Q and A On Causes of Shoulder Pain: 13 Major Medical Conditions Causing Shoulder Pain

What Causes Shoulder Pain

What Causes Shoulder Pain?

The following 13 Major Medical Conditions Can Cause Shoulder Pain or Shoulder Joint Pain

  • Inflammation– Tendinitis (rotator cuff tendinitis), bursitis and arthritis.
  • Rotator Cuff Tear
  • Frozen Shoulder
  • Shoulder Joint Instability
  • Calcified Tendinitis
  • Shoulder Joint Tear
  • Impingement Syndrome
  • Injury– Tear of soft tissue, dislocation and fracture.
  • Sprain– Overextension, falling on outstretched arm.
  • Pinched Nerve
  • Referred Pain– Gallbladder disease, heart disease.
  • Radicular Pain– Cervical (neck) disk herniation or bulge disk, cervical spinal stenosis.
  • Primary or Metastatic Tumor of shoulder joint.

What is Shoulder Joint Tendinitis?

Several tendons support shoulder joint. Inflammation of tendon is known as tendinitis. Most common tendinitis is rotator cuff tendinitis.

What Is Shoulder Joint Bursitis?

Bursa is the synovial sac filed with lubricant fluid and lies between tendon, muscles, and bones. There are four bursas around the shoulder joint. Bursa protects tendon, ligaments and muscles from friction with bones resulting in soft tissue damage. Bursitis is the inflammation of the membrane of the bursa.

Causes of Bursitis Are As Follows-

  • Excessive strenuous use of the shoulder joint
  • Excessive non-strenuous activity of shoulder joint like frequent combing of the hair
  • Associated with Rotator Cuff Tendinitis
  • Complications of Arthritis
  • Trauma

Watch 3D Video on 5 Major Types of Arthritis of the Shoulder Joint

What Is Shoulder Joint Arthritis?

Shoulder joint can be affected by rheumatoid or osteoarthritis. Osteoarthritis causes wear and tear of the joint structures causing tear of soft tissue or dislocation. Pain is secondary to inflammation of the joint soft tissue and capsule. Joint is swollen and stiff resulting in severe intractable pain.

What Is Rotator Cuff Tear or Injury?

Rotator cuff tear or injury occurs when the tendons of the rotator cuff separate from the capsule of the joint and bone. Surgery is sometimes necessary for this condition.

What Is Frozen Shoulder Pain?

Frozen shoulder is also known as adhesive capsulitis. Frozen shoulder results following injury and inflammation of the fibrous tissue of the capsule. Inflamed capsule and ligaments cause severe pain and restriction of the shoulder joint movements, thus known as frozen shoulder.

Causes of inflammation of the capsule are as follows-

  • Injuries
  • Autoimmune Disease
  • Diabetes
  • Stroke
  • Lung Diseases
  • Connective Tissue Disorders
  • Thyroid Disease
  • Heart Disease

What Is Shoulder Joint Instability?

The tensile strength of joint capsular ligament prevents subluxation and dislocation of the joint. Capsule is supported and reinforced by tendons and muscles of the shoulder joint. Instability of shoulder joint occurs secondary to loose capsule or weakness in tendon and muscles. Weak capsule or tendon causes on and often displacement of head of the humerus because of loose intact capsule, rim, and rotator cuff.

Complication of instable shoulder joint is as follows-

  • Dislocations– Partial or Complete.
  • Subluxation– Partial dislocation of shoulder joint.
  • Tear of ligament, tendon and muscles.

What is Calcific Tendinitis?

Calcific tendonitis is a painful condition seen in patient following calcium deposits within a tendon or ligaments. Several ligaments and tendons are involved in maintaining normal function of the shoulder joint. Calcium tendinitis is more often seen with calcium deposits of rotator cuff.

Causes of Calcium Tendinitis Are As Follows-

Acute Calcific Tendinitis (ACT)– ACT is cause by excessive use of shoulder joint and often seen in following individuals-

  • Tennis Player.
  • Baseball Pitcher.

