctor to help with shoulder pain

Some simple exercises for the shoulder can help you to limber up and strengthen the tendons and muscles of the rotator cuff.

But we recommend you consult a physical therapist to learn how to do these exercises. Then, we can guide you on performing the movements and exercises correctly – without risking further injury.

The exercises we recommend also depend on the root cause of your shoulder pain. For example, if you have tendonitis or bursitis, you should practice specific range of motion exercises daily to prevent frozen shoulder syndrome. 

You can do other things to prevent shoulder pain, including building your shoulder strength with resistance training. Or changing your sleeping position to sleep on the opposite side of your back.

But we can advise you on the best changes to make depending on the root cause of your shoulder pain. 

Book your free consultation now to find out how we can help you identify and fix the source of your shoulder pain. 


*Please note that if there is no previous injury. Your shoulder pain is severe and comes on suddenly for no plausible reason, you should contact a doctor immediately, as it could be because of a heart attack.

Some of the other signs and symptoms of a heart attack are: 

  • Pain in the jaw or neck 
  • Difficulty in breathing 
  • Sudden tightness in the chest
  • Sweating excessively for no reason
  • Spells of dizziness

In case of any traumatic injury to the shoulder, if there is swelling, bleeding, or exposed tissue, we also recommend that you visit the emergency room as soon as possible.

Tom Willemann

Tom Willemann

Tom Willemann is a premier physical therapist based out of Bergen County, New Jersey. He holds an MS in physical therapy from the University of Miami, is credentialed in the world-renowned McKenzie Method of Mechanical Diagnosis and Therapy (MDT), and holds an OCS (Orthopedic Clinical Specialist) certification. As of 2018, there are approximately 14,000 ABPTS certified specialists in the nation and less than 400 of them are located in the state of New Jersey. Tom is the owner and director of Apex Orthopedic Rehabilitation in Paramus. He opened the clinic, which specializes in spine and sports injury prevention, in 2004 after many years of experience in the field. Tom’s caring interest in others and his strong belief in continuity of care, combined with his clinic’s ability to find solutions for the most difficult orthopedic problems, have earned Apex Orthopedic Rehabilitation its excellent reputation with patients and medical professionals in northeastern New Jersey and beyond. A true “family man,” Tom takes pride in his clinic’s warm and welcoming environment.
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