Shoulder pain can be a sign of a heart attack. If you are also having trouble breathing and feel a tightness in your chest, call triple zero (000) immediately and ask for an ambulance.
Shoulder pain is common, however, and has many different causes — including a sports injury or a fall — but usually it isn’t a sign of anything serious. The pain may occur in the joint itself, or in the many muscles, tendons and ligaments in the shoulders.
Seek medical attention immediately if you have injured your shoulder and the joint is deformed, you can’t use it, the pain is intense or there is sudden swelling.
What is shoulder pain?
Shoulder pain is usually felt in the front of the shoulder, or at the top of the arm. Often, the pain is only felt when you move your arm in a certain way.
The pain may be deep and sharp, or there may be numbness, tingling or pins and needles. It may radiate down into the arm or up into the head, or there may be pain between the shoulder blades. Sometimes the pain may be caused by problems in the neck or spine, rather than the shoulder.
When should I see a doctor?
If you have shoulder pain that won’t go away or which is getting worse, or you have other symptoms that are causing you concern, make an appointment to see your doctor.
The doctor will most likely examine your shoulder and ask about your symptoms. They may suggest an x-ray or other scans to assist with diagnosis, although such tests are usually only helpful in certain situations, such as if there is an injury that needs to be investigated.
What causes shoulder pain?
Shoulder problems can be serious or minor. They can also be acute (meaning with a sudden onset) or chronic (meaning they develop over and last for a long period of time).
The causes of shoulder pain include:.
- general wear and tear with increasing age
- poor posture
- an injury to the shoulder (tears or strains, dislocation or fracture)
- a frozen shoulder (when the tissues harden around the joint)
- overuse (for example, during certain sports or other activities that involve continual or repetitive use of the shoulder)
- inflammation in the fluid sacs in the joints, called bursitis
- weakness or overuse of the muscles around the shoulder, called the rotator cuff
- inflammation of the tendons, called tendonitis
- problems with the muscles, ligaments and tendons around the shoulder
- pain from a problem in the neck or spine
- nerve pain
- pain after surgery
Shoulder pain can sometimes be caused by an underlying medical condition, such as fibromyalgia or polymyalgia rheumatica. Occasionally, shoulder pain and shortness of breath appear as symptoms when someone is having a heart attack.
How is shoulder pain diagnosed?
A doctor will examine the shoulder and may order tests including x-rays, CT scans, MRI, bone scan or ultrasound.
How is shoulder pain treated?
The treatment recommended for shoulder pain will depend on the cause.
In the first few days after an injury, putting a cold pack on the sore area (for 10 to 20 minutes, 3 times a day) can help to reduce inflammation. After that, a hot pack can be used to help relax the shoulder muscles.
Pain relievers or anti-inflammatory medications may also help control the pain.
But for persistent or intense pain, or if you’re injured, you should see a doctor or physiotherapist, who may suggest:
- resting your shoulder for some time (usually only a couple of days)
- taping your shoulder for support, or resting your arm
- laser or ultrasound therapy
Steroid injections or surgery may be recommended for some injuries.
If the pain lasts for longer, you may get stronger pain relief medication from a specialist. This might include medication to relax the muscles or treat nerve pain. Sometimes, injections to block the pain may be recommended.
If the condition is severe, you may be advised to have nerve stimulation to the spinal cord. Sometimes surgery is needed to correct structural problems, such as an arthroscopy, stablisation surgery or a joint replacement.
Can shoulder pain be prevented?
You may be able to prevent some shoulder pain by:
- staying in good physical shape
- being aware of your posture and how you perform activities
- warming up before exercise and stretching after exercise
- lifting and carrying heavy items correctly
- taking breaks, stretching and relaxing
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Last reviewed: March 2021