If you’re unsure what causes your shoulder pain, this shoulder pain diagnosis chart may help you.
The shoulder is one of the most complex and versatile joints in the human body. It is made up of an intricate system of soft tissues, muscles, tendons, ligaments, and bones. Since your shoulder has an impressive range of motion, it is also very vulnerable to injury.
Shoulder pain is one of the most often injured body parts. The reason is – The shoulder joint is one of the most vulnerable joints in the human body. Shoulder pain can reduce your ability to move freely and hinder everyday routines like combing your hair and brushing your teeth.
If you have an injury that affects any part of these shoulder bones, it can cause pain, soreness, and discomfort in your shoulder. Shoulder pain can have many causes. You can injure your shoulder from an accident or play a rigorous sport like long tennis or football.
In some cases, shoulder pain can accompany conditions like arthritis which is called referred pain. The good news is – Shoulder pain isn’t life-threatening. Your shoulder should feel better after a few days of proper rest. However, if your shoulder pain persists, it could signal something more severe.
Shoulder Pain Diagnosis Chart: Common Causes
Bursae are tiny, fluid-filled sacs that are found in joints throughout the body, including the shoulder. The bursa sac acts as a cushion and prevents friction between bones, muscles, overlying soft tissues, and tendons.
Overuse of the shoulder can cause inflammation and swelling of the bursa – A condition known as bursitis.
The most common symptom of bursitis is intense pain in the shoulder, especially during movement.
Your tendon is a connective tissue that joins your muscles to your bone. When your tendon becomes inflamed from injury or overuse, you have tendinitis. Tendinitis can cause sudden pain in the shoulder, which worsens movement. A tender, swollen lump can also develop on the shoulder, lasting from a few days to a few weeks.
There are 2 types of tendinitis.
Acute tendinitis: Overusing your shoulder during contact sports or work can cause acute tendinitis.
Chronic tendinitis: Arthritis or other degenerative diseases that appear with age can cause chronic tendinitis.
How to diagnose shoulder tendinitis
Step 1: Sit down and raise the affected arm (shoulder) forward to the front.
Step 2: While holding your arm in front of you, turn your palm upwards
Step 3: Your partner should try to push your arm downwards while you move it upwards.
If you feel pain in the front of your shoulder while resisting your partner’s arm push, it could mean biceps tendonitis is the cause of your shoulder pain.
3. Shoulder impingement
Shoulder impingement is a painful condition when your shoulder blade (acromion) presses on the underlying soft tissues when you move your arm away from your body. As your arm is raised, the acromion puts pressure or impinges on your tendons and bursa. Shoulder impingement can lead to bursitis and tendinitis, causing intense pain and inflammation.
How to diagnose Impingement
Step 1: Sit down and let your partner raise the arm of your affected shoulder to the front and overhead as far as possible.
Step 2: Your partner should place one hand on your arm and put the other hand supporting your shoulder blade (scapula).
The area where your shoulder bursa and rotator cuff tendons are (the sub-acromial space) reduces when you raise your arm and push it to the limit. If you feel pain in your shoulder, you have shoulder impingement.
4. Shoulder Instability
Shoulder instability occurs when the head of the upper arm (humerus) pops out of the shoulder socket. Shoulder instability can arise as a result of a sudden injury or from overuse.
Your shoulder dislocations can be partial when the head of the upper arm comes just partially out of its socket.
A complete dislocation means the ball has come out of the socket entirely. Shoulder dislocations which may be partial or complete, cause pain and discomfort when you move your arm or raise your arm away from your body. When you have torn ligaments, tendons, or muscles in your shoulder, you are prone to shoulder dislocations.
Arthritis is a degenerative disease that affects joints in the body, including the ball and socket joint in the shoulder.
Osteoarthritis is the most common culprit of shoulder pain. Other symptoms of osteoarthritis include swelling, pain, and stiffness.
The shoulder pain could develop slowly and might worsen over time.
When you break a bone in your body, you have a fracture. Shoulder fractures commonly involve breaking of the clavicle (collarbone), humerus (upper arm bone), or scapula (shoulder blade).
Shoulder fractures are often the result of injury as a motor vehicle accident or contact sports injury. Shoulder fractures can cause severe pain, swelling, and bruising on the shoulder.
Diagnosis of Rotator Cuff Tear
Step 1: Sit down and ask your partner to raise the painful shoulder to the side and parallel to the ground.
Make sure you relax the arm and ask your partner to drop your arm.
If your arm drops automatically and you cannot keep your arm in the parallel position, you may have a rotator cuff tear.
Top tip: You can soothe the pain of a torn rotator cuff by elevating the scapula towards your ear.
7. Frozen Shoulder
Adhesive capsulitis is another name for a frozen shoulder. It happens in people that have kept their arms immobilized for a long time. Frozen shoulder is usually characterized by pain and stiffness in the shoulder, which may intensify over time.
