From Jonathan Cluett, M.D.,
Your Guide to Orthopedics.
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About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

Shoulder pain is an extremely common complaint, and there are many common causes of this problem. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause. If you have shoulder pain, some common causes include:

• Bursitis | Rotator Cuff Tendonitis
  The most common diagnosis in patients with shoulder pain is bursitis or tendonitis of the rotator cuff.

• Rotator Cuff Tear
  Rotator cuff tears occur when the tendons of the rotator cuff separate from the bone. Surgery is sometimes necessary for this condition.

• Frozen Shoulder
  Also called 'adhesive capsuliitis,' this is a common condition that leads to stiffness of the joint. Physical therapy and stretching are extremely important aspects of treatment.

• Calcific Tendonitis
  Calcific tendonitis is a condition of calcium deposits within a tendon -- most commonly within the rotator cuff tendons. Treatment of calcific tendonitis depends on the extent of symptoms.

• Shoulder Instability
  Instability is a problem that causes a loose joint. Instability can be caused by a traumatic injury (dislocation), or may be a developed condition.

• Shoulder Dislocation
  A dislocation is an injury that occurs when the top of the arm bone becomes disconnected from the scapula.

• Shoulder Separation
  Also called an AC separation, these injuries are the result of a disruption of the acromioclavicular joint. This is a very different injury from a dislocation!

• Labral Tear
  There are several patterns of a torn labrum and the type of treatment depends on the specific injury.

• SLAP Lesion
  The SLAP lesion is also a type of labral tear. The most common cause is a fall onto an outstretched hand.

• Arthritis
  Shoulder arthritis is less common than knee and hip arthritis, but when severe may require a joint replacement surgery.

• Biceps Tendon Rupture
  A proximal biceps tendon rupture occurs when the tendon of the biceps muscle ruptures near the joint.

When do you need to call your doctor about your shoulder pain?
If you are unsure of the cause of your shoulder pain, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of these conditions must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

• Inability to carry objects or use the arm
• Injury that causes deformity of the joint
• Shoulder pain that occurs at night or while resting
• Shoulder pain that persists beyond a few days
• Inability to raise the arm
• Swelling or significant bruising around the joint or arm
• Signs of an infection, including fever, redness, warmth
• Any other unusual symptoms

What are the best treatments for shoulder pain?

The treatment of shoulder pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment.

Not all treatments listed here are appropriate for every condition, but may be helpful in your situation.

• Rest: The first treatment for many common conditions that cause shoulder pain is to rest the joint, and allow the acute inflammation to subside. It is important, however, to use caution when resting the joint, because prolonged immobilization can cause a frozen shoulder.

• Ice and Heat Application: Ice packs and heat pads are among the most commonly used treatments for shoulder pain. So which one is the right one to use, ice or heat? And how long should the ice or heat treatments last? Read on for more information about ice and heat treatment.

• Stretching: Stretching the muscles and tendons that surround the joint can help with some causes of shoulder pain. A good routine should be established, and following some specific suggestions will help you on your way.

• Physical Therapy: Physical therapy is an important aspect of treatment of almost all orthopedic conditions. Physical therapists use different modalities to increase strength, regain mobility, and help return patients to their pre-injury level of activity.

  Some specific exercises may help you strengthen the muscles around the joint and relieve some of the pain associated with many conditions.

• Anti-Inflammatory Medication: Nonsteroidal anti-inflammatory pain medications, commonly referred to as NSAIDs, are some of the most commonly prescribed medications, especially for patients with shoulder pain caused by problems such as arthritis, bursitis, and tendonitis.

• Cortisone injections: Cortisone is a powerful medication that treats inflammation, and inflammation is a common problem in patients with shoulder pain. Discuss with your doctor the possible benefits of a cortisone injection for your shoulder pain condition.