Treating Common Shoulder Injuries & Pain Conditions

The shoulder joints are some of the most frequently used joints in your body. The shoulder is also the joint with the most mobility and range of motion. Our doctors and surgeons with University Orthopaedic Services at University of Utah Health provide exceptional care, cutting-edge therapies, and a wide range of surgical and non-surgical treatments to help patients experiencing shoulder pain.

female tennis player injures shoulder

What Does Shoulder Pain Mean?

Shoulder pain could be related to any of the joints, ligaments, muscles, and tendons in the shoulder that work together to move your arms. These include your:

  • upper arm bone (humerus),
  • shoulder blade (scapula),
  • collarbone (clavicle), and
  • shoulder socket (glenoid).

Muscles, tendons, and ligaments in the rotator cuff connect the upper arm bone to the shoulder blade and keep it inside the socket. This gives you a wide range of motion in your arms, which also creates more opportunities for problems with connective tissues and bones in and around your shoulder.

If you experience shoulder pain that worsens, lasts more than four weeks, or does not improve with time, it may be time to see an orthopedic doctor.

Shoulder Pain Causes

People experience shoulder pain from a variety of conditions or injuries such as:

  • Arthritis — Shoulder arthritis can develop as a result of wear and tear over time from acute injuries or conditions like rheumatoid arthritis.
  • Fractures — The collarbone, upper arm, or shoulder blade could all experience a fracture (cracked or broken bone). This is most often caused by a fall, accident, or sports-related contact.
  • Tendon damage — Tendons are small cord-like connectors between your muscles and bones. Tendon damage can occur from acute injuries like throwing a ball or chronic injuries such as a degenerative disease.
  • Inflammation Shoulder inflammation occurs with soft tissues, tendons, or ligament damage. Pain associated with inflammation can lead to restricted mobility in the shoulder and difficulty performing basic movements.
  • Instability — In order for your shoulder to remain stable, the top of your upper arm bone must be securely held inside the shoulder socket with tendons. Shoulder instability occurs when it comes out of the socket (dislocates) partially or fully.
  • Other conditions
    • Nerve problems,
    • Tumors,
    • Infections, or
    • Disk herniation (ruptured cushioning in the neck that can cause arm or shoulder pain)

Find a Shoulder Specialist

Types of Shoulder Pain

With so many different moving parts inside and around the shoulder, it can be difficult to distinguish whether shoulder pain is in the joint or the muscle. Most shoulder pain requires a consultation with an orthopedic specialist who can review your symptoms, order imaging tests, and diagnose what is happening.

Rotator Cuff Tears

A torn rotator cuff is one of the most common shoulder injuries for adults. It can cause pain and weakness in your shoulder that makes daily activities difficult. A rotator cuff tear is a tendon that either partially or fully detaches from the arm bone. Without treatment, a partial tear can get worse and become a complete tear.

Rotator Cuff Tendonitis

Tendons inside the rotator cuff can become inflamed or damaged, causing tendonitis. 

At first, symptoms may be mild such as:

  • some pain both during activity and during rest,
  • radiating pain from the shoulder to the side of the arm,
  • sharp or sudden pain when lifting things overhead, or
  • pain when throwing.

However, symptoms often progress to:

  • severe pain that makes it difficult to sleep,
  • loss of range of motion in the shoulder,
  • weakness, or
  • an inability to reach around toward your back. 

Biceps Tendonitis

This inflammation occurs in the upper biceps tendon that connects the muscle to your shoulder. In the early stages, your tendon will be swollen and irritated. However, the protective tendon cover (sheath) and the tendon, itself, may thicken over time. If left untreated, biceps tendonitis can lead to a biceps tendon tear.

Biceps Tendon Tears

These are injuries to one or both of the tendons connecting the bicep muscle to the shoulder bone. They can be partial or complete tears. If it is a partial tear or only affects one tendon, you may still be able to use your arm, but will notice weakness and pain. Partial tears may be treated without surgery. However, a complete tear in one or both tendons usually requires surgery to repair.

People most at risk are:

  • adults with jobs or hobbies that require heavy overhead lifting,
  • athletes who play sports that require repetitive motions like throwing or swimming, and
  • individuals with a history of steroid use.

You may have a biceps tendon tear, if you experience the following symptoms:

  • sudden, sharp pain in the upper arm, sometimes with a pop or snap you can hear,
  • bruising from the upper arm to the elbow,
  • pain, tenderness, and weakness in the shoulder and elbow,
  • pain when you turn your palm over, or
  • a muscle bulge near your elbow, if you have a complete tear.

Shoulder Bursitis

Bursae are small sacs of fluid that create a cushion between the bones and soft tissue in the joints. They reduce friction so your muscles and bones glide smoothly past one another. When bursae become inflamed or swollen, bursitis may cause pain in the shoulder.

