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).
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.
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.
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
Chest pain or pressure, or a strange feeling in the chest.
Nausea or vomiting.
Pain, pressure, or a
strange feeling in the back, neck, jaw, or upper belly, or in one or both
shoulders or arms.
Lightheadedness or sudden
A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, numbness,
tingling, or a strange feeling in your chest or other areas.
Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury.
Symptoms of shock (most of which will be present) include:
Feeling very dizzy or
lightheaded, like you may pass out.
Feeling very weak or having
Not feeling alert or able to think clearly. You
may be confused, restless, fearful, or unable to respond to questions.
Pain in children 3 years and older
Severe pain (8 to 10): The pain
is so bad that the child can't stand it for more than a few hours, can't sleep,
and can't do anything else except focus on the pain. No one can tolerate severe
pain for more than a few hours.
Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and
sleep, but the child can tolerate it for hours or days.
Mild pain (1 to 4): The child notices and may complain of the pain,
but it is not bad enough to disrupt his or her sleep or activities.
With severe bleeding, any of these may
Blood is pumping from the wound.
bleeding does not stop or slow down with pressure.
Blood is quickly soaking through bandage after bandage.
With moderate bleeding, any of these may
The bleeding slows or stops with pressure but
starts again if you remove the pressure.
The blood may soak through
a few bandages, but it is not fast or out of control.
With mild bleeding, any of these may be
The bleeding stops on its own or with
The bleeding stops or slows to an ooze or trickle after
15 minutes of pressure. It may ooze or trickle for up to 45 minutes.
Major trauma is any event that can
cause very serious injury, such as:
A fall from more than
10 ft (3.1 m) [more than
5 ft (1.5 m) for children under
2 years and adults over 65].
A car crash in which any vehicle
involved was going more than
20 miles (32 km) per
Any event that causes severe bleeding that you cannot
Any event forceful enough to badly break a bone.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.
Try home treatment to relieve the
Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are:
Diseases such as diabetes, cancer, heart disease,
Long-term alcohol and drug
Steroid medicines, which may be used to treat a variety
Chemotherapy and radiation therapy for
Other medicines used to treat autoimmune
Medicines taken after organ transplant.
having a spleen.
Pain in adults and older children
Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Symptoms of infection may
Increased pain, swelling, warmth, or redness in or
around the area.
Red streaks leading from the area.
Pus draining from the area.
When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood
supply to the area. This can be serious.
There are other reasons
for color and temperature changes. Bruises often look blue. A limb may turn
blue or pale if you leave it in one position for too long, but its normal color
returns after you move it. What you are looking for is a change in how the area
looks (it turns blue or pale) and feels (it becomes cold to the touch), and
this change does not go away.
Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:
Your age. Babies and older
adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.
Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.
Seek Care Today
Based on your answers, you may need care soon. The
problem probably will not get better without medical care.
Call your doctor today to discuss the symptoms
and arrange for care.
If you cannot reach your doctor or you don't
have one, seek care today.
If it is evening, watch the symptoms and
seek care in the morning.
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Call your doctor now to discuss the symptoms and
arrange for care.
If you cannot reach your doctor or you don't have
one, seek care in the next hour.
You do not need to call an
You cannot travel safely either by driving
yourself or by having someone else drive you.
You are in an area
where heavy traffic or other problems may slow you down.
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.
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.
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.
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
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.
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.
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.
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.
How this information was developed to help you make better health decisions.