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Chronic Shoulder Pain: Causes and Treatments
A shoulder injury can limit your range of motion and prevent you from participating in activities that you once loved, such as working out at the gym or playing sports with your friends. But maybe it’s been a while now since you got injured and you still haven’t recovered—or perhaps there was never any obvious injury in the first place. In this case, you may be suffering from chronic shoulder pain, which is defined as shoulder pain that has been present for more than six months.
Chronic shoulder pain can complicate day-to-day activities and have a negative impact on your quality of life. Gaining a better grasp on what causes it and how to treat it can help you in your recovery. Thus, in this article we’ll touch on the following topics:
- What Causes Chronic Shoulder Pain?
- How to Diagnose Chronic Shoulder Pain
- How to Treat Chronic Shoulder Pain
- When to See a Doctor for Chronic Shoulder Pain
- How to Prevent Shoulder Pain
What Causes Chronic Shoulder Pain?
There are a number of different things that can cause one to experience chronic shoulder pain. Your shoulder itself consists of three bones—your humerus, scapula, and clavicle—and a variety of muscles, tendons, and other tissues. Damage to any of these bones, muscles, tendons, or tissues, whether through an immediate injury or through repetitive motion over time, can result in chronic shoulder pain.
Some people even experience shoulder pain from sleeping the wrong way. Nighttime shoulder pain is more common than you may think, and there are several easy ways to deal with it. You could try switching up your sleeping position or use MedCline’s Shoulder Relief System, designed to minimize the amount of pressure you put on your shoulder at night.
Though the exact cause of your shoulder pain depends on factors like your age, health, and lifestyle, here are four common reasons that people experience chronic shoulder pain.
Tendon damage
While a partial or complete tearing of the tendon may result in shoulder pain, conditions such as rotator cuff tendinitis, bursitis, and impingement syndrome can all have an impact on the muscles and tendons in your shoulder.
Rotator cuff tendinitis and impingement syndrome occur when the tendons connecting your muscles to the bones in your shoulder become irritated, inflamed, or swollen. These conditions are common in both young, active individuals as well as middle-aged people, and can be caused by repetitive stressful activities involving your shoulder. As a result of so many athletes suffering from these conditions, they are often informally referred to as swimmer’s and pitcher’s shoulder.
Bursitis is a condition that often accompanies rotator cuff tendinitis. Bursae are fluid-filled sacs in your joints that serve as cushions between bone and soft tissue, and they can become inflamed and irritated if you overuse your shoulder.
Shoulder instability
The upper bone in your arm is called the humerus and the top of it fits securely into your shoulder socket, also known as the glenoid. Shoulder instability occurs when the top of the humerus is pushed out of the glenoid and becomes dislocated. Dislocations are usually caused by a sudden and forceful impact, such as a collision in a contact sport or a car accident. However, some people may also experience shoulder instability as a result of simple day-to-day activities or repetitive overhead motions that loosen the ligaments in their shoulders.
Whether it’s the result of a sudden impact or repetitive use over time, shoulder instability can often be extremely painful, and can severely limit your range of motion with that arm. Additionally, after you dislocate your shoulder once, it increases the chances that it will happen again in the future.
Broken bone
If you fracture your humerus, scapula, or collarbone, this can potentially cause you a great deal of shoulder pain and you’ll need to seek medical attention. Although many things can cause a fracture, they’re most often caused by physical trauma. Athletic injuries are common in younger people, while a simple fall can potentially break a bone in an older individual. On the other hand, stress fractures are a little less dramatic, and can happen when a bone faces repetitive stress, weakens over time, and eventually breaks.
Arthritis
There are over 100 different types of arthritis, and arthritis-related conditions, currently affecting more than 50 million US adults. It’s a common condition that’s typically, but not exclusively, seen in older individuals. Osteoarthritis is the type of arthritis most likely to affect one’s shoulder, as it can be brought about through past injuries or repetitive use.
Arthritis can present itself in overt ways, causing swelling, stiffness, and pain in your joints, but also in more subtle ways. For example, if your arms are falling asleep at night on a regular basis, this could be an early sign of rheumatoid arthritis. Both rheumatoid arthritis and osteoarthritis can be painful conditions that intensify over time if you don’t seek medical treatment.
How to Diagnose Chronic Shoulder Pain
In order to diagnose chronic shoulder pain, your doctor will first take a look at your medical history. They will review your past injuries and conditions to evaluate your current state of health and make an accurate diagnosis.
One of the most important factors that doctors will take into account is your age. If you’re young and in good health, then the cause of your pain could be something like shoulder instability or mild rotator cuff disease. If you’re older than 40, though, there’s a higher risk that you’re experiencing something more serious, such as chronic rotator cuff disease or adhesive capsulitis (frozen shoulder). Some of the other factors that your doctor will consider when making a diagnosis include:
- Past and ongoing health problems, disorders, and diseases
- Participation in sports, especially contact sports and weightlifting
- Your occupation
- Recreational activities you participate in
- Limitations on your range of motion
- Location of the pain
After reviewing your medical history and asking any relevant questions, a physical examination is the next step in the diagnostic process. During a physical exam, your doctor will check for any sensitivity or swelling and they may ask you to make certain movements in order to test your range of motion. If the doctor is unable to reach a diagnosis after a physical exam, or if they have any additional concerns, they might suggest that you get an X-ray or MRI in order to get a clearer picture of the problematic area.
