Understanding Shoulder Pain: Causes, Prevention, and Treatment Options

The shoulder is the most complex and mobile joint in the human body, making it particularly susceptible to injury across all age groups. “Shoulder pain is a common issue that’s generally related to aging and everyday wear and tear, but acute traumatic injuries can also occur,” explains Ilya Voloshin, chief of the Shoulder and Elbow Division in the University of Rochester’s orthopaedics department.

Why Does Your Shoulder Hurt?

As tendons age, they become more vulnerable to injury, often due to overuse. Repetitive or strenuous activities performed without proper conditioning, stretching, or warm-up can lead to inflammation and pain. Shoulder pain may also result from acute injuries such as:

• Falling
• Hoisting heavy objects (e.g., grocery bags)
• Yardwork
• Athletic activities like tennis or golf

Additionally, shoulder pain can be nerve-related. Conditions such as neck arthritis or carpal tunnel syndrome may cause pain to radiate to the shoulder or shoulder blade. In some cases, pain occurs without overuse, injury, or related conditions, often due to everyday habits.

Everyday Habits That May Cause Shoulder Pain

Certain daily routines can contribute to shoulder discomfort:

• Sleep position: Sleeping on your side may place extra pressure on the shoulder joint. Adjusting your position can help reduce pain.
• Lifting: Improper lifting techniques, such as bending at the waist, can strain the shoulders. Always bend your knees and keep your arms close to your side when lifting.
• Desk posture: Prolonged sitting at a desk, especially with hunched shoulders, can lead to problems. Poor posture narrows the rotator cuff space, potentially causing painful impingement. Maintaining an upright posture allows the shoulder joint to move freely.

Common Shoulder Injuries and Their Symptoms

Rotator Cuff Injury

Rotator cuff disease is the most prevalent shoulder issue, affecting nearly everyone at some point. Symptoms include:

• Sharp pain, particularly when reaching backward or to the side
• Dull aching that intensifies at night

Nighttime pain is common with rotator cuff injuries: When upright, gravity helps stabilize the shoulder’s ball in the socket. When reclining, the ball of a rotator cuff-deficient shoulder is harder to stabilize, which can cause pain. Sleeping in a more upright position or using a reclining chair may help alleviate discomfort.

Frozen Shoulder

Frozen shoulder occurs when individuals stop moving their arm, allowing scar tissue to form around the joint, making movement extremely painful. However, 80% of frozen shoulder cases improve without surgery.

“If you have any kind of shoulder pain that isn’t caused by a fracture or dislocation, keep moving it! Once it gets frozen, the recovery process takes a lot longer. Physical therapy is the first step, and cortisone injections may help.” — Ilya Voloshin, chief of the Shoulder and Elbow Division, University of Rochester

Shoulder Impingement

Shoulder impingement occurs when tendons or bursae in the shoulder become pinched or compressed. There are two types:

• External impingement: Occurs above the rotator cuff, often due to repetitive overhead movements.
• Internal impingement: Typically affects athletes, particularly those involved in throwing sports, and involves the rotator cuff tendon being pinched between the humeral head and the glenoid.

Early intervention, including rest, physical therapy, and activity modification, can prevent worsening symptoms.