Shoulder pain? 3 common causes

A complex ball and socket joint that moves in many directions and is responsible for so much activity in daily life and overhead sports, the shoulder is subject to plenty of wear and tear. So, it’s not surprising that shoulder pain is a fairly common occurrence, especially as we age.

Endeavor Health orthopaedic surgeon Patrick Birmingham, MD, breaks down some of the most frequent shoulder injuries and when it’s important to check in with a physician for treatment.

Rotator cuff tears, cartilage or labrum tears, and frozen shoulder are among the most common sources of shoulder pain and/or loss of mobility.

1. Rotator cuff tears

   “If you are over 40 and you have weakness and pain at night in your shoulder, assume it’s a rotator cuff tear until proven otherwise,” said Dr. Birmingham.

   Full or partial tendon tears can happen in a single traumatic event like falling on an outstretched arm or they can be the result of years of wear and tear, and aging as the blood supply to the area lessens over time. Wear and tear can come from sports (think swimming and throwing) or even daily activities like reaching to put things on high shelves.

   Feeling pain at night is one of the telltale signs of a rotator cuff tear. “If your shoulder has been bothering you for a while it’s important to see a physician and have an MRI to determine the extent of the injury,” emphasized Dr. Birmingham.

   Some partial tears can heal over time, but a full thickness rotator cuff tear won’t heal on its own and will get progressively bigger over time and ultimately can reach a point where it can’t be surgically repaired so there is a time urgency to being evaluated, he added.

   Treatment for partial tears generally includes rest and physical therapy to develop strength and increase range of motion. Icing can decrease inflammation after an initial injury and anti-inflammatory medicines, like Advil and Aleve, can also be helpful.

   Surgical repair for rotator cuffs is typically outpatient and can often be done with a nerve block rather than general anesthesia, said Dr. Birmingham. Minimally-invasive arthroscopic surgery is a straight-forward procedure that usually takes no more than one hour. Rehab after surgery is a longer process as patients are in a sling for six weeks and will need at least three months to fully heal.

2. Labrum tears

   Labrum tears are more often related to a traumatic injury or dislocation. The labrum is a thick cartilage that helps stabilize the shoulder joint, and labrum tears are common injuries for athletes like football players and wrestlers when an arm is jerked or yanked with force, causing shoulder dislocations and/or tears.

   Treatment depends on the severity and location of the tear. Surgery to repair a torn labrum is shorter than a rotator cuff procedure and typically takes only 30-40 minutes, said Dr. Birmingham. Patients are usually in a sling for three weeks and will need three months to heal.

3. Frozen shoulder

   Characterized by pain and stiffness, frozen shoulder can be associated with autoimmune conditions, particularly diabetes. The painful condition happens when the connective tissue in the joint thickens, making it difficult and uncomfortable to move the arm, explained Dr. Birmingham.

   However, the less you move your arm, the worse the condition gets and it can take a long time to resolve. Frozen shoulder can happen after rotator cuff surgery if patients are not diligent about doing prescribed exercises for recovery.

   Seeing a physician is an important first step to secure a diagnosis and begin treatment of daily exercises and stretches to help preserve strength and recover range of motion, said Dr. Birmingham.