How Do I Get My Shoulder to Stop Hurting?

Reviewed on 9/21/2021

Treatment for shoulder pain depends on the cause and there are many different causes. Shoulder pain may often be relieved with rest, ice, and over-the-counter pain medications. Sometimes shoulder pain will require immobilization, physical therapy, or surgery to fix the problem.
Treatment for shoulder pain depends on the cause and there are many different causes. Shoulder pain may often be relieved with rest, ice, and over-the-counter pain medications. Sometimes shoulder pain will require immobilization, physical therapy, or surgery to fix the problem.

Shoulder pain has many possible causes. It is important to see a doctor for a diagnosis to determine the cause of shoulder pain, because treatment to get your shoulder to stop hurting depends on the cause. 

Shoulder pain may often be relieved with rest, ice, and over-the-counter pain medications; however, some causes of shoulder pain require immobilization, physical therapy, or surgery to fix the problem. In addition, some causes of shoulder pain may be referred pain from another condition, such as a heart attack or gallbladder problems. 

Causes and treatments for shoulder pain include: 

  • Shoulder dislocation
    • The ball of the upper arm bone (humerus) is placed back into the joint socket (a closed reduction) by a doctor
      • Severe pain stops almost immediately when the shoulder is put back in place
    • Rest 
    • Ice 
    • Immobilization in a sling or brace
    • Rehabilitation exercises to restore the shoulder's range of motion, strengthen the muscles, and help prevent dislocation of the shoulder again in the future. 
    • Surgery, in cases where therapy and bracing fail
  • Shoulder separation
    • Nonsurgical treatments to help manage pain
      • Sling
      • Cold packs
      • Medications can often 
    • Surgery, if pain persists or the deformity is severe
    • Rehabilitation to restore and rebuild motion, strength, and flexibility
  • Bone fracture
    • Most can be treated without surgery
      • Immobilization with a sling or shoulder immobilizer
      • Rest
      • Icing
      • Pain medications
      • Physical therapy
    • Surgery may be needed if there is a compound fracture or a bone is shifted out of place
      • Fixation of the fracture fragments with plates, screws, or pins 
      • Shoulder replacement
  • Cartilage tear
    • Rest 
    • Physical therapy
    • Anti-inflammatory medications 
    • Cortisone injections
    • Surgery may if the tear gets worse or does not improve after physical therapy
  • Rotator cuff tear
    • Nonsurgical treatment usually helps relieve pain for about 80% of patients
      • Rest
      • Sling to help immobilize and protect the shoulder 
      • Avoiding activities that cause shoulder pain
      • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve) to reduce pain and swelling
      • Strengthening exercises and physical therapy
      • Steroid injections
    • Surgery if pain does not improve with nonsurgical methods
  • Frozen shoulder
    • Generally, gets better over time, but it may take up to 3 years
    • Nonsurgical treatment
      • Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Advil, Motrin) to reduce pain and swelling
      • Steroid injections
      • Hydrodilatation, a procedure that involves gently injecting a large volume of sterile fluid into the shoulder joint to expand and stretch the shoulder joint capsule
      • Physical therapy
    • Surgery, if symptoms are not relieved by therapy and other conservative methods
  • Shoulder impingement/rotator cuff tendinitis
    • Rest
    • Activity modification
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve) to reduce pain and swelling
    • Physical therapy
    • Steroid injections
    • Surgery, if nonsurgical treatment does not relieve pain
  • Bursitis
    • Treatment for chronic bursitis includes: 
      • Reduction in activities that cause swelling
      • Immobilization 
      • Use of anti-inflammatory medications
      • Icing 
      • Cortisone injection, if the above treatments do not help
    • Treatment for infected bursitis includes: 
      • Removal of fluid with a syringe (aspiration) 
      • Antibiotics 
      • Ice, rest, and anti-inflammatory medications for swelling and inflammation
    • Treatment for traumatic bursitis includes: 
      • Removal of fluid with a syringe (aspiration) 
      • Icing and NSAIDs to help to reduce swelling
      • Compression of the bursa with an elastic bandage 
  • Osteoarthritis (degenerative joint disease)
    • Can affect any joint, including the shoulders
    • Ice or heat applied to the affected joint for short periods, several times a day
    • Medications such as NSAIDs or corticosteroid injections
    • Lifestyle modifications such as rest or a change in activities
    • Physical therapy
    • Supportive or assistive devices (such as a brace, splint, elastic bandage) 
    • Surgery, if nonsurgical treatments do not help pain 
  • Rheumatoid arthritis
    • Medications to relieve symptoms and other that can modify the course of the disease.
      • Aspirin and ibuprofen can help reduce the pain and inflammation 
      • Disease-modifying drugs such as methotrexate, sulfasalazine, and gold injections, along with biologics
      • Exercise and physical therapy
      • Joint replacement surgery 
  • Bone spurs (osteophytes)
    • Only treated if they cause pain or damage other tissues
    • Rest
    • Ice
    • Stretching
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin)
    • Corticosteroid injections
    • Surgical removal of the bone spur
  • Heart attack
    • In addition to shoulder pain, symptoms may include: include: chest discomfort, discomfort in other areas of the upper body, shortness of breath, breaking out in a cold sweat, nausea, or lightheadedness
    •  A heart attack is a medical emergency. Call 911 and get to a hospital’s emergency department right away.
  • Referred pain
    • Shoulder pain may also be a sign of problems with the gallbladder or liver
    • See a doctor for diagnosis

