What are the causes of shoulder problems?

Most shoulder problems fall into four major categories:

  • Tendon inflammation (bursitis or tendinitis) or tendon tear
    • Bursitis: this fluid filled sac acts as a cushion between bones and overlying soft tissues and can become inflamed and swollen. The bursa of the shoulder sits between the rotator cuff and a part of the shoulder blade known as the acromion.
    • Tendinitis: this is wearing down of the tendons that are involved in helping move your shoulder.
    • Tendon tear: splitting or tearing of the shoulder tendons may result from acute injury or degenerative changes due to aging, long term overuse and “wear and tear”, or a sudden injury. These tears may also occur in the biceps tendon.
  • Dislocation
    • Shoulder dislocation and instability occurs when the head of the upper arm bone is forced out of the shoulder socket. Once the ligaments, tendons and muscle around the shoulder become loose or torn, dislocations can occur repeatedly. Repeated dislocations can lead to increased risk of developing arthritis in the shoulder joint.
  • Arthritis
    • There are different causes for arthritis. The most common cause is osteoarthritis, also known as “wear and tear” arthritis. Arthritis causes pain, swelling and stiffness. Symptoms tend to develop in middle age and pain worsens over time. Other types of arthritis are related to tendon tears, infection or inflammation of the joint.
  • Fracture or Trauma
    • Fractures are broken bones. Fractures can involve the collar bone, upper arm (humerus) or shoulder blade (scapula). Trauma or injury can involve the ligaments, tendons or muscles around these bones. These injuries often cause shoulder blade pain, swelling and bruising around the shoulder

Other much less common causes include infection, tumour, nerve-related or referred pain from the neck.

How is shoulder pain diagnosed?

Shoulder pain requires thorough evaluation in order to determine the cause and provide you with the best treatment options.

The first step in the evaluation is a thorough medical history, followed by a comprehensive physical examination by an orthopaedic shoulder surgeon.

Your Melbourne Arm Clinic shoulder surgeon may then order specific investigative tests to help identify the cause of your pain and any other problems. This may include X-rays, ultrasound, CT scan or an MRI scan depending on the likely cause.

Shoulder pain treatment

Treatment is dependent on the cause.

Modification of activity may be required and physiotherapy may help to improve your shoulder strength, movement, and flexibility. Medication may be prescribed to reduce inflammation and pain.

Surgery may be required to resolve some shoulder problems, once non operative options have been trialed and exhausted. Surgery can involve arthroscopy shoulder surgery to remove scar tissue or repair torn tissues, or traditional, open procedures for larger reconstructions or shoulder replacement.

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