Your shoulders are among the most complex joints in your body. In addition to the ball-and-socket joint itself, there are other parts of the shoulder that can cause pain, including tendons, muscles and other ‘soft’ tissues.
Since your shoulders are so important to your daily function, a painful shoulder can have a significant impact on your quality of life. You may be able to manage pain from milder injuries at home, but there are many cases where a doctor should diagnose and treat the problem.
The type of care needed will depend on symptom severity.
When to seek routine care
Contact your doctor for shoulder pain if:
- Pain is not subsiding, despite resting the shoulder and refraining from the activities that caused the pain.
- Pain is present even if you’re not using your arm.
- Pain is accompanied with arm numbness, weakness, or paralysis.
- The type or intensity of pain changes, for example from an ache to a sharp pain.
- Pain returns when you resume activities, such as reaching up or lifting something heavy.
- There is new swelling or a lump near or on the shoulder.
When to seek same day care
Some shoulder pain symptoms call for same day care. If you have shoulder pain but no obvious injury, you should see your doctor as soon as possible if you have the following symptoms:
- severe pain
- trouble moving your shoulder and using your arm
- an abnormal sensation in your arm, hand or fingers
If you can’t get a same-day appointment, go to an urgent care clinic if possible.
When to seek emergency care
You need emergency care when you have an injury caused by a trauma, like a fall, and you have any of the following additional symptoms:
- an obvious deformity of your shoulder (possible dislocation)
- swelling
- severe pain
- a bone has broken through your skin
- a loss of sensation in your arm, fingers or hand
Delaying treatment could cause permanent damage to and around your shoulder.
Unless there is an injury that clearly needs a doctor’s care, some shoulder pain can be managed at home. You can usually self-treat shoulder pain from repetitive use by stopping the activity.
However, the longer you continue the activity, the worse the pain can be and the worse the damage may be to the shoulder structure. The most common home care recommendations for shoulder pain include:
- Rest. Reduce your activity, taking a break from the repetitive motions that may have caused your pain. If your shoulder pain is from an athletic or training injury, talk to the coach or an athletic trainer for alternate training.
- Ice. Apply ice to your shoulder for about 20 minutes a few times a day. Do not apply ice to bare skin.
- Heat. Warm packs are good for sore muscles, tendons and ligaments and mild injuries that do not cause significant swelling. Heat will increase blood flow to the area, which helps with healing and relaxes tension. For acute or very painful injuries, start with ice and alternate with heat after 48 hours (or follow your doctor's instructions).
If you can take over-the-counter pain relievers, these may help as well by reducing inflammation and pain.
You may also want to protect your shoulder with a brace or support to prevent further injury. If the weight of your arm pulls down on your shoulder and increases the pain, a sling may be helpful. However, immobilizing your shoulder could lead to other issues, such as frozen shoulder. If the pain is bad enough to require immobilizing, you should see a doctor for a diagnosis.
Considering the range of motion a shoulder has, it’s perhaps not too surprising how common shoulder pain really is—it’s estimated about 7.5 million people a year see a doctor for shoulder pain, and many more manage the pain at home.
Your shoulder allows you to move your arms from side to side, forward and backward, and up above your head. A painful shoulder injury can occur from repetitive motions or acute, sudden injuries; chronic illnesses like arthritis can damage the joint as well. Here are the most common reasons people experience shoulder pain:
- Torn rotator cuff. Four muscles in your upper arm connected with tendons to form the rotator cuff, which—as the name implies—allows you to rotate your arm. These tendons can tear with enough force, resulting in a torn rotator cuff.
- Frozen shoulder. Your shoulder can become so stiff that you can’t lift or move your arm away from your torso. Frozen shoulder can occur if there is scar tissue or it can simply happen without any particular reason.
- Tendinitis. Repetitive motions can cause the tendons to become irritated and inflamed.
- Sprains. A fall, particularly if you land on an outstretched hand, can stretch or tear the ligaments holding the joint together, causing a sprained shoulder.
- Strains. Strained shoulder muscles are caused by overuse or sudden increase in use.
- Arthritis. The most common type of arthritis to affect the shoulder is osteoarthritis.
- Bursitis. Bursitis occurs when the small fluid-filled sacs that prevent your bones from rubbing against other parts of your shoulder become inflamed and painful.
- Fractures (breaks). Most shoulder fractures occur when you fall and land on an outstretched hand.
- Separation. A separated shoulder can occur if you fall on your shoulder or your shoulder is hit with a strong force. The ligaments that attach your shoulder to your collar bone become stretched or torn.
- Dislocation. A shoulder dislocation is different from a shoulder separation. A strong blow to the shoulder can force the ball of the humerus out of the shoulder socket. A dislocation can be partial or total.
If you go to an emergency department, the attending emergency physician or an orthopedic specialist (an orthopedic surgeon) will evaluate you.
Primary care doctors can treat most cases of shoulder pain that are not urgent, but your doctor may refer you to another doctor if you need more specialized care. Your doctor may or may not order a shoulder X-ray or other type of imaging test.
Depending on the underlying cause of shoulder pain and its treatment options, here are some specialists you may see:
- orthopedic specialist or orthopedic surgeon
- rheumatologist
- physical medicine or rehabilitation specialist
- sports medicine doctor
- physical therapist
- athletic trainer
Shoulder pain can interfere with so much in your life, from work and play to sleeping. It’s important to get your shoulder checked if your pain doesn’t go away because with some injuries, such as frozen shoulder, the longer you wait for medical help, the harder it can be to treat the problem.
If you have shoulder pain or swelling and it’s not going away, speak with your doctor about your diagnosis and treatment options.
