What is Shoulder Pain?

August 21, 2019

There can be many different sources of shoulder pain.

Shoulder pain is a common reason for a doctor’s visit. Most often shoulder pain is related to a strain or sprain from lifting something heavy at home or in the gym. If the pain continues after a week or so and especially if it’s associated with weakness, it’s time to see your doctor for a full examination and work up.

Shoulder pain can be caused by a variety of sources. Some common ones include:

  1. Bursitis
  2. Tendonitis
  3. Impingement
  4. Rotator cuff tear


  1. Bursitis

The bursa is a small fluid-filled sac that is located between the tendons and bones in the shoulder. It allows for smooth movements of the parts of the shoulder. If it becomes swollen then regular movements of the shoulder can cause pain. Diagnosis is usually made by a physical exam and possibly with imaging tests. Treatment usually involves physical therapy, anti-inflammatories and steroid injections into the bursa which often provide immediate relief.


  1. Tendonitis

The tendons connect muscle to bone and can get irritated/swollen or torn which leads to pain and sometimes weakness. This usually results in pain with certain movements of the shoulder and can often have no pain at rest. Diagnosis is made by physical examination with your doctor and treatment involves physical therapy, anti-inflammatories and steroid injections if necessary.  


  1. Impingement

Shoulder impingement is a common source of pain and can happen at any age. It is caused by the pinching of the rotator cuff (a group of muscles and tendons that make up part of the shoulder) and the acromion (upper part of the shoulder). Pain is often experienced with overhead activities that impinge or pinch the shoulder and cause pain. Pain can also occur at rest when sleeping on the affected shoulder. Treatment involves physical therapy, anti-inflammatories and steroid injections into the bursa which sits in between the rotator cuff and acromion. If a patient elects for an injection they can often experience immediate pain relief. Injections with physical therapy and anti-inflammatories often provide relief. Symptoms can last several weeks to months and physical therapy is very helpful.


  1. Rotator Cuff tear

The rotator cuff is a collection of muscles and tendons that make up the upper shoulder. A tear in any of these structures can cause pain and weakness if there is a large full-thickness tear.

Diagnosis is made with a physical exam and confirmed with an MRI. Treatment depends on the extent of the tear and disability caused by the tear. In some cases, a small tear can cause significant weakness and larger tears may not always cause weakness. Physical therapy is often recommended in all tears with the exception of full-thickness tears with retraction which may require surgical correction.

If you have significant weakness from a shoulder injury, it’s important to see your doctor right away as delaying surgery can also have adverse effects.

Sometimes your doctor will consider a bursa injection for a mild rotator cuff tear with additional physical therapy and anti-inflammatories.