Written By: Chloe Wilson BSc (Hons) Physiotherapy
Reviewed By: SPE Medical Review Board
A shoulder pain diagram is a really useful tool when it comes to working out what is causing your pain. There are lots of different structures around the shoulder from bones to tendons and labrums to bursa.
Damage to any one of these structures can cause shoulder pain. Knowing what typically causes pain in which area of the shoulder, neck and upper arm makes it much easier to work out what is wrong, so we've devised some shoulder pain diagrams to help.
You'll find four different shoulder pain diagrams here:
These shoulder pain diagnosis charts will help you identify what is causing your pain and then you can find out the best ways to treat it and stop the pain from coming back.
The front shoulder pain diagram focuses on shoulder problems that cause pain on the front and side of the shoulder and upper arm.
Shoulder bursitis is when there is inflammation of one the small fluid-filled sacs, found at various locations around the shoulder. The pain typically develops slowly and gets worse when lifting the arm above head height. LEARN MORE >
A SLAP Tear is where there is damage to the upper portion of the ring of cartilage that lines the shoulder joint, usually from a fall or with repetitive overhead activities. LEARN MORE >
With a rotator cuff tear there is damage to one or more of the four rotator cuff tendons that support the shoulder. Rotator cuff tears are usually caused by gradual wear and tear from repetitive friction, but can occur suddenly from a fall or heavy lifting. LEARN MORE >
A fracture anywhere towards the top of the upper arm bone is known as a proximal humerus fracture. These fractures are normally the result of a fall onto an outstretched arm or a car accident as it takes a great deal of force to break the bone, so you will know you've done something. 75% of proximal humeral fractures affect people over the age of 60. LEARN MORE >
A Bankart lesion is where there is a tear in the bottom part of the labrum, the ring of cartilage found around the shoulder socket. It typically occurs when the shoulder dislocates and is a common cause of ongoing shoulder instability. LEARN MORE >
Also known as adhesive capsulitis, around 3% of the population will suffer from a frozen shoulder, usually between the ages of 40-70 and in the non-dominant hand. Symptoms get gradually worse starting with pain and progressing to severely restricted shoulder movement. It can take months to recover without the correct treatment. LEARN MORE >
Degeneration of inflammation of the biceps tendon is known as biceps tendonitis. It typically affects athletes between the ages of 18-35 and non-athletes over the age of 65 and often develops alongside other shoulder problems. Pain from biceps tendonitis typically gets worse with overhead activities, lying on your side or with any pressure through the tendon and there may be a snapping sound with arm movements. LEARN MORE >
Shoulder impingement syndrome occurs when one or more of the structures gets repeatedly squashed between the shoulder bones. It usually develops gradually due to repetitive wear and tear of the bones and/or soft tissues but can occur suddenly with an injury. The classic feature of shoulder impingement is a painful arc of movement and there may be associated weakness. Impingement syndrome is one of the most common causes of shoulder pain. LEARN MORE >
A clavicle fracture can cause pain anywhere along the collarbone, as shown in the front shoulder pain diagram. The clavicle is the most frequently broken bone in the body, usually from a fall, motor vehicle accident or a direct blow. Other possible causes of collarbone pain include ligament damage, bone infections and osteolysis. LEARN MORE >
Neural problems are a very common cause of shoulder and arm pain. Nerve problems typically cause a burning, sharp, shooting pain anywhere from the neck down the arm and may extend all the way to the hand. There are often changes in sensation such as tingling and numbness and there may be weakness in the arm. LEARN MORE >
Brachial neuritis is a rare condition caused by inflammation of a group of nerves known as the brachial plexus that control the shoulder and arm. Brachial neuritis usually develops very quickly, often at night, causing intense shoulder and arm pain. It can affect people at any age but is most common in young/middle aged adults. LEARN MORE >
Injuries to the sternoclavicular joint are a rare cause of collarbone pain, where the clavicle joins with the sternum (breast bone). It usually takes a considerable force to damage the joint and as well as pain, there is often a visible lump where the collar bone has shifted out of place. LEARN MORE >
The acromioclavicular joint sits between the collar bone and the shoulder and is supported by four strong ligaments. Damage to any of these ligaments or wear and tear of the bones can lead to pain over the ACJ as shown in orange on the shoulder pain diagram. LEARN MORE >
Supraspinatus tendonitis is a common cause of shoulder pain causing a deep aching, burning pain at the top and front of the shoulder which may radiate down the upper arm as shown on the shoulder pain diagram. It often causes a sharp catching pain when lifting the arm and limits overhead activities. LEARN MORE >
The most serious cause of left arm pain is a heart attack. The classic symptoms of a heart attack are intense chest pain and tightness which may radiate down the left arm, shortness of breath, rapid pulse and feeling nauseous. If you suspect you are having a heart attack you should seek medical attention immediately.
A break in the long middle section of the upper arm is known as a mid-shaft humerus fracture. Fractures here are typically due to high-energy injuries in younger people e.g. sporting tackle or RTA and low-energy injuries in the over 60's e.g. a fall. LEARN MORE >
Our next shoulder pain diagram focuses on problems around the back of the shoulders and the shoulder blades. There is some overlap with some of the conditions we've already looked at the can refer pain down the side and back of the arms as well as the front.
