Patient guides › Musculoskeletal pain
Shoulder Pain: Specialist Summary
The most common causes of shoulder pain are rotator cuff (shoulder tendon) problems such as wear or tears, impingement syndrome, frozen shoulder and arthritis; pain referred from the neck can also be felt in the shoulder. The right treatment depends on identifying the source of pain through examination and, when needed, ultrasound or MRI. Many shoulder problems can be managed with exercise-based physical therapy and medication or injection options.
When to see a doctor
- Pain lasting several weeks, waking you at night or limiting arm elevation
- Shoulder movement becoming increasingly restricted and stiff
- Emergency (red flags): deformity or complete inability to lift the arm after a fall or injury; redness, warmth and fever of the shoulder (joint infection); left shoulder or arm pain with chest pain, shortness of breath or sweating (may be cardiac, call emergency services)
- Numbness or weakness in the arm, which may originate from the neck or nerves
Treatment options
- Conservative: activity modification, appropriate pain medication
- Physical medicine and rehabilitation: shoulder and shoulder blade stabilisation exercises, stretching, manual therapy and physical modalities when needed
- Injections: ultrasound-guided intra-articular or subacromial injections and nerve blocks in selected patients
- Surgery: for traumatic full-thickness tendon tears, recurrent dislocations, or conditions not responding to adequate conservative treatment
Surgery or not? A tear on imaging is not by itself a reason for surgery; degenerative tears, especially in older people, can often be managed with exercise. When unclear, age, tear type, weakness, functional goals and response to treatment are considered together, with orthopaedics when needed.
Frequently asked questions
Does frozen shoulder go away by itself? The pain may partly settle over time, but the risk of lasting restricted movement is high and the process can be long; treatment helps with pain and movement.
Can shoulder pain come from the neck? Yes; examination and, when needed, MRI or EMG help distinguish the source.
Do injections damage the tendon? Repeated steroid injections should be planned carefully; frequency is decided by your doctor.
Sources
Turkish version: doktorfizik.com/rehber/omuz-agrisi/