What to do about shoulder pain

There’s a lot on your shoulders. Add pain to the mix, and it’s not much fun. So, what can you do about your shoulder pain?

Pain or discomfort in the shoulder is pretty common. In fact, more than two-thirds of Americans will experience shoulder pain at some point in their lifetime.

Some shoulder pain will disappear on its own, but the key to treating pain effectively is determining the underlying cause of the discomfort.

Let’s take a deeper dive into what you should know about shoulder pain, including potential causes and how to prevent it.

Breaking down shoulder anatomy

When you’re young, you learn all about anatomy and the various types of joints in the body. The shoulder is what’s known as a “ball and socket joint,” which acts pretty much like it sounds.

It includes a partially spherical end — the ball — that lies within a socket. This structure allows for multidirectional movement and rotation.

In addition to the shoulder joint itself, the shoulder also contains tendons, cartilage, muscle and bone. While you might logically think only of the shoulder blade when you think of bone in the shoulder, the shoulder actually includes three bones — the humerus (upper arm), scapula (shoulder blade) and clavicle (collarbone).

Muscles and tendons work together to keep the arm centered in the shoulder socket, and together, they are known as the rotator cuff.

Uncovering the causes of shoulder pain

With so many moving parts, it shouldn’t surprise us that there can be many reasons for shoulder pain. For the most part, according to the American Academy of Orthopaedic Surgeons, issues affecting the shoulder fall into three categories:

• Arthritis
• Fracture or instability
• Tendon inflammation or tear

Let’s break those down a little further:

Arthritis

There are many different types of arthritis, but the most common type affecting the shoulder is osteoarthritis. This type of arthritis can lead to swelling, pain and stiffness, which often worsens gradually over time.

When osteoarthritis impacts the shoulder, the cartilage covering the ends of the bones wears away gradually, causing the bones to rub together. This can disrupt movement within the joint and lead to bone spurs. This, in turn, can cause pain and a loss of motion over time.

If you’re diagnosed with osteoarthritis impacting the shoulder, your doctor may recommend rest, modified activities, physical therapy and NSAIDs to help minimize and prevent further shoulder pain.

Fracture or instability

This one’s pretty self-explanatory. Fractures are a fairly common source of shoulder pain — and may occur in any of the three bones of the shoulder.

When a fracture occurs, it will usually cause severe, noticeable pain, swelling and bruising.

Shoulder dislocation is also common. It occurs when the ball of the shoulder slides out of the socket, which inflames tissues in the shoulder and can sometimes even injure the bone itself.

Prevention of this type of shoulder pain largely depends on a person’s age and activity level. Older adults most commonly break or dislocate a shoulder when a fall occurs, so taking fall prevention measures is important. It’s also key to exercise regularly and incorporate moves that build muscle and strengthen balance.

In younger people, these injuries most often occur as a result of a car accident or athletic participation.

Tendon inflammation or tear

Inflammation in the shoulder takes a couple different forms — bursitis and tendinitis. Bursitis occurs when the small, fluid-filled sacs cushioning the bones (bursae) inflame and swell. This causes the tissue to become inflamed and painful.

Tendinitis occurs when the tendon connecting muscle to bone is inflamed, and the biceps and rotator cuff tendons are most commonly affected.

A tendon tear can occur because of an injury or over time as the tendon degenerates.

To prevent this type of shoulder pain, you’ll want to take steps to adapt your lifestyle habits, particularly related to activity. It’s important to avoid overtaxing your shoulders, and mixing up the type of physical activity you perform can help avoid overuse. You’ll also want to stretch regularly, ensure your desk is set up in an ergonomic way, and make sure you’re performing exercises with proper form.

Keeping shoulder pain at bay

Our shoulders do a lot of work for us — and that puts them at an increased risk of injury and pain. But there are steps you can take to keep your shoulders healthy.

First up, work on improving your posture. One easy way to do that is to pull your shoulder blades back and hold for a few seconds, then repeat up to 20 times a few times a day.

You should work on strengthening your shoulder muscles by incorporating shoulder-specific exercises into your workout routine. This will include a focus on the four rotator cuff muscles and the shoulder blade muscles. Rowing exercises are particularly helpful.

Pair those exercises with stretching. Don’t just focus on the shoulders when stretching, either. Your chest muscles can impact your shoulders, so stretch those out, too.

Daniel H. Doty, MD, is a Tennessee native and graduate of University of Tennessee College of Medicine. He is fellowship trained in elbow and shoulder surgery.

Believe you have suffered a shoulder injury or aggravated an old injury? The Erlanger Orthopaedic Institute offers comprehensive care for a variety of urgent or chronic injuries, including those affecting the shoulders. To book an appointment, call 423-778-ORTH (6784).