Straining the upper trapezius muscles is a common cause of pain across the top part of the back of the shoulders. You may have overworked the muscles doing heavy lifting or playing racket sports or may store tension in your upper traps if you spend all day in-front of the computer. LEARN MORE >
Neck problems often refer pain down across the back of the upper shoulder region. There may be wear and tear in some of the neck bones, arthritis or disc degeneration. If your shoulder pain gets worse when you move your head, the problem may actually be in the neck rather than the shoulder. The pain may refer across both shoulders. LEARN MORE >
Pain between the shoulder blades, particularly in the upper thoracic region is often linked with poor posture. This is very common in people who work on a computer all day and in tall people who have a tendency to stoop, but there are some really simple things you can do that can make a big difference. LEARN MORE >
Overloading the trapezius muscles is another common cause of pain between the shoulder blades. Heavy lifting, repetitive overhead work, carrying heavy bags, stress and muscle weakness often trigger pain in this region. LEARN MORE >
Problems in the upper spine (cervical and thoracic region) are a common cause of upper back pain. There may be wear and tear of the vertebrae, narrowing of the neural canals, abnormal spine curvature, disc degeneration or spinal damage. LEARN MORE >
Pain between the shoulder blades can be a sign of an underlying medical issue. The most serious is an aortic dissection where there is a tear in one of the major heart vessels which causes immediate, severe pain. Upper back pain after eating may be a sign of gall bladder disease. LEARN MORE >
A tear in one of the rotator cuff muscles often causes pain down the outer side of the shoulder and part way down the arm. There may be an acute tear after an injury or heavy lifting, or a degenerative tear from repetitive wear and tear. LEARN MORE >
Shoulder impingement syndrome can also cause pain down the outer part of the arm and can be quite diffuse. There may be primary impingement from wear and tear or congenital bony abnormalities or secondary impingement due to shoulder instability. LEARN MORE >
A frozen shoulder typically causes pain all around the shoulder, front and back. Initially pain is worse with any shoulder movements but after a while the main problem becomes stiffness and restriction rather than pain. Frozen shoulders typically only cause pain in one shoulder. LEARN MORE >
People typically think of heart attacks causing a crushing pain in the front of the chest, but actually the pain may be more in the back of the shoulder and between the shoulder blades, particularly in women. If your shoulder blade pain is severe or is accompanied by shortness of breath, rapid pulse, sweating or fatigue, seek medical attention immediately. LEARN MORE >
Also known as Upper Thoracic Syndrome, T4 syndrome a rare condition that causes a complex combination of symptoms including thoracic pain which may radiate across the shoulder blades and down one or both arms, headaches, stiffness and muscle spasms. The main focus of pain tends to be at the T4 vertebra as shown on the shoulder pain diagram but can extend out further. LEARN MORE >
Small, tight bands of fascia known as trigger points can cause pin point areas of pain around the shoulder. They tend to be extremely sensitive to touch and cause a deep, dull aching pain. Trigger points are particularly common in the upper and middle trapezius muscle fibers. LEARN MORE >
Also known as Snapping Scapula Syndrome, scapulothoracic bursitis is one of the more rare causes of shoulder blade pain. It develops when there is a problem with how the shoulder blade moves over the rib cage. It causes a constant, dull ache in the shoulder blade and people often notice a grinding or snapping sensation with arm movements. LEARN MORE >
It takes a great deal of force to break the scapula and there are almost always other associated injuries such as broken ribs and spinal injuries. Scapular fractures are usually the result of high speed impacts such as MVA's or falling from a great height. LEARN MORE >
Certain lung conditions can also refer pain to the shoulder blade region which may be associated with shortness of breath. The most common are a pneumothorax, pleurisy and pancoast tumours. LEARN MORE >
Nerve damage can cause pain anywhere from the neck, down the back of the arm and sometimes all the way to the hand as shown on the posterior shoulder pain diagram. There may be a problem in the nerve itself or the nerve may be getting squashed by other structures such as the spinal vertebra and discs, or irritated by inflammatory chemicals. Shoulder and arm pain from nerve damage is typically associated with altered sensation and weakness. LEARN MORE >
Elbow pain is a common problem which may or may not be linked to problems further up the arm or in the shoulder.
There may be inner elbow pain, outer elbow pain or pain at the front or back of the elbow. The pain may be confined to the elbow, or may spread further down the arm, and in some cases, into the hand.
If your pain is further down the arm, visit the elbow pain diagnosis section which has various elbow pain diagnosis charts to help you work out what is wrong.
Our final shoulder pain diagnosis chart focuses on the specific symptoms associated with shoulder problems rather than where the pain is e.g. there may be strange symptoms such as clicking, grinding or tingling, or the pain may get worse at night or when you lie on your side.
Now shoulder pain can be a tricky one as it is often difficult to pinpoint where the pain actually is. Shoulder pain can be quite diffuse and it may feel like the whole shoulder aches all the way down the arm.
Common symptoms that can help you work out what is wrong include:
Often, the problem isn't actually coming from the shoulder at all, it is actually coming from the neck. A quick way to tell is to think about whether your shoulder pain gets worse when you move your head or your arm. If it gets worse when you move your head, check out the Nerve Pain article.
Hopefully by looking at our shoulder pain diagram and diagnosis charts you have a clearer idea of what is going on in your shoulder. You can find out loads more about each condition including the causes, treatment options and recovery process by looking at the relevant article.
If you want to look at a specific area in a bit more depth, choose from the following:
And remember, the shoulder pain diagram and diagnosis charts here are not a substitute for medical advice. If you are not sure whether you need to see your doctor, have a look at our handy guide.
Page Last Updated: 12/14/2022
Next Review Due: 12/14/2024
December 14, 2022
Diagnose Your Pain
November 3, 2022
February 2, 2022
1. NHS UK: Shoulder Pain
2. British Medical Journal - Shoulder pain: diagnosis and management in primary care. Caroline Mitchell, Ade Adebajo, Elaine Hay and Andrew Carr