Written By: Chloe Wilson BSc (Hons) Physiotherapy
Shoulder pain diagnosis is all about working out what is causing your pain so you can treat it effectively.
There are lots of possible causes of shoulder pain. There might be a problem with one of the bones, some soft tissue damage or inflammation or the pain may be referred from elsewhere.
The simplest place to start with shoulder pain diagnosis is to think about whereabouts in your arm the majority of your pain is. Some shoulder problems will cause pain in a very specific spot, others will be much more general.
The shoulder is the most mobile joint in the whole body – think how much more movement there is in your shoulder than your knee. To achieve all this movement the joint has to sacrifice stability for mobility, making it prone to injury. And to make things more complicated, the shoulder is very close to the neck and it is common for neck problems to cause shoulder pain, even in people when there is no pain in the neck itself.
One of the most common reasons that people with shoulder pain fail to respond to treatment is incorrect diagnosis so for anyone with shoulder pain diagnosis is key. The absolute best way to accurately diagnose shoulder pain is to see your doctor or a physical therapist. But I know this isn’t always possible so let me share with you some ideas.
By thinking about where in the arm the pain is, we can make a start with diagnosing shoulder pain. Shoulder problems often refer pain, meaning symptoms may also be felt in the arm, hand, neck or back, but thinking about where the main area of pain is a great place to start.
Pain on the front of the shoulder is a common problem. It may come on suddenly due to an injury such as a fall or heavy lifting, or more gradually, particularly if you do lots of repetitive overhead activities.
You can find out all about the most common causes in the front shoulder pain article, including how to tell what is wrong and what to do about it.
Upper arm pain is usually caused by a problem inside the shoulder joint or the surrounding muscles.
Inflammation of the soft tissues is a common problem here and movement is often restricted.
Find Out More: Upper Arm Pain
When there is nerve damage in the neck or arm, shoulder pain is often accompanied by symptoms that extend down the arm.
If you experience any tingling, pins and needles, weakness or numbness in the arm or hand, it is likely there is some nerve damage.
Find Out More: Arm Nerve Pain
The collar bone, aka clavicle, is the thin bone that runs in front of the upper ribs between the shoulder and the breast bone, aka sternum. Pain felt across the front of the upper chest is often due to a problem with the collar bone.
Find Out More: Collar Bone Pain
The shoulder blades rest over the back of the rib cage and play a really important role in controlling shoulder movement.
If the shoulder blades can’t glide freely over the ribs then friction results in pain and inflammation.
Full Article: Shoulder Blade Pain
If you get a sharp pain in your shoulder, chances are something is getting squashed or structures are catching each other. Often there is an underlying dull ache but you get a sharp pain when moving your arm in certain directions as things get pinched.
There are lots of different causes which we look at in more detail in the Sharp Shoulder Pain article, including diagnosis and treatment options.
The upper back area between the shoulder blades is a common place to experience pain.
Common causes of pain here are muscle strain or poor posture but it can indicate a serious underlying medical issue.
Find Out More: Pain Between Shoulder Blades
Pain in your left arm tends to ring alarm bells and everyone’s first thought is that they might be having a heart attack. While this may be the case, there are lots of other possible causes.
Find Out More: Left Arm Pain
If there is a burning sensation in or around your shoulder there is a strong chance the pain is coming from your neck or one of the nerves that travels down your arm, even if you don’t have any pain in your neck.
In the burning shoulder pain section we look at how to tell whether the pain is coming from your neck or your shoulder so you can hone in on a shoulder pain diagnosis.
Many people with shoulder problems have difficulty getting a good night's sleep. It may be that the pain gets gradually worse during the day, that you only notice it at night or that the pain wakes you up, a particularly common problem if you to sleep on your side.
In the shoulder pain at night article, we look at the common causes, why pain typically gets worse at night and how to beat it.
Another option with shoulder pain diagnosis is to think about the associated symptoms. Often it can be really hard to pin point where the pain is originating from and it may move around. When this is the case it can help to think a bit more about how it feels e.g. burning, dull or stabbing pain, or any specific symptoms you are getting such as tinging, numbness or weakness.
Persistent Restricted Shoulder Movement: stiffness that lasts for several months often indicates a frozen shoulder
Recurrent Shoulder Dislocations: instability due to labrum tear
If your shoulder pain is fairly minor and your arm movements are not particularly limited, you can try self-managing your symptoms at home. Talk to your pharmacist about medication, try using ice or heat packs. Try to avoid any heavy lifting, but do keep your shoulder gently moving. Resting it completely can actually make things worse.
See you regular doctor if:
Seek urgent medical attention if:
Your doctor will arrange for any necessary test or scans to confirm your shoulder pain diagnosis and can then advise you on self-management or refer your on for care e.g. with a physical therapist or orthopedic surgeon.
Shoulder pain diagnosis is complex. There are a number of different structures in and around the shoulder that cause pain when they are damaged. Pain often comes and goes, moves around and fells different at different times making it difficult to accurately diagnose shoulder pain.
If you are still not sure what is causing your shoulder pain, it is definitely worth seeing your doctor. Remember, the most effective treatment comes on the back of a good shoulder pain diagnosis.
Page Last Updated: 09/09/2021
Next Review Due: 09/09/2023
British Medical Journal (BMJ) - Shoulder Pain: Diagnosis & Management in Primary Care. C. Mitchell, E. Hay & A. Carr