What Are Symptoms of Shoulder Pain?

Symptoms that may accompany shoulder pain can vary depending on the cause and may include: 

  • Deformity
  • Swelling
  • Numbness
  • Weakness
  • Stiffness
  • Bruising
  • Tenderness
  • Warmth of the affected area
  • Redness that may spread away from the affected site and go up or down the arm
  • Limited range of motion in the shoulder
  • Inability to move the shoulder or arm
  • Grinding sensation when the shoulder is moved
  • Swelling around the middle of the collarbone area
  • Sensation of something sticking up on the shoulder
  • Arm rotated outward
  • Sensation of a “dead arm”
  • Feeling of grinding, locking, or catching while moving the shoulder
  • Crepitus or crackling sensation when moving the shoulder in certain positions
  • Pain radiating from the front of the shoulder to the side of the arm
  • Sudden pain with lifting and reaching movements
  • Athletes in overhead sports may have pain when throwing or serving a tennis ball
  • Loss of strength 
  • Difficulty doing activities that place the arm behind the back, such as buttoning or zippering
  • Fever, if there is an infection, such as with infected bursitis
  • Loss of appetite and decreased energy, such as with rheumatoid arthritis
  • Signs of a heart attack may also include: chest discomfort, discomfort in other areas of the upper body, shortness of breath, breaking out in a cold sweat, nausea, or lightheadedness
    • A heart attack is a medical emergency
    • Call 911 and get to a hospital’s emergency department (do not drive yourself) if you have symptoms of a heart attack

 

How Is Shoulder Pain Diagnosed?

The cause of shoulder pain is diagnosed with a patient history and physical examination of the shoulder that may include tests to assess range of motion and strength. 

Tests used to help diagnose the cause of the shoulder pain include: 

  • X-rays
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan 
  • Ultrasound
  • Electromyogram (EMG) to evaluate nerve function
  • Arthrogram, a type of X-ray study in which dye is injected into the shoulder to better show the joint and its surrounding muscles and tendons
    • May be combined with an MRI
  • Arthroscopy, a surgical procedure that looks inside the joint with a fiber-optic camera 
  • Blood tests

SLIDESHOW

What Is Rheumatoid Arthritis (RA)? Symptoms, Treatment, Diagnosis See Slideshow

Health Solutions From Our Sponsors

Reviewed on 9/21/2021
References
https://orthoinfo.aaos.org/en/diseases--conditions/

https://www.hss.edu/conditions_shoulder-labrum-tears-overview.asp

https://www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-bursitis

https://www.uofmhealth.org/health-library/tp23002spec