Shoulder Pain, Chronic Shoulder Pain: What Causes It? Is It Dangerous?

Shoulder pain or pain in the shoulder joint is a problem commonly found in people of all genders and ages, whether teenagers who play sports, working-age individuals who use computers for long periods, or the elderly who often have degenerative joint problems. Shoulder pain may seem minor, but if not treated properly, it may lead to a chronic condition that significantly affects daily life, or it may also be a warning sign of other underlying diseases.

Key Takeaways

• Shoulder pain can be caused by many factors, ranging from minor injuries to muscles or tendons to other diseases that cause shoulder pain, such as myocardial ischemia, liver disease, or cholecystitis, etc.
• If shoulder pain persists for more than 3–6 months or is accompanied by other symptoms such as radiating pain down the arm, arm weakness, or frozen shoulder, a doctor should be consulted for timely diagnosis and treatment.
• Shoulder pain can be treated in many ways, ranging from non-surgical treatment such as medication and physical therapy to surgery in severe cases.

What causes shoulder pain?

Shoulder pain (Shoulder Pain) is a feeling of discomfort or pain in the shoulder joint area. The shoulder joint consists of 3 main bones: the humerus, the scapula, and the clavicle. There are many muscles, tendons, and nerves connected in a complex manner, making the shoulder joint highly flexible and capable of the greatest range of motion in the body. It is also frequently used, which makes it prone to problems.

The causes that may lead to shoulder muscle pain are as follows:

• Overuse injury: This is a common cause, such as lifting heavy objects, exercising with incorrect posture, or sitting and working at a computer for long periods in an improper position, which can result in shoulder muscle inflammation or tendon inflammation.
• Injury from accidents: Collisions, impacts, or forceful arm swinging may cause tears of shoulder muscles and tendons, rotator cuff tears, shoulder dislocation or subluxation, and fractures.
• Degeneration due to aging: Commonly found in the elderly. When the shoulder joint has been used for a long time, degeneration occurs, making it easier to have shoulder pain.
• Frozen shoulder: A condition in which the shoulder joint is inflamed and fibrous tissue forms in the joint capsule, resulting in reduced movement along with pain.
• Arthritis involving the shoulder joint: Such as rheumatoid arthritis or gout, which cause joint inflammation.
• Inflammation or referred pain from other areas: Such as myocardial ischemia, cholecystitis, cervical spondylosis, liver disease, including cancer.

How is shoulder pain different by location?

Observing the location of pain is an important step in diagnosing shoulder pain because each location is often associated with different causes, such as:

• Pain at the top of the shoulder may be caused by inflammation of the acromioclavicular joint or muscle pain from heavy use.

• Pain at the front of the shoulder may be related to inflammation or tear of the biceps brachii tendon. Patients often feel pain at the front of the shoulder when lifting heavy objects or raising the arm forward.
• Pain at the back of the shoulder is often caused by muscle inflammation, resulting in pain in the back of the shoulder, scapular muscles, and neck, especially in people who sit in the same position for long periods. In some cases, it may also be caused by scapular depression.
• Pain at the side of the shoulder is often related to tendon problems, causing pain when raising the arm high or when lying on the affected side. However, if there is radiating pain down the arm, it may be a sign of cervical nerve compression.

What should be done for chronic shoulder pain? When should a doctor be seen?

If there is chronic right shoulder or left shoulder pain lasting more than 3–6 months or occurring repeatedly, a doctor should be consulted for diagnosis and appropriate treatment. Chronic shoulder pain can be caused by many factors. If left untreated for a long time, symptoms may worsen, become more difficult to treat, and significantly affect quality of life.

Diagnosis of shoulder pain: what is involved?

