Shoulder Pain Causes

Written By: Chloe Wilson BSc (Hons) Physiotherapy
Reviewed By: SPE Medical Review Board

Common Shoulder Pain Causes: Symptoms, Diagnosis & Treatment Options

Shoulder pain causes a whole range of problems, affect around 70% of people at some point in their lives.

The shoulder joint is the most mobile joint in the whole body - just think about the movements you can do with your arm compared to your leg.

But it is vital to have good strength and stability to allow all of this shoulder and arm movement without pain and the risk of injury.

Shoulder pain may come on suddenly or build up gradually over time, be linked with a specific injury or have no obvious cause.

Common Causes of Shoulder Pain

Shoulder pain causes may stem from one of the four shoulder joints, the muscles, bones, or other soft tissues such as the labrum. Here we will look at the most common shoulder pain causes, how they develop, typical symptoms and then go on to look at how to treat them.

 The most common shoulder pain causes come from:

  • Soft Tissue Injuries: shoulder muscles, ligaments, bursa, joint capsule and labrum e.g. shoulder impingement and bursitis
  • Bone Injuries: shoulder fractures, wear and tear or bone spurs
  • Neurological Conditions: Problems in central or peripheral nervous systems
  • Skin Problems: e.g. acne
  • Referred Pain: shoulder and arm pain from a nearby structure e.g. neck

So let's have a look at the most common shoulder pain causes:

1. Shoulder Impingement Syndrome

Shoulder Pain Causes: Impingement Syndrome - Symptoms, Diagnosis & Treatment

Shoulder impingement syndrome is one of the most common causes of shoulder pain. With impingement syndrome, soft tissues in the shoulder get pinched or trapped leading to inflammation and tearing. 

Shoulder impingement is typically caused by anything which reduces the space between the shoulder bones such as bursitis or bone spurs.

Common symptoms of shoulder impingement syndrome are:

  • Sharp pain in the shoulder
  • Pain gets worse when arm above head or behind back
  • Difficulty sleeping, especially lying on your side
  • Restricted arm movements

Find Out More: Shoulder Impingement Syndrome: Causes & Treatment 

2. Rotator Cuff Tears

Shoulder Pain Causes - Rotator Cuff tears. Symptoms, diagnosis & treatment

Another one of the most common shoulder pain causes is a rotator cuff tear. This is where there is damage to one of the stabilising muscles of the shoulder.

Rotator cuff tears may develop suddenly with an injury such as a fall or heavy lifting, or may develop gradually over time from wear and tear and friction. 

Common symptoms of a rotator cuff tear include:

  • Dull, aching shoulder pain
  • Pain gets worse when lifting or twisting the arm
  • Shoulder and upper arm weakness
  • Shoulder popping and cracking noises

Find Out More: Rotator Cuff Tears: Causes & Treatment

3. Frozen Shoulder

Common Shoulder Pain Causes: Frozen Shoulder aka Adhesive Capsulitis

Frozen shoulders, aka adhesive capsulitis, are one of the common shoulder pain causes in women aged 40-60. With a frozen shoulder, there is inflammation, thickening and tightening of the joint capsule.

This may develop following an injury, shoulder surgery or various medical conditions such as diabetes.

Common symptoms include:

  • Increasing shoulder pain and stiffness
  • Severely restricted shoulder movements & function
  • Typically only affects one shoulder at a time
  • Symptoms last for months - years

Find Out More: Frozen Shoulders: Causes & Treatment

4. Glenoid Labrum Tear

Common Causes of Shoulder Pain: Labrum Tears - Symptoms, Diagnosis & Treatment

Glenoid labrum tears, where there is damage to the special layer of cartilage the forms the outer rim of the shoulder socket, are another possible cause of shoulder pain.

Labrum tears are usually caused by a sudden injury to the shoulder such as a fall, road traffic accident, awkward/heavy lifting or shoulder dislocation but can also develop gradually with repetitive overhead activities such as decorating.

Damage may occur in the upper part of the shoulder labrum, known as a SLAP Tear, or the lower part of the labrum may tear, known as a Bankart Lesion.