Frozen Shoulder (Adhesive Capsulitis)

If you experience severe pain and stiffness in the shoulder that worsens over time until it’s hard or nearly impossible to move, you may have a frozen shoulder.

Dislocated Shoulder

This injury occurs when the ball at the top of your arm bone is forced out of the shoulder socket. It may come partially or entirely out of the socket. Dislocations occur after sudden injury and with overuse. Experiencing one shoulder dislocation may increase your risk of another in the future.

Repeated shoulder dislocations can lead to chronic instability. You may also have loose ligaments or notice your shoulder “giving out” frequently without ever experiencing an actual dislocation.

Shoulder Impingement

A shoulder impingement happens when the top of the shoulder blade puts pressure on the soft tissues in your shoulder as you lift your arm away from your body. Impingement can lead to bursitis (inflammation of the fluid-filled sacs that cushion your joints) and tendonitis (inflammation of the tissue connecting your muscles to your bones). This could cause significant muscle pain and restrict the movements in your shoulder.

Osteoarthritis

This condition is a result sports injuries, work injuries, infection, inflammation, or normal wear and tear on the joint. It causes pain and stiffness in your shoulder as protective bone coverings like cartilage wear down or the fluid in your joints builds. Shoulder arthritis may also develop after a rotator cuff tear when the upper arm bone is out of place and rubs against other surfaces in the shoulder.

Shoulder Pain Diagnosis

At your initial appointment, your doctor will ask how and when the pain started, and what treatments (if any) you have already tried. If you previously had imaging for your shoulder injury, bring that to your appointment. However, your doctor may still recommend additional imaging to compare with the older imaging results.

During the examination, your doctor will:

  • look for swelling or deformities,
  • observe the range of motion in your joint, and
  • check around the joint for weakness or tenderness.

For many shoulder injuries, the doctor will also order tests such as:

  • X-ray This identifies fractures or bone injuries.
  • Magnetic resonance imaging (MRI) An advanced imaging technology that looks at the ligaments, tendons, and other soft tissues around your shoulder.
  • Computed tomography (CT) scan This imaging scan gives a more detailed view of the bones.
  • Diagnostic arthroscopy A simple surgical procedure that inserts a fiber-optic camera into the joint to see damage that may not be evident from other imaging tests.

Shoulder Pain Treatment

Treatment for shoulder pain depends on the type and severity of your shoulder injury, which can include:

  • Cortisone injections — A non-invasive treatment to relieve shoulder pain. We will perform ultrasound-guided injections in several areas of the shoulder to reduce the risk of arthritis.
  • Physical therapy Your doctor will prescribe shoulder pain exercises and stretches for shoulder pain to regain strength and range of motion resulting from a chronic or degenerative condition.
  • Shoulder arthroscopy surgeryThis minimally invasive shoulder surgery repairs damage that cannot be treated with physical therapy alone.
  • Shoulder replacement surgeryThis is a more invasive procedure to replace the entire shoulder joint if necessary.

In addition to the treatments above, your doctor may recommend modifying activities to avoid damaging or reinjuring your shoulder. He or she may also recommend rest and anti-inflammatory medication (NSAIDs) to relieve your pain.

Shoulder Pain Exercises at Home

Your physical therapist may give you shoulder pain exercises to do at home to:

  • stretch and strengthen the muscles and tendons in your shoulder.
  • improve your posture.
  • teach you proper movement for everyday activities.

Before you do any of these exercises at home, perform them with your physical therapist to ensure correct movement. If any movements cause pain, talk to him or her about making adjustments.

Stretching exercises may include:

  • anterior (front) shoulder stretches,
  • posterior (back) shoulder stretches,
  • wall stretches,
  • pendulum exercises, or
  • towel or banded stretches.

Strengthening exercises may also include:

  • banded internal and external rotations,
  • wall push-ups,
  • isometric (holding and contracting the muscle in a specific position) shoulder exercises,
  • arm reaches, or
  • shoulder blade retractions (drawing back).

Schedule an Appointment with One of Our Orthopedic Specialists

Many shoulder injuries will get worse if they are not treated. Prolonging treatment could result in a longer recovery or injuries that cannot be easily or completely fixed. 

We are always accepting new patients, so primary care doctors and other physicians can send referrals to our doctors at University Orthopaedic Services. Patients can also schedule a consultation directly by calling 801-587-7109.

When to See an Orthopedic Doctor

If you're suffering from shoulder or elbow pain, you may not know when it's appropriate to seek out a specialist for pain relief. Learn how to spot the signs of severe or prolonged pain that can't be remedied at home.

When to Seek Help