Diagnosis of shoulder pain consists of the following steps:

• History taking: The doctor will take a detailed history, including the nature of the pain, the time of occurrence, and activities that trigger symptoms, such as shoulder pain after lifting heavy objects.
• Physical examination: The doctor will examine the range of motion of the shoulder joint, the strength of shoulder muscles, and press to identify tender points.
• Additional investigations: The doctor may order an X-ray to detect bone abnormalities such as degeneration, dislocation, subluxation, or bone spurs. In cases where tendon or rotator cuff tears are suspected, an MRI may be considered.

How is shoulder pain treated to relieve discomfort?

Treatment of shoulder pain mainly depends on the cause and severity of symptoms and can be divided into two main approaches:

Non-surgical treatment for shoulder pain

• Behavioral modification: During periods of significant inflammation, activities that heavily use the shoulder, such as lifting heavy objects or excessive shoulder exercises, should be avoided. Importantly, prolonged rest should be avoided as it may lead to frozen shoulder. Shoulder exercises are recommended.

• Medication: The doctor may prescribe pain relievers and non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain.
• Injection: Local steroid injections can rapidly reduce pain and inflammation, but the effect is temporary.
• Physical therapy: This is an effective method to restore shoulder muscle strength. The doctor may choose appropriate methods for each patient, such as shockwave therapy to reduce muscle tension, ultrasound therapy to reduce pain and increase blood circulation, acupuncture or shoulder manipulation to reduce muscle tightness, etc.

Surgical treatment for shoulder pain

Surgery is an option considered when non-surgical treatment is ineffective or when tendons or important structures of the shoulder joint are severely torn.

• Arthroscopic surgery: This method is minimally invasive. The doctor inserts a camera and small instruments into the shoulder joint for treatment, such as removing fibrous tissue or repairing shoulder tendons. After surgery, patients recover faster than with conventional surgery.
• Open surgery: This requires a larger incision than arthroscopic surgery. It is usually used when large structural repairs are needed, such as shoulder joint replacement or repair of severe tendon tears that cannot be sutured.

Do not leave chronic shoulder pain untreated; seek treatment promptly to improve quality of life

Shoulder pain, whether in the right shoulder, left shoulder, or chronic shoulder pain, affects daily life. If left untreated for a long time, it may lead to complications such as frozen shoulder or tendon tears. Receiving prompt diagnosis and treatment will help reduce severity and restore shoulder joint function to normal more quickly.

For those with shoulder pain who are looking for effective solutions, consultation is available at the Orthopedic Center, Praram 9 Hospital, which has a team of specialists and modern treatment technology to ensure effective treatment of bone and joint diseases, including muscle injuries, restoring good quality of life to patients once again.

For more information

• Facebook: Praram 9 Hospital International & Expats
• Line: @Praram9Hospital
• Tel. 1270

Frequently Asked Questions about Shoulder Pain

1. What type of shoulder pain requires seeing a doctor?

A doctor should be consulted if there is chronic shoulder pain accompanied by other abnormal symptoms such as arm weakness, inability to lift the arm, radiating pain down the arm, or pain that interferes with sleep.

2. How does the cycle of frozen shoulder occur?

It usually begins with shoulder joint pain from some cause, leading the patient to avoid using or moving the arm frequently. When the shoulder joint moves less, it stimulates the formation of more fibrous adhesions in the joint capsule, resulting in stiffness and limited movement.

3. Can shoulder pain be treated by oneself?

If shoulder pain is caused by overuse or minor injury, initial self-care includes reducing usage in the early phase, applying cold compresses within 24–48 hours from onset, and taking pain relievers such as paracetamol or NSAIDs. However, shoulder use should not be stopped for more than 2–3 days, as it may lead to frozen shoulder.

References

Shoulder Pain. (2023, July 10). Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/25122-shoulder-pain

Pietrangelo, A. (2023, May 22). Why Does My Shoulder Hurt?. Healthline. https://www.healthline.com/health/chronic-pain/shoulder-pain

Durning, M.V. (2024, June 19). Shoulder Pain. WebMD. https://www.webmd.com/pain-management/why-does-my-shoulder-hurt