Common symptoms of a labrum tear include: 

  • Shoulder instability
  • Arm weakness
  • Catching/locking sensation
  • Shoulder dislocation

Find Out More: Shoulder Labrum Tear: Causes, Treatment & Recovery

5. Supraspinatus Tendonitis

Common Causes of Shoulder Pain: Supraspinatus Tendonitis - Symptoms, Diagnosis & Treatment

Supraspinatus tendonitis is another of the possible shoulder pain causes in middle age. It is caused by irritation and inflammation of the supraspinatus rotator cuff tendon, typically from repeated friction on the tendon caused by narrowing of the subacromial space and/or repetitive overhead activities.

The classic features of supraspinatus tendonitis are: 

  • Shoulder pain, most classically a painful arc when abducting arm
  • Sleep disturbance
  • Arm weakness 
  • Reduced shoulder function

Find Out More: Supraspinatus Tendonitis: Treatment & Recovery

6. Biceps Tendonitis

Causes of Shoulder Pain: Biceps Tendonitis - Symptoms, Diagnosis & Treatment

Biceps tendonitis can cause shoulder pain or elbow pain, depending on which part of the tendon is affected.

Inflammation or degeneration, from repetitive overhead activities, heavy lifting, contact sports or aging leads to inflammation or degeneration of one of the biceps tendons.

Common symptoms of biceps tendonitis include:

  • Deep throbbing pain front of shoulder or elbow,
  • Pain gets worse with activity,
  • Night pain which can affect sleep
  • Snapping sensation when moving the arm

Find Out More: Biceps Tendonitis: Causes & Treatment

7. Shoulder Bursitis

Causes of Shoulder Pain: Shoulder Bursitis - Symptoms, Diagnosis & Treatment

Bursitis shoulder pain causes discomfort and restriction of arm movements due to Inflammation of one of the small fluid-filled sacs around the shoulder.

Shoulder bursitis may develop after repetitive overhead activities, a fall,  shoulder impingement or certain medical conditions

Common symptoms of shoulder bursitis include: 

  • Aching shoulder pain - location depends on which bursa is affected
  • Pain gets worse with arm movements or lying on affected side
  • Restricted arm movements due to pain and stiffness
  • Arm weakness
  • Feeling unwell

Find Out More: Shoulder Bursitis: Causes & Treatment

8. Snapping Scapula Syndrome

Shoulder Pain Causes: Snapping Scapula aka Scapulothoracic Bursitis

Snapping scapula syndrome is caused by inflammation of the bursae underneath the shoulder blade aka Subscapularis Bursitis.

It typically develops due to poor posture, overuse, bony abnormality, shoulder weakness or after an injury

Typical shoulder symptoms include: 

  • Snapping or grating noise in the shoulder blades with arm movement
  • Constant aching pain
  • Lump on shoulder blade

Find Out More: Snapping Scapula Syndrome: Causes & Treatment

9. Shoulder Fractures

Causes of Shoulder Pain: Shoulder Fractures - Symptoms, Diagnosis & Treatment

One of the more serious shoulder pain causes is a fracture or break in one of the shoulder bones.

Shoulder fractures are typically caused by a fall onto the arm or hand, a direct blow to the upper arm/shoulder, or changes in bone structure from aging or osteoporosis.

If you have a broken shoulder, you will normally know about it and there may be: 

  • Obvious deformity
  • Severely restricted arm/shoulder movement,
  • Extensive swelling and bruising
  • Altered sensation e.g. tingling or numbness

Find Out More: Shoulder Fractures: Causes, Types & Treatment
: Clavicle Fractures: aka Broken Collar Bone

10. Brachial Neuritis

Shoulder Pain Causes: Brachial Neuritis aka Parsonage Turner Syndrome

One of the rarer shoulder pain causes is inflammation of the nerves at the brachial plexus, known as Brachial Neuritis or Parsonage Turner Syndrome.

Brachial neuritis may develop in response to an infection, systemic illness, vaccination, injury or surgery and there may be a genetic predisposition to it.

