1. Health
Send to a Friend via Email

Shoulder Pain Symptoms

By

Updated April 07, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Shoulder Pain:

Shoulder pain is an extremely common complaint that has several possible causes. When considering treatment for a shoulder condition, your doctor will need to assess the cause of the pain. Without a proper diagnosis, it is difficult to initiate the best treatment for your condition. Learn about some of the common symptoms of shoulder pain, and what these may tell your doctor about your condition.

Location of Pain:

  • Outside of Shoulder: Pain over the outside of the shoulder often extends down the arm. The pain is often a deep muscle ache. The most common cause of pain over the outside of the shoulder is a rotator cuff problem, including tendonitis, bursitis, or a rotator cuff tear.

  • Front of Shoulder: Pain in the front of the shoulder is most commonly related to the biceps tendon. The biceps tendon attaches deep inside the shoulder; problems of the biceps include biceps tendonitis, SLAP tears and biceps tears.

  • Top of Shoulder: The most common cause of pain in the top of the shoulder is an abnormal AC joint. Problems of the AC joint include AC arthritis, distal clavicle osteolysis, and shoulder separations.

Timing of Pain:

  • Constant pain: Most shoulder problems tend to be bothersome with activity. Rotator cuff tendonitis and tears are usually painful with activities such as reaching or throwing. Constant pain is less typical for these conditions. Frozen shoulder can cause constant pain, but it's usually most painful when reaching behind your back or head.

  • Night pain: Pain at night is typical of rotator cuff problems. The reasoning is unclear, but it's not usual for patients with rotator cuff tendonitis, or a rotator cuff tear, to be awakened from sleep or have difficulty falling asleep because of shoulder pain.

Mobility:

The mobility of your shoulder is limited with many conditions, but in different ways. In general, we talk about active range of motion (what you can do) and passive range of motion (what your examiner can do).

Limited active range of motion is typical of a rotator cuff problem. In these conditions, the muscle will not do the appropriate work, so the shoulder feels stiff. But if someone does the work for you by lifting your arm, the shoulder moves normally.

Loss of passive range of motion is typical of a frozen shoulder and arthritis. With frozen shoulder, scar-like tissue builds up around the shoulder, leading to loss of motion—even if someone tries to move it for you. Shoulder arthritis can cause bone spurs and rough cartilage that can also limit mobility.

Strength:

With 17 muscles that surround the shoulder, there are many conditions that can limit shoulder strength. There are four rotator cuff muscles that are critical to moving the shoulder. These are not the big muscles involved with lifting heavy objects, but they are critical to moving the shoulder normally, and problems of the rotator cuff significantly limit shoulder strength.

Your doctor can isolate each of the rotator cuff muscles with specific tests and maneuvers to determine where a problem may exist. Sometimes the rotator cuff muscles don't work normally because of inflammation, and other times because they are detached (torn).

Instability/Popping Out:

Shoulders that feel unstable may feel as though they will pop out of joint. If someone has dislocated his shoulder, then the normal ligaments that hold the shoulder in position may be damaged, and the shoulder can have a tendency to pop out of joint again.

Other people have loose ligaments that result in a chronically unstable shoulder called multidirectional instability. These are usually young, athletic women who feel their shoulder not staying tightly in position (subluxation of the shoulder).

Popping, Clicking, Snapping:

Shoulder noises tend to occur with one of two conditions. Problems with the labrum or biceps tendon can cause a popping or snapping sensation. When the biceps tendon is unstable, it may shift from its normal position, causing a snapping sensation. The shoulder labrum is cuff of cartilage that deepens the shoulder socket. Labral tears can catch in the shoulder, causing a click or pop.

Shoulder arthritis can cause the smooth cartilage to wear away from the shoulder joint. Exposed bone and uneven cartilage surfaces may cause a grinding sensation called crepitus.

Examining the Shoulder:

Determining the cause of your shoulder pain requires an individual trained in understanding both the symptoms of your shoulder pain, and in performing an examination to test for different conditions. A proper shoulder examination will assess the strength, motions, and functions of the shoulder joint.

Sources:

Tonino PM, et al. "Complex Shoulder Disorders: Evaluation and Treatment" J Am Acad Orthop Surg March 2009 ; 17:125-136.

  1. About.com
  2. Health
  3. Orthopedics
  4. Shoulder & Elbow
  5. Finding the Cause
  6. Shoulder Pain Symptoms

©2014 About.com. All rights reserved.

We comply with the HONcode standard
for trustworthy health
information: verify here.