By Andrea Bowers, MD, Orthopedic Surgeon

Our shoulder is an amazing joint, allowing us to throw overhand, reach overhead, out to the side, behind the back, and across our body. It offers a greater range of motion than any other joint in the body.

However, repetitive stress on the muscles, tendons, and cartilage (whether from hurling 100 mph fastballs, tossing long touchdown passes, or repeatedly reaching overhead to place items on a high shelf), an acute, sudden injury, or a chronic disease like arthritis all can lead to pain.

Here’s what you need to know about shoulder pain, how you can treat it at home, and when you should see a health care provider.

Causes of Shoulder Pain
The shoulder has many parts that cause pain, weakness, and instability. There are three bones: the humerus (upper arm), scapula (shoulder blade), and clavicle (collarbone). The top of the humerus is shaped like a ball, and fits into the shallow socket of the scapula. Ligaments and a tissue called the labrum keep the ball centered in the socket. Rotator cuff muscles and tendons provide stability and allow you to rotate your arm.

Given this complex anatomy, there's plenty of opportunity for something to go wrong and significantly impact the quality of your life.

Common causes of shoulder pain include:

• Torn rotator cuff — a rip in the tendons that connect to the head of the humerus
• Labral tear or biceps tendon tear — can occur in a traumatic fashion or with repetitive wear
• Fracture — mostly occurring when you fall and land on an outstretched hand
• Separation — a strong force causes the ligaments that attach your shoulder to your collar bone to become stretched or torn
• Dislocation — a blow to the shoulder forces the ball of the joint out of the socket
• Arthritis — wearing down of cartilage that causes pain, stiffness, and reduced range of motion
• Frozen shoulder — often occurring for unknown reasons, your shoulder becomes so painful and stiff you can’t lift or move it
• Shoulder impingement syndrome (tendinitis) — the tendons in the shoulder become irritated and inflamed
• Bursitis — small fluid-filled sacs that prevent your bones from rubbing together become inflamed and painful

Treating Shoulder Pain at Home
In the case of many repetitive use injuries, care can first be managed at home. This includes rest from the activity causing the pain, applying ice to the joint and heat to the muscles, and taking over-the-counter pain relievers such as ibuprofen, acetaminophen, or naproxen.

When to See the Doctor
If you have persistent pain that has lasted more than several weeks or has not been relieved by home treatments, contact your health care provider. Make an appointment if:

• You have pain or difficulty carrying objects, lifting or raising your arm, or reaching backward or across your body
• Pain is present even if you are not using your arm
• You have trouble sleeping because of the shoulder pain
• You have swelling, redness, or tenderness around your joint and arm
• You hear a snapping, clicking, or popping sound in your shoulder

Seek emergency medical care if:

• You have severe pain
• Your shoulder pain is accompanied by trouble breathing, chest discomfort, weakness, or lightheadedness—these are signs of a heart attack. Call 911!
• Your injury is the result of a fall or other traumatic event and there is deformity of your shoulder
• You have lost sensation in your arm, fingers, or hand

Treatment will depend on the cause of your shoulder pain. Medication, physical or occupational therapy, or corticosteroid injections may help relieve your symptoms. If conservative measures do not work, joint surgery may be an option. Types of surgical remedies include shoulder arthroscopy, rotator cuff repair, anatomic shoulder replacement, and reverse shoulder replacement.

Don’t Let Joint Pain Hold You Back
From pain management and physical therapy, to surgery and rehabilitation, Virtua Health can help you get back in the game. Our board-certified and fellowship-trained sports medicine specialists and orthopedic surgeons guide your care – from diagnosis to treatment, and beyond. Learn more about the Virtua Orthopedics & Spine program or call 856-517-8812