Shoulder Pain

Is this your symptom?

  • Pain in the shoulder

Causes

There are many possible causes of shoulder pain. Some common minor causes are:

  • Muscle overuse
  • Muscle strain
  • Muscle aches that occur with the common cold, the flu, and other viral illnesses.

Sometimes shoulder pain can be from arthritis. Arthritis means joint ("arthr") inflammation ("itis"). There are different types of arthritis. The most common type of shoulder arthritis is osteoarthritis:

  • This is also called "wear and tear" arthritis.
  • As people get older the cartilage in the joints wears down.
  • This type of arthritis often affects both sides of the body equally. The joints hurt and feel stiff.
  • Osteoarthritis is seen more often after age 50. Nearly everyone will get some wear and tear arthritis as they get older.

Other causes of shoulder pain are:

  • Biceps tendinitis
  • Bursitis
  • Cervical radiculopathy (pain from pinched nerve in neck)
  • Polymyalgia rheumatica
  • Rotator cuff tear
  • Rotator cuff tendinitis (shoulder impingement)

When Should You Seek Medical Help Right Away?

Here are some signs that the shoulder pain might be serious.

You should call 911 or go to the emergency department right away if shoulder or arm pain occurs with:

  • Chest pain lasting longer than 5 minutes
  • Trouble breathing or unusual sweating (such as sweating without exertion)

You should seek medical help right away if:

  • Signs of infection occur (such as spreading redness, red streak, warmth)
  • Rash or blisters in same area as pain
  • Joint swelling with fever occurs
  • Entire arm is swollen

Pain Scale

  • None: No pain. Pain score is 0 on a scale of 0 to 10.
  • Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
  • Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
  • Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

When to Call for Shoulder Pain

Call 911 Now

  • Similar pain before from "heart attack"
  • Similar pain before from "angina" and not relieved by nitroglycerin
  • You think you have a life-threatening emergency

Call Doctor Now or Go to ER

  • Severe shoulder pain
  • Shoulder or arm pain happens with exercise (such as while walking, goes away on resting)
  • Fever and red area of skin
  • Large red area or red streak
  • Entire arm is swollen
  • Weakness (loss of strength) in arm or hand of new onset
  • Numbness (loss of feeling) in arm or hand of new onset
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Red area of skin that is painful (or tender to touch)
  • Group of small blisters in same area as pain
  • Looks like a boil, infected sore, or other infected rash
  • You think you need to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Shoulder pain keeps you from working or going to school
  • Shoulder pain lasts more than 7 days
  • Shoulder pains off and on for weeks or months (are frequent, come and go)
  • Caused or worsened by bending the neck
  • Can't move shoulder normally
  • You have other questions or concerns

Self Care at Home

  • Mild shoulder pain
  • Caused by strained muscle
  • Caused by overuse from recent vigorous activity (such as sports, lifting, physical work)

Care Advice

Mild Shoulder Pain

  1. What You Should Know:
    • Shoulder pain can be caused by many things. Muscle aches can occur with the common cold, the flu, and other viral illnesses. Muscle strain and overuse can cause shoulder pain. Shoulder pain can also be caused by arthritis, tendinitis, or a pinched nerve in the neck.
    • The best way to treat arm pain will depend on the exact cause.
    • Here is some care advice that should help.
  2. Cold or Heat:
    • Some people find that a cold or heat pack helps with the pain.
    • Cold Pack: For pain or swelling, use a cold pack or ice wrapped in a wet cloth. Put it on the sore area for 20 minutes. Repeat 4 times on the first day and then as needed.
    • Heat Pack: If pain lasts over 2 days, apply heat to the sore area. Use a heat pack, heating pad, or warm wet washcloth. Do this for 10 minutes and then as needed. You can also take a hot bath or hot shower instead. Move the sore area under the warm water.
  3. What to Expect:
    • Muscle aches from the common cold, the flu, and other viral illness most often last just 2 to 3 days.
    • Minor muscle strain and overuse should start to get better in a couple days. The pain should go away within one week.
    • Pain and stiffness from osteoarthritis (wear and tear arthritis) can be chronic. That is, it can last weeks, months or years. Sometimes the pain can flare up and then get better after a couple days.
    • What to expect in other cases will depend on the cause of pain.
  4. Call Your Doctor If:
    • Severe pain
    • Pain keeps you from doing normal activities (such as school, work)
    • Pain lasts more than 7 days
    • Signs of infection occur (such as spreading redness, red streak, warmth)
    • You think you need to be seen
    • You get worse

Muscle Strain or Overuse

  1. What You Should Know - Muscle Strain:
    • A muscle strain occurs from over-stretching or tearing a muscle. People often call this a "pulled muscle." This muscle injury can occur while playing a sport or lifting something. Sometimes it can also occur while doing normal activities.
    • People often describe a sharp pain or popping when the muscle strain occurs. The muscle pain worsens when moving the arm.
    • Here is some care advice that should help.
  2. What You Should Know - Overuse:
    • Sore muscles are common following vigorous activity (such as sports, weight lifting, and moving furniture). This can happen when your body is not used to this amount of activity.
    • Shoulder and upper arm muscles often feel achy and sore all over.
    • Here is some care advice that should help.
  3. Apply a Cold Pack:
    • Apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes. Repeat this in 1 hour and then every 4 hours while awake.
    • Do this for the first 48 hours after an injury.
    • This will help decrease pain and swelling.
  4. Apply Heat to the Area:
    • Beginning 48 hours after an injury, apply a warm washcloth or heating pad for 10 minutes three times a day.
    • This will help increase blood flow and improve healing.
  5. Hot Shower:
    • If stiffness lasts over 48 hours, relax in a hot shower twice a day.
    • Gently move the shoulder under the falling water.
  6. Rest vs. Movement:
    • Complete rest should only be used for the first day or two after an injury.
    • Staying active helps muscle healing more than resting does.
    • Continue normal activities as much as your pain permits.
    • Avoid heavy lifting and active sports for 1 to 2 weeks or until the pain and swelling are gone.
  7. What to Expect:
    • Minor muscle strain and overuse should start to get better in a couple days.
    • The pain should go away within one week.
  8. Call Your Doctor If:
    • Severe pain
    • Pain keeps you from doing normal activities (such as school, work)
    • Pain lasts more than 7 days
    • You think you need to be seen
    • You get worse

Over-The-Counter Pain Medicines

  1. Pain Medicine:
    • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
    • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
    • Use the lowest amount of a drug that makes your pain feel better.
    • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  2. Call Your Doctor If:
    • You have more questions
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Last Reviewed: 12/11/2017 1:32:06 AM
Last Updated: 5/7/2017 1:36:17 PM

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