How to Treat Chronic Shoulder Pain
Once you have a diagnosis, it’s much easier to come up with a treatment plan. The best course of treatment for chronic shoulder pain depends on the primary cause of the pain and its severity. In some cases, the issue can be treated by yourself at home—for instance you could help a shoulder injury heal by simply reducing the amount of strain you put on it. Try using MedCline’s patented Shoulder Relief System to put yourself in the best position to sleep with rotator cuff pain.
However, not everything can be solved at home. In more severe cases, you’ll likely need to see a doctor, who can recommend more intensive treatment options, such as physical therapy or surgery.
For mild to moderate shoulder pain, some common treatment options include:
- Taking over-the-counter anti-inflammatory medication
- Applying an ice pack to the shoulder for about 20 minutes per day, three to four times per day, until you begin to feel relief
- Resting
- Abstaining from activities involving shoulder movement and overhead motions
If the shoulder pain is more severe, then the above options still might be able to help, but a full recovery may require more serious steps. In this case, additional treatment options could include:
- Undergoing occupational or physical therapy
- Undergoing shoulder surgery
- Taking prescription anti-inflammatory medication
- Wearing a shoulder sling or brace
Exercises to Alleviate Shoulder Pain
According to health.harvard.edu, stretching two to three times a week can be an effective way to reduce your shoulder pain. Regularly exercising and stretching can also strengthen your muscles and increase your flexibility, helping to prevent another shoulder injury in the future.
Try out the following exercises and stretches and see if any of them help to relieve your chronic shoulder pain:
Crossover shoulder stretch
- Stand with your feet shoulder width apart
- Bring your left arm across your body, keeping it straight
- Hook your right arm over your left elbow to keep the arm in place
- Hold the stretch for about 60 seconds
- Switch sides
Standing row
- Secure a resistance band to a door at chest height
- Hold one handle in each hand with your palms facing down
- Stand three to four feet away from the door with your feet shoulder width apart and your knees bent
- Starting with both arms out in front of you, slowly pull your elbows back, keeping your chest out and your back straight
- Return to the starting position once your hands reach your body
- Try starting with three sets of 10-15 reps, and take 45-60 seconds of rest between each set
Shoulder rolls
- Stand with your feet shoulder width apart
- Let both arms hang at your sides
- Rotate your shoulders forward, up, and back in a controlled manner
- Make circles for 30 seconds in each direction
Remember that whenever you stretch or exercise, it’s always essential that you continually drink water and stay hydrated. Dehydration can potentially increase the chance of reinjury or cause cramping, which is the exact opposite of what you’re trying to achieve by doing these exercises.
When to See a Doctor for Chronic Shoulder Pain
While giving your shoulder time to rest and administering at-home treatments can often be the most cost-effective and hassle-free way to deal with shoulder pain, it doesn’t always work. Sometimes the pain is so severe or persists for so long that getting medical attention is the only option left at your disposal. Of course, in some instances you’ll need to see a doctor immediately—for example, if you break your collarbone or dislocate your shoulder, it’s crucial that you get treatment as soon as possible.
You should also set up an appointment with your doctor if you experience:
- Inability to move your shoulder
- Intense bruising
- A burning sensation around the joint
- Continued pain after two to three weeks of home treatment
Additionally, if the pain is so intense that it makes sleeping difficult, you should take action. Try out an arthritis pillow from MedCline’s Shoulder Relief System in order to minimize the strain you put on your shoulder each night.
How to Prevent Shoulder Pain
Regular stretching and exercise can help to prevent future injuries. Before lifting weights, playing sports, or participating in any strenuous physical activities, always remember to stretch. Don’t just stretch the shoulders either—stretch out your back, your legs, and the rest of your body as well in order to minimize the risk that you experience an injury. Hold stretches for at least a minute to get their full effect.
If you’re currently recovering from a shoulder injury, make sure you give it plenty of time to rest and recover before getting back into a normal exercise routine. And, if you’ve had shoulder injuries in the past, consider placing an ice pack on the affected area for around 15 minutes after exercising.
Chronic shoulder pain is no joke. It can prevent you from doing the activities you love and impede your ability to live life to the fullest. But once you identify the cause of your chronic shoulder pain, it becomes much easier to find a solution.
In many cases, you should be able to treat your shoulder pain from the comfort of your own home. You could apply an ice pack to your injury to reduce swelling, do some simple stretches to increase flexibility, or purchase MedCline’s Shoulder Relief System to take pressure off the affected area and keep comfortable at night. Don’t let chronic shoulder pain interfere with your life—take action early to address the problem and find a solution.
References:
Harvard Women's Health Watch. “Ouch! Shoulder Pain and How to Treat It.” Harvard Medical School, Harvard Health Publishing , 13 Apr. 2020, www.health.harvard.edu/pain/ouch-shoulder-pain-and-how-to-treat-it.
“Rotator Cuff Tendonitis: Symptoms, Causes, Treatments.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/17449-rotator-cuff-tendonitis.
“Shoulder Pain and Problems.” Johns Hopkins Medicine, The Johns Hopkins University , www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-pain-and-problems.
Tobola, Allison, et al. “Identifying Shoulder Pain in Older Patients: The History, Physical Examination, and Testing.” Rheumatology Network, 6 June 2009, www.rheumatologynetwork.com/view/identifying-shoulder-pain-older-patients-history-physical-examination-and-testing.
What Is Arthritis?. Arthritis Foundation , www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/what-is-arthritis.
