Minor shoulder problems, such as sore muscles and aches and pains,
are common. Shoulder problems develop from everyday wear and tear, overuse, or
an injury. They can also be caused by the natural process of aging.
Your shoulder joints move every time you move your arms. To better
understand shoulder problems and injuries, you may want to review the anatomy
and function of the
shoulder . The shoulder is a ball-and-socket joint with
three main bones: the upper arm bone (humerus), collarbone (clavicle), and shoulder blade (scapula). These
bones are held together by muscles,
ligaments. The shoulder joint has the greatest
range of motion of any joint in the body. Because of
this mobility, the shoulder is more likely to be injured or cause problems. The
acromioclavicular (AC) joint, which lies over the top
of the shoulder, is also easily injured.
Shoulder problems can be
minor or serious. Symptoms may include pain, swelling, numbness, tingling,
weakness, changes in temperature or color, or changes in your range of motion.
Shoulder injuries most commonly occur during sports activities, work-related
tasks, projects around the home, or falls. Home treatment often can help
relieve minor aches and pains.
Sudden (acute) injury
Injuries are the most common
cause of shoulder pain.
A sudden (acute) injury may occur from a
fall on an outstretched arm, a direct blow to the shoulder, or abnormal
twisting or bending of the shoulder. Pain may be sudden and severe. Bruising
and swelling may develop soon after the injury. If nerves or blood vessels have
been injured or pinched during the injury, the shoulder, arm, or hand may feel
numb, tingly, weak, or cold, or it may look pale or blue. Acute injuries
- Bruises (contusions ), which occur when small
blood vessels under the skin tear or rupture, often from a twist, bump, or
fall. Blood leaks into tissues under the skin and causes a black-and-blue color
that often turns purple, red, yellow, and green as the bruise
- Injuries to the tough, ropy fibers (ligaments) that
connect bone to bone and help stabilize the shoulder joints (sprains).
- Injuries to the tough, ropy
fibers that connect muscle to bone (tendons).
- Pulled muscles (strains).
- Injuries to nerves, such as
brachial plexus neuropathy.
- Separation of the shoulder, which occurs when the
outer end of the collarbone (clavicle) separates from the end (acromion) of the
shoulder blade because of torn ligaments. This injury occurs most often from a
blow to a shoulder or a fall onto a shoulder or outstretched hand or
- Damage to one or more of the four tendons that cover the
shoulder joint (torn rotator cuff), which may occur from a direct blow
to or overstretching of the tendon.
- Broken bones (fractures). A break may occur when a bone is twisted,
struck directly, or used to brace against a fall.
- Pulling or
pushing bones out of their normal relationship to the other bones that make up
the shoulder joint (subluxation or
You may not recall having a specific
injury, especially if symptoms began gradually or during everyday activities.
Overuse injuries occur when too much stress is placed on a joint or other
tissue, often by overdoing an activity or through repetition of an activity.
Overuse injuries include:
- Inflammation of the sac of fluid that cushions
and lubricates the joint area between one bone and another bone, a tendon, or
the skin (bursitis).
- Inflammation of the tough,
ropy fibers that connect muscles to bones (tendinitis).
Bicipital tendinitis is an inflammation of one of the
tendons that attach the muscle (biceps) on the front of the upper arm bone
(humerus) to the shoulder joint. The inflammation usually occurs along the
groove (bicipital groove) where the tendon passes over the humerus to attach
just above the shoulder joint.
frozen shoulder, which is a condition that limits
shoulder movement and may follow an injury.
- Overhead arm
movements, which may cause tendons to rub or scrape against a part of the
shoulder blade called the acromion. This rubbing or scraping may lead to
abrasion or inflammation of the
rotator cuff tendons (also called
Other causes of shoulder symptoms
Overuse and acute
injuries are common causes of shoulder symptoms. Less common causes of shoulder
- Muscle tension or poor
- Pain that is coming from somewhere else in your body
(referred shoulder pain).
- Breakdown of the
cartilage that protects and cushions the shoulder joints (osteoarthritis).
- Calcium buildup in
the tendons of the shoulder.
- An irritated or pinched nerve or a
herniated disc in the neck.
