Shoulder Pain

What Causes Shoulder Pain?

Pain in the shoulder joint can cause significant disability because we use our arms frequently throughout the day to complete our daily activities and communicate.  Some shoulder conditions, such as frozen shoulder or shoulder arthritis, may lead to pain if the shoulder joint becomes too stiff.  This limits the ability to reach overhead, dress, sleep, and lift objects without discomfort.  Alternately, too much flexibility of the shoulder can cause the joint to painfully slip out of place with activity, as is the case with shoulder dislocation or a labral tear.  Repetitive activities may strain the shoulder, leading to tendinitis or bursitis.  Unfortunately, trauma or a fall can lead to broken bones or a rotator cuff tear, which may be managed with surgery or with physical therapy depending on many factors.  Despite the variety of possible causes for shoulder pain, physical therapy is often helpful for reducing pain and improving daily function.

Symptoms of Shoulder Pain

  • Pain or stiffness in the neck, shoulder, mid back, or upper arm
  • Reduced neck or shoulder flexibility
  • Weakness in the affected arm or difficulty raising the arm without help
  • Popping/clicking of the shoulder joint
  • Feeling like the shoulder joint may go out of place
  • Difficulty reaching overhead
  • Difficulty reaching behind the back

Common Treatments of Shoulder Pain

  • Postural correction and re-education
  • Dry needling
  • Electrical stimulation
  • Ergonomics assessment/education
  • Heat/Cold
  • Soft tissue mobilization/joint mobilization
  • Strengthening exercises
  • Stretching/flexibility exercises

Treatment of shoulder pain will depend on the specific factors that contribute to the pain and disability.  If shoulder tightness and lack of movement is a problem, stretches may be prescribed to gradually restore motion.  Manual treatments, such as soft tissue or joint mobilization, may also be used to reduce stiffness in the shoulder joint and surrounding muscles.  Lifestyle modification may be discussed to avoid bothersome activities and to change other activities to prevent pain onset.  Workspace assessment and adjustment may also reduce pain during the workday.  Exercises to improve the strength and control of muscles around the shoulder and shoulder blade are often prescribed to improve movement efficiency and the stability of the shoulder joint.  Rehabilitation following surgery can be complex and varies depending on the surgery that was performed; often, close monitoring in the early stages of recovery is especially required.