Typical symptoms of brachial neuritis include:

  • Initially - Rapid onset of shoulder and arm pain, usually at night
  • Progresses To: weakness, altered sensation and paralysis

Find Out More: Brachial Neuritis: Causes, Symptoms & Treatment

11. Restless Arm Syndrome

Common Causes of Shoulder and Arm Pain: Restless Arm Syndrome

Another rare cause of shoulder problems is restless arm syndrome. With restless arm syndrome is where there is a problem in the central nervous system which results in abnormal sensations and/or movements in the arms.

You are more prone to developing restless arm syndrome with a dopamine imbalance, pregnancy and certain medical conditions e.g. Parkinson’s & kidney disease and there is a strong genetic link too.

Common symptoms of restless arm syndrome are:

  • Sudden, jerky, uncontrollable arm movements,
  • Symptoms get worse in the evenings or when relaxing,
  • Altered sensation in the arm

Find Out More: Restless Arm Syndrome: Causes & Treatment

12. Shoulder Acne

Shoulder Problems: Shoulder and Arm Acne - causes, symptoms & treatment

Shoulder acne is a common shoulder problem caused by clogged, irritated skin pores which results in spots or lesions around the shoulder.

Acne at the shoulder or in the arm is usually caused by excess oil secretion, skin friction, excess keratin or an allergic reaction

Different types of shoulder acne present differently and there may be anything from small white or black heads to pus filled spots across the shoulders, arms and back. Shoulder acne may or may not cause shoulder pain

Find Out More: Shoulder Acne: Types, Causes & Treatment

13. Swimmers Shoulder

Swimmers shoulder is the most common injury seen in swimmers affecting up to 90% of people who swim regularly. 

Swimming makes the shoulder complex work really hard through a huge range of movement and against a great deal of resistance. And strokes such as freestyle and butterfly require the shoulder to work in it's most vulnerable position.

If you swim regularly and have shoulder pain, chances are it's swimmers shoulder. 

Find Out More: Swimmers Shoulder: Causes, Treatment & Prevention

14. Elbow Pain

There are a number of different things that can cause pain further down the arm at the elbow

  • Lateral Elbow Pain: pain on the outer side of the elbow is most frequently due to Lateral Epicondylitis aka Tennis Elbow
  • Medial Elbow Pain: pain on the inner side of the elbow is typically due to Medial Epicondylitis aka Golfers Elbow
  • Posterior Elbow Pain: pain at the back of the elbow is usually due to olecranon bursitis

If you don't already know what is wrong with your shoulder and want some help working it out, visit the shoulder pain diagnosis section.

How Common Are Shoulder Pain Causes?

Shoulder pain is a really common problem affecting people at any age, but some shoulder pain causes are more common than others:

Diagnosing Shoulder Pain Symptoms

Many shoulder pain causes can be identified by the symptoms you are experiencing. Sometimes, there is an overlap of symptoms between conditions, and it is not uncommon to be suffering from more than one shoulder problem at the same time.

The following symptoms can be helpful when identifying shoulder pain causes:

If you want help working out which of these shoulder pain causes is affecting you, visit the shoulder pain diagnosis section.

Treating Causes Of Shoulder Pain

Treatment will vary for different shoulder pain causes. In most cases, exercises will help to strengthen the shoulder and improve it's stability. You can find a whole range of exercises, whatever your problem in the exercises for shoulder pain section.

Other things such as injections, friction massage, posture correction and in some cases surgery may also be suitable for some shoulder pain causes.

To find the correct treatment for the different shoulder pain causes, use the links above.

Page Last Updated: 06/07/2022
Next Review Due: 06/07/2024


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References

1. Shoulder Disorders and Occupation. By Dr CH Linaker & Dr K Walker-Bone. Journal of Best Practice & Research Clinical Rheumatology. June 2015

2. Shoulder Pain: Diagnosis and Management in Primary Care - by C Mitchell, A. Adebajo, E. Hay & A. Carr. British Medical Journal. 2005