- Infection in the skin (cellulitis),
joint (infectious arthritis), bursa (septic bursitis), or bone (osteomyelitis).
cancer that has spread to the bones of the shoulder or spine.
- Abuse. Any shoulder injury (especially a dislocated
shoulder) that cannot be explained, does not match the explanation, or occurs
repeatedly may be caused by abuse.
Treatment for a shoulder injury may include
first aid measures, physical therapy, medicine, and, in some cases, surgery.
Treatment depends on:
- The location, type, and severity of the
- How long ago the injury occurred.
- Your age,
health condition, and activities, such as work, sports, or hobbies.
Check your symptoms to decide if and when
you should see a doctor.
First aid for a suspected broken bone
- Control bleeding . Apply steady, direct
pressure for a full 15 minutes. Use a clock—15 minutes can seem like a long
time. Resist the urge to peek after a few minutes to see whether bleeding has
stopped. If blood soaks through the cloth, apply another one without lifting
the first. If there is an object in the wound, apply pressure around the
object, not directly over it.
- Remove all rings or bracelets. It may
be difficult to remove the jewelry after swelling develops.
- Use a
sling to support an injured shoulder.
- If a
bone is sticking out of the skin, do not try to push it back into the skin.
Cover the area with a clean bandage.
If a cast or splint is applied, it is
important to keep it dry and to try to move the uninjured parts of your limb as
normally as possible to help maintain muscle strength and tone. Your doctor
will give you instructions on how to
care for your cast or splint.
Home treatment for minor symptoms
Home treatment may
help relieve pain, swelling, and stiffness.
If your injury does
not require an evaluation by a doctor, you may be able to use home treatment to
help relieve pain, swelling, and stiffness. It may take up to 6 weeks or longer
before your symptoms are gone.
- Rest and protect an
injured or sore area. Stop, change, or take a break from any activity that may
be causing your pain or soreness.
- Ice will
reduce pain and swelling. Apply
ice or cold packs immediately to prevent or minimize swelling. Apply the ice
or cold pack for 10 to 20 minutes, 3 or more times a day.
- For the first 48 hours after an injury,
avoid things that might increase swelling, such as hot showers, hot tubs, hot
packs, or alcoholic beverages.
- After 48 to 72 hours, if swelling is
heat and begin
gentle exercise with the aid of moist heat to help
restore and maintain flexibility. Some experts recommend alternating between
heat and cold treatments.
- Wear a
sling for the first 48 hours after the injury, if it
makes you more comfortable and supports your shoulder. If you feel you need to
use a sling for more than 48 hours, discuss your symptoms with your
- Elevate the injured or sore area on
pillows while applying ice and anytime you are sitting or lying down. Try to
keep the area at or above the level of your heart to help minimize
- Gently massage or rub the area to relieve pain and
encourage blood flow. Do not massage the injured area if it causes
- Try bending forward at the waist and let your affected arm hang straight down. Move your hips and legs and let that motion gently swing your arm back and forth .
- Do not smoke or use other tobacco products. Smoking slows
healing because it decreases blood supply and delays tissue repair. For more
information, see the topic
Medicine you can buy without a prescription
| Try a nonprescription
medicine to help treat your fever or pain:|
- Acetaminophen, such as
- Nonsteroidal anti-inflammatory drugs (NSAIDs):
- Ibuprofen, such as Advil or
- Naproxen, such as Aleve or Naprosyn
- Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.
| Be sure to follow these
safety tips when you use a nonprescription medicine:|
- Carefully read and follow all directions
on the medicine bottle and box.
- Do not take more than the
- Do not take a medicine if you have had an
allergic reaction to it in the past.
you have been told to avoid a medicine, call your doctor before you take
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home
- Signs of infection or inflammation
- Numbness; tingling; or cool, pale skin
- Shoulder range of motion or strength in the joint
decreases or does not return to normal.
- Symptoms do not improve
despite home treatment.
- Symptoms become more severe or
The following tips may prevent shoulder
problems or injuries.
General prevention tips
- Stay in good overall physical shape. Strengthen
your wrist, arm, shoulder, neck, and back muscles to help protect and decrease
stress on your shoulder. Do stretching and range-of-motion (ROM) exercises for
your arms and shoulders.
- Maintain good posture. Stand straight and
relaxed, without slumping.