How to diagnose a frozen shoulder
Step 1: Stand in front of a mirror.
Step 2: Raise your arms slowly to the front and over your head. If you have a frozen shoulder, you’ll feel intense pain in the affected arm before it reaches your ear level.
Step 3: A definitive test for frozen shoulder is to stand with both arms at your side, then flex your elbows at ninety degrees.
Step 4: Gradually rotate your arms outwards. If you have a frozen shoulder, the affected arm will not rotate outward properly compared to the healthy shoulder.
When should I seek medical help for my shoulder pain?
Shoulder pain is usually not life-threatening. In most cases, proper rest and medications will soothe your shoulder pain.
However, suppose your shoulder pain accompanies fever, bruising, inability to move your shoulder, heat, and tenderness around the joint, or pain that persists past a few weeks of home treatment. In that case, you should seek medical help. If your shoulder pain results from injury and you are bleeding, or you see exposed tissue, you should visit your doctor.
Sudden shoulder pain that is not caused by injury can be a symptom of a heart attack. Other symptoms of a heart attack include:
If you notice signs of a heart attack, make sure you call 911 immediately.
Shoulder Pain Diagnosis Chart: Diagnosis Tests for Shoulder Pain
If you have persistent shoulder pain, your doctor may attempt specific tests to help identify the cause of your pain. The type of tests your doctor will carry out include:
X-rays: These use electromagnetic waves to show images of any injuries to the bones that make up your shoulder joint. Your doctor may carry out an X-ray test if he suspects a fracture.
Magnetic resonance imaging (MRI) and ultrasound: These use magnetic fields to create images of soft tissues. An MRI scan will help your doctor detect injuries to the tendons and ligaments in your shoulder joint.
Computed tomography (CT) scan: This test integrates x-rays with computer technology to produce a very comprehensive image of your shoulder bones.
Electrical studies: Your doctor may attempt a test to assess nerve function, such as an EMG (electromyogram).
Arthrogram: During this x-ray study, a special dye is injected into the shoulder to show the shoulder’s bones, muscles, ligament, and tendons. Anthrograms may be combined with an MRI.
Arthroscopy: This surgical procedure allows your doctor to view your shoulder joint with a narrow fiber-optic camera. Arthroscopy helps show soft tissue injuries that are not visible from physical examination, x-rays, and other imaging tests.
Treatment options for shoulder pain
Treating your shoulder pain will depend on the cause and the severity. Luckily, shoulder pain usually resolves on its own after a few weeks.
If you have shoulder pain, your doctor may suggest several treatment options, including:
Rest is the most straightforward remedy for shoulder pain. If you have pain in your shoulder, try resting for a few days to allow the acute inflammation to subside.
Top tip: While resting your shoulder is essential, ensure you don’t leave your shoulder immobilized for too long because it can lead to stiffness.
2. Activity Changes
Your doctor may recommend you rest and avoid the activities responsible for your shoulder pain. The reason is – overusing a painful shoulder can worsen the pain.
3. Ice and Heat Application
You can apply ice packs to acute shoulder injuries to reduce swelling and soothe the pain.
Heat pads are also used to ease stiffness, relax the muscles, and reduce pain.
Top tip: I recommend talking with your physical therapist before you use ice or heat packs. Your doctor will determine the length of time for applying your heat packs.
4. Physical Activity
Physical therapy is an essential part of shoulder pain treatment. Your physical therapist will recommend different exercises you can use to increase your shoulder strength and improve mobility.
Your doctor may prescribe medication to reduce inflammation and relieve pain, such as nonsteroidal anti-inflammatory medications (NSAIDs) or corticosteroids.
Corticosteroids have anti-inflammatory properties and can be taken orally or intravenously.
Top tip: If medication is prescribed to relieve shoulder pain, make sure it is taken only as directed.
Simple treatment methods such as rest, exercise, and medication are effective for most cases of shoulder pain. However, In extreme cases, your doctor may suggest surgery.
For example, specific shoulder problems, such as recurring dislocations, shoulder impingement, and rotator cuff tears, may not subside with medication or rest. In these cases, surgery may be a possible solution.
The surgery for shoulder pain can help to remove damaged scar tissue and repair torn tissues.
The shoulder has distinctive anatomy and a wide range of motion. The impressive mobility of the shoulder joint also makes it highly susceptible to injury. The common causes of shoulder pain include accidents, repeated movements, contact sports, manual labor, and aging.
If you have intense shoulder pain that persists after a few days, you must seek medical attention immediately.
- Ewald, A. (2011, February 15). Adhesive capsulitis: A review. American Family Physician, 83(4), 417–422
- Monica, J., Vredenburgh, Z., Korsh, J., & Gatt, C. (2016, July 15). Acute shoulder injuries in adults. American Family Physician, 94(2), 119–127