Localized Shoulder Pain

Has your shoulder become painful or difficult to move? Does it hurt when reaching overhead, reaching behind your back, lifting, throwing, or lying on the affected side? Some episodes begin suddenly after lifting, reaching, or an awkward movement. Others develop gradually after repetitive work, sports, or everyday activities.

The fact that your pain stays mainly around your shoulder is actually an important clue. Muscle spasms often develop as the body's natural way of protecting an injured area by limiting movement. Although this can make your shoulder feel stiff or weak, it does not necessarily mean you have suffered a serious injury.

If your pain is travelling below your elbow, into your forearm or hand, rather than staying mainly around your shoulder, please click here to learn about radiating shoulder pain.

Many patients assume shoulder pain means they have torn their rotator cuff or injured the supraspinatus tendon. While the rotator cuff is the primary stabilizer of the shoulder and is involved in almost every shoulder movement, a tear is only one of many possible causes of shoulder pain.

In my 30 years of clinical practice, I have found that ongoing shoulder pain most commonly comes not from the initial injury, but rather the secondary adhesions and scar tissue that severely impact normal biomechanical motion. This limitation then results in protective muscle splinting and loss of normal shoulder movement.

Most shoulder patients only seek treatment after a long period of time, as many shoulder injuries appear to be improving on their own, only to become aggravated with a particular motion or activity.

This leads the patient to think it is their fault and that if only they had not done this or that, the pain would have improved. Eventually, after running out of options, trying free advice and exercises that do not seem to work, they finally seek professional advice. These patients are now presenting with a complex overlay of muscle, joint, capsule, ligament, and biomechanical issues, making an accurate diagnosis the first step toward effective treatment.

Episodes of uncomplicated shoulder pain that resolve without treatment in a few days are usually suggestive of a simple pulled or strained muscle without any significant underlying biomechanical problem.

If your pain and shoulder stiffness continue beyond a couple of days, there is usually an underlying issue that needs to be addressed. Many patients begin performing the same generic rotator cuff exercises they find online, believing they have torn their rotator cuff. Unfortunately, these cookie-cutter exercise programs often irritate the already painful tissues because they do not address the actual cause of the problem.

Addressing the entire shoulder complex and identifying all the underlying involved structures is key to restoring normal shoulder movement, reducing pain, and returning to your normal activities.

Yes. The good news is that most localized shoulder pain responds very well to conservative care once the source of the problem has been accurately diagnosed. Over the past 30 years, I have had the privilege of helping thousands of patients with shoulder pain, with most pain free and back to pre-injury activity in as little as 1–4 weeks.

If your shoulder pain has not improved after a few days, keeps returning, or is interfering with your sleep, exercise, work, or normal daily activities, it is time to have it evaluated.

Different shoulder conditions often produce remarkably similar symptoms, but do not all require the same treatment. An evaluation is designed to determine exactly what is causing your pain so the right treatment can be recommended from the beginning.