- Warm up well and stretch before any
activity. Stretch after exercise to keep hot muscles from shortening and
- Wear protective gear during sports or recreational
activities, such as roller-skating or soccer.
- Wear your seat belt
when in a motor vehicle.
- Do not use alcohol or other drugs before
participating in sports or when operating a motor vehicle or other
- Don't carry objects that are too
heavy. Make sure children and teenagers use school bags and backpacks correctly.
- Avoid catching falling objects.
- Use a step
stool. Do not stand on chairs or other unsteady objects.
- Use the
correct body movements or positions during activities, such as lifting, so that
you do not strain your shoulder. Do not lift objects that are too heavy for
- Avoid overusing your arm doing repeated movements that can
bursa or tendons. In daily routines or hobbies, think
about the activities in which you make repeated arm movements. Try alternating
hands during activities such as gardening, cooking, or playing musical
rest, ice, compression, and elevation (RICE) for home
- Avoid keeping your arms out to the side or raised
overhead for long periods of time, such as when painting a ceiling. If you must
do these things, take frequent breaks, and use RICE for home treatment.
- Consider consulting a sports-training specialist if you are a
competitive or serious recreational athlete. The specialist can recommend
training and conditioning programs to prevent shoulder problems or
- Make sure your child's backpack is the right size with
good support. Carrying heavy backpacks may increase the risk of shoulder
problems or injury.
- If you feel that activities at your workplace
are causing pain or soreness from overuse, call your human resources department
for information on alternative ways of doing your job or to discuss equipment
modifications or other job assignments.
- Make your home safe to reduce the chances of falls.
- Keep your baby or toddler safe from falls.
Keep your bones strong
- Eat healthy foods such as milk, cheese, yogurt,
and dark green, leafy vegetables like broccoli. For more information, see the
- Exercise and stay active.
Talk to your doctor about an exercise program that is right for you. Begin
slowly, especially if you have been inactive. For more information, see the
- Don't drink more than 2 alcoholic
drinks a day if you are a man, or 1 alcoholic drink a day if you are a woman.
Drinking alcohol increases your chances of having weak bones (osteoporosis). It also increases your chances of
- Do not smoke or use other tobacco products. Smoking
increases your chances of having osteoporosis. It also causes problems with the
blood supply in your arms and slows healing. For more information, see the
Shoulder injuries such as bruises, burns,
fractures, cuts, or punctures may be caused by
abuse. Suspect possible abuse when an injury cannot be
explained or does not match the explanation, repeated injuries occur, or the
explanations for the cause of the injury change. You may be able to prevent
further abuse by reporting it and seeking help.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
- What are your main symptoms?
- How long
have you had your symptoms?
- What were you doing when you first
noticed your symptoms?
- Have you had this problem in the past? If
so, do you know what caused the problem at that time? How was it
- How and when did an injury occur? How was it
- Have you ever had any injuries to the same area? Do you
have any ongoing problems because of the previous injury?
activities related to sports, work, or your lifestyle, make your symptoms
better or worse?
- Do you think that activities related to your job
or hobbies caused your symptoms?
- What home treatment measures have
you tried? Did they help?
- What prescription and nonprescription
medicines have you taken? Did they help?
- Were illegal drugs or
alcohol involved in your injury?
- Do you have any
If you have a shoulder problem, the following list of
questions may help you and your doctor determine how much your shoulder and arm
function has changed.
- Is your arm comfortable hanging at your
- Can you sleep on your affected side?
- Can you wash your back or opposite
- Can you toss an object underhand?
- Can you
toss an object overhand?
- Can you put your hand behind your
- Can you tuck in the back of your shirt?
- Can you carry
20 lb (9 kg) at your side, such
as carrying a light suitcase?
- Can you put a
1 lb (0.5 kg) object up on a
shelf at chest level or higher?
- Can you put an
8 lb (3.6 kg) object up on a
shelf at chest level or higher?
- Animal and Human Bites
- Arm Injuries
- Arm Problems, Noninjury
- Back Problems and Injuries
- Burns and Electric Shock
- Chest Problems
- Neck Problems and Injuries
- Puncture Wounds
|By: ||Healthwise Staff ||Current as of: May 16, 2013|
|Medical Review: ||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
David Messenger, MD