Shoulder pain that limits what you can reach for

Shoulder pain can make getting dressed, reaching a shelf or sleeping on that side a struggle. It can come from the shoulder joint, a tendon, a nerve in your neck or something else, so we start by finding which movements hurt and where the problem seems to start. At our Clarksville office, we'll explain what we find before we recommend any shoulder pain treatment.

When does shoulder pain need urgent medical care?

Some shoulder pain needs medical care, not an appointment with us. Get urgent medical care for any of the warning signs the NHS lists for shoulder pain: sudden or very bad shoulder pain, an arm or shoulder that's changed shape, marked swelling, an arm you can't move, an arm or shoulder that's hot or cold to the touch, pins and needles that don't go away, no feeling in your arm or shoulder, pain that started after an injury or accident like a fall, severe pain in both shoulders, or pain with a fever or feeling unwell.

Shoulder or arm discomfort that comes with chest pain, shortness of breath, sweating or nausea can signal a heart attack. That's an emergency. Call 911.

Common shoulder problems, and what the names mean

Several shoulder problems feel alike. These are the names you may hear after an exam.

Term	What it means
Rotator cuff tendinitis, bursitis, or impingement	Problems with the shoulder tendons or the nearby bursa can make lifting the arm painful.
Rotator cuff tear	A tendon may tear from an injury or from wear over time. Weakness and pain can come with it.
Instability or dislocation	The top of the upper arm bone may slip partly or completely out of its socket. Repeated episodes need assessment.
Arthritis	Changes in the joint can cause pain and stiffness. Treatment depends on the type and how severe it is.

The AAOS, the orthopedic surgeons' association, describes each of these as a separate problem.

And a few more:

• Frozen shoulder: the joint capsule thickens and stiffens, so it won't move far, even when someone else moves it.
• Calcific tendinitis: calcium deposits build up in a rotator cuff tendon and can cause considerable pain and restricted movement.
• AC joint injury or separation: the ligaments where the collarbone meets the shoulder can be stretched or torn.
• Labral tear: damage to the rim of cartilage around the socket can cause catching, locking, pain or weakness, though other problems cause them too.
• Biceps tendon tear: the tendon that attaches the biceps at the shoulder can tear partly or all the way through. A sudden pop, bruising or a change in the muscle's shape needs to be checked.

Can shoulder pain come from the neck?

Yes. Cervical radiculopathy means a nerve root in the neck is irritated or compressed, and it can cause shoulder or arm pain with numbness, tingling or weakness. Our exam looks for that pattern, to help tell it apart from a shoulder problem.

The two can hurt in the same spot, so where it hurts, or a symptom list online, can't settle which one is behind yours. Our neck pain and arm or leg symptoms pages go deeper.

What happens at a shoulder pain exam?

We'll start with how it began, which movements hurt, and what's gotten weaker or harder to do. Then we look at the shoulder and the neck: at how the joints move, where muscles are tight, and for signs of an irritated nerve. If it points to something we don't treat, or to a problem that needs medical care, we'll tell you and refer you.

What are the treatment options for shoulder pain?

Imaging answers specific questions: X-rays show bone, and MRI and ultrasound can look at soft tissue. The next step depends on the diagnosis, and the options the AAOS describes include activity changes, rehabilitation, medication discussed with a medical professional, or specialist treatment. Some tendon tears and repeat dislocations may need a surgical opinion.

Any adjustment we recommend is based on what the exam found, and we'll go over those findings with you first. The alternatives are the options above, from activity changes and rehabilitation to a surgical opinion. Spinal manipulation can cause soreness or a headache afterward, and serious neurological complications have been reported, although how often they happen is uncertain.

Planning shoulder pain treatment around your goals

We'll talk about what you want to get back to, like reaching the top cupboard or getting through a shift at work, and build the plan around it. Our work injury page covers pain that started on the job. If we are not able to help you with your problem or are unable to reduce your pain levels, we will make sure to give you a recommendation to another experienced provider. You don't need to know if it's your shoulder or your neck; looking into that is our job.