“Doc, Why Does My Shoulder Hurt?”

One of the most common complaints in an orthopaedic office is shoulder pain. It can begin suddenly or be a nagging pain that just doesn’t seem to go away. Let’s review and discuss the common reasons for shoulder pain and the treatment that can be used.

The most important question can often determine the reason for your shoulder pain – “how did it start?” (Was there a specific event that occurred, such as a fall? Did it just begin one day when you got out of bed? Do you perform repetitive activities in your job or sport?) Couple the answer to this question with your age and the cause of your pain is often narrowed to several common causes.

A traumatic injury often results in a rotator cuff tear (tendons attached to the side of the shoulder) and causes pain with reaching away from the body, pain at night while trying to sleep, and weakness. It is a common scenario no matter the age of the patient. A younger person (<50-60 years old) often needs an “ah-hah” moment (fall from height, weight lifting injury, etc) to sustain a rotator cuff tear but as we age, a traumatic injury is not required to sustain a tear. Some research has suggested that 70% of people older than 70 years old have degree of a rotator cuff tear as the tendon degenerates with age.

Common causes of shoulder pain in a younger patient include bursitis and tendonitis. A young overhead athlete or weightlifter will often tear the labrum (liner that surrounds the socket). Fortunately, a younger person with these problems often do not need surgery, but rather, a non-inflammatory medication (NSAID, cortisone injection) and possibly physical therapy.

One of the most important treatments that everyone can do is stretch to prevent a frozen shoulder. A shoulder that is inflamed and hurts to move will develop stiffness if not treated with dedicated stretching. A sling is NEVER the answer unless your visit to your local emergency finds you have broken a bone during your fall.