Chronic Calcific Tendinitis (CCT)– CCT causes long-term chronic tendinitis and pain. CCT is observed in-

  • Degenerative Diseases- Like osteoarthritis
  • Old Age- Wear and tear of tendon

What Is Shoulder Joint Tear?

Shoulder joint tear could be partial or complete. Tear may involve one of the following soft tissues.

  • Ligaments
  • Tendons
  • Muscles
  • Cartilages
  • Glenoid Labrum Tear

What is Glenoid Labrum Tear?

X-Ray, CAT scan or MRIs are often used for diagnosis of fracture of bone. Fracture of cartilage and soft tissue is difficult to diagnose with radiological studies. Soft tissue and cartilage fracture is diagnosed using telescope as in arthroscopy. Glenoid labrum tear is a fracture of the rim of the capsule or the cartilage of shoulder joint. Diagnosis is often difficult unless arthroscopy is performed.

What Is Shoulder Joint Impingement Syndrome?

Shoulder impingement syndrome occurs as a result of thickening of coraco-acromial ligament. Rotation or movements of the shoulder joint causes pinch and pressure over the underlying soft tissue resulting in severe pain. Impingement can cause following complication resulting in severe pain.

  • Bursitis.
  • Tendinitis.
  • Rotator Cuff Tear.

What Is Shoulder Joint Dislocation?

Dislocation is a separation of head of the humerus from the socket or glenoid cavity of the scapula bone. Shoulder joint is susceptible for dislocation because of wide range of movements within the capsule. Shoulder joint dislocation results in 50% of the ER cases of joint dislocation. Shoulder joint dislocation causes shift of head of femur in anterior, posterior or inferior position of the joint.

What Is Shoulder Joint Fracture?

Fracture is a partial break or complete separation of the bone.

Classification of Fracture– Fracture is classified according to direction of the break or separation of the bones.

  • Direction
    • Transverse
    • Oblique
    • Spiral
  • Separation-
    • Hairline Fracture– bone pieces or segments are not dislodged.
    • Partial Separating Fracture– partial separation or shift is detected.
    • Complete Separation Fracture– divided in several groups as follows-
      • Comminuted– Broken into several pieces
      • Impacted Fracture– Bone fragments are impacted into adjacent fragments of fracture bone
      • Avulsion Fracture- Fragments of the bone are displaced at adjacent position.

Cause of Fracture

  • Injury– fall, direct impact caused by auto or work accident.
  • Degenerative Joint Disease– Osteoarthritis.
  • Sports Injury– Fall, stress on impact over outstretched upper extremity.

Fracture Involves Following Shoulder Joint Bones

  • Head of humerus
  • Shaft of the humerus
  • Glenoid cavity or socket of scapula

What Is Referred Shoulder Joint Pain?

Referred pain is the pain felt at different location while cause of the pain is at different site and unrelated to the region where pain is felt.

Following Diseases Causes Referred Pain at Shoulder Joint-

  • Gallbladder Disease
  • Liver Disease
  • Heart Disease
  • Diseases of Cervical (neck) spine– Disk Herniation, Bulge Disk, Spinal Stenosis, Cervical Radiculopathy, Cervical Facet Joint Pain

What Is The Risk Of Shoulder Joint Injury?

Risk of shoulder joint injury results from repeated use of optimum range of movements.

Following are the risk dynamics of shoulder joint injury-

  • Pre-Existing Arthritis– Osteoarthritis and Rheumatoid Arthritis.
  • Frequent Fall– Frequent spell of dizziness, history of Epilepsy.
  • Vertigo– Resulting in dizziness and frequent fall.
  • Slip and Fall– On slippery surface with arm outstretched.
  • Direct impact– Over the shoulder.
  • Contact Sports– Like Wrestling, Football or Ice Hockey.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:June 14, 2018

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