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The Complete Guide to Shoulder Pain and the Treatment Options

Shoulder pain is a common yet debilitating problem. It can range from mild aches and pains to more severe injuries such as impingement syndrome (ruptured tendons in the rotator cuff), fracture, or dislocation. In addition to acute injury, shoulder problems can also be caused by overuse. Other causes of shoulder pain include arthritis, fibromyalgia, and emotional trauma; while they may affect other joints in your body as well, they are most commonly found in your shoulders and upper back.

Pain in the shoulder is often attributed to many different factors, including overuse, lateral instability, repetitive movements, and poor posture. Despite numerous theories, the root cause of shoulder pain is generally believed to be a complex combination of muscle imbalance and nerve irritation (often referred to as ‘pathomechanics’). The following sections will look at each of these contributing factors.

Different Types of Shoulder Pain

Muscle Imbalance

Muscle imbalance is a common cause of shoulder pain. The shoulder is a complex muscle system consisting of two opposing shoulder muscles, the front deltoid, and the back trapezius. When these muscles are abnormal, they may press on different nerves or tissues, resulting in pain. An imbalance between the two muscles can be called ‘avascular impingement’ or ‘subacromial impingement.’ These conditions contribute to pain in the shoulder, especially in overhead movement.

Repetitive Movements

Repeated movements of the shoulder often result in pain. This can be attributed to overuse or a pattern of repetitive stress placed on tendons, muscles, or nerves.  Overuse can result from a lack of awareness about symptoms and signs related to repetitive movements. For example, activities that require the shoulder more than others may be completed without proper evaluation of symptoms and signs.

Lateral Instability

Shoulder instability can result from a sudden injury or the development of a degenerative condition resulting in dislocation or subluxation. The absence of muscle balance around the shoulder can predispose an individual to both conditions. Overuse or misuse of muscles, joints, and nerves may contribute to this type of trauma.  Subluxation is often a precursor to surgery and may require treatment before, during, and after.

Postural dysfunctions

Awkward positions and prolonged periods in one position may cause neck and shoulder pain development. Poor posture may result from several factors, including occupation, lifestyle, age, or weight. Many people are not aware that the way they sit, stand, or sleep can cause abnormal strain on their neck and shoulders.

Muscle spasm

Muscles naturally become tight over time from holding positions that are repeated. This frequently occurs due to the repetitive strain that occurs from overuse. When a muscle becomes tight, it cannot perform typically, resulting in pain. The muscles may also become tight from increased workload or speed of movement. Muscle spasms may result from overuse, repetitive stress, poor posture, or other causes.

Strained nerves

Shoulder pain can be caused by irritation of nerves that supply the shoulder muscles with input. Two primary nerves can be irritated from overuse. They are the anterior and posterior deltoid nerves. The anterior deltoid nerve supplies the front side of the shoulder. The posterior deltoid nerve supplies the backside of the shoulder and can cause pain on both sides if irritated.

Different Types of Treatments Available

Immediately after a shoulder injury occurs, treatment focuses on clearing out any injured tissues and repairing the underlying ligaments, tendons, or nerves. Once an injury has healed, the focus turns to ttreatmuscular imbalance or nerve irritation to prevent the recurrence of shoulder pain.

Immediate Treatment

The first step after a shoulder injury is to make sure that there is no further damage to the joint or torn ligaments. This could occur if the shoulder were dislocated before treatment. Most shoulder injuries will not require surgery, and therefore, immediate treatment should focus on restoring healthy shoulder function.

Secondary Treatment

Once the injury has healed, addressing any muscle imbalance or nerve irritation is essential to prevent future injury or pain. Several common treatments can be successful in correcting these conditions.

Neurolytic therapy

Neurolytic therapy utilizes an electrical current or an anesthetic cream to stimulate pain receptors. The procedure iis usuallyperformed by a physiotherapist. The benefits of this treatment include patient satisfaction, reduced pain, and improved range of motion.

Electrical stimulation

This is currently the most often used method for treating shoulder pain and range of motion limitation. It is also used in active stretching programs to increase flexibility in injured muscles.

Intra-articular dry needling uses a dry needle to treat pain points within the joint. It can be used in conjunction with joint mobilization.

Laser therapy

This is used to treat muscle or nerve pain. It is often used in combination with other modalities of treatment.


This treatment utilizes sound waves at a specific frequency to induce tissue repair and decrease inflammation. It can be combined with other treatments for better results.

How to Tell if You Need a Doctor for your Shoulder Pain

If you have sustained a shoulder injury, it is essential to seek medical attention. In the following sections, we will look at the many reasons you should see your doctor after a shoulder injury.

Physical Signs of Shoulder Pain

Grip Strength

If you cannot grasp an object with both hands and a tingling sensation accompanies the pain, you may be experiencing nerve irritation. You may also experience muscle weakness, numbness, or pain in your arms and hands.

Shoulder Instability

This is the inability to hold your shoulder in a stable position for a prolonged period. If the shoulder does not remain in a stable position, it will shift around and cause pain. 


If you are experiencing pain and tingling, you have developed nerve irritation. This could be radiating down your upper arm and into your hand. This sensation is similar to electric shock sensations patients may experience after certain surgeries.

Range of motion problems

Limited shoulder motion can result from several different shoulder injuries. If pain occurs as your shoulder is moved into various positions, you may be experiencing structural damage.


Numbness in the arm or hand indicates that there may be nerve irritation and possibly a more severe injury. 

Fatigue and weakness

If you are suffering from these symptoms, you may have developed inflammation in the muscles surrounding the area.

How to Use Home Remedies and Nontraditional Treatments for Shoulder Pain

Different types of treatment are used to treat shoulder pain. One very unconventional method is to treat the problem from the outside. If you have tried several traditional treatments and have not had success, you may want to try this alternative.

Massage Therapy

In general, massage therapy can be beneficial for many people suffering from shoulder pain. It is that massage stimulates circulation in your muscles and tendons while also decreasing inflammation and muscle spasm. It also boosts the immune system and gives your body a chance to rest.

As a general rule, massages should be performed two times per day. However, how frequently you receive massage therapy depends on how severe your shoulder pain is. This type of care is most beneficial for treating muscle tension and spasm in most cases. Starting with more frequent massages will provide better results than doing less frequent ones.

Hot/Warm Compress

If you are experiencing inflammation and stiffness, a hot or warm compress can provide relief. Heat can loosen the muscles, while cold or cooling compresses can decrease inflammation. The combination of both is optimal. Apply heat for 15-20 minutes, followed by a cold for 20 minutes.

Use heat and cold in the following way: 2 minutes with warm heat (use a heating pad), 2 minutes of gentle movement, followed by 2 minutes with ice (wrapped in a towel). Then repeat ten times.

Shoulder Strap

A shoulder strap can help alleviate shoulder pain by decreasing the amount of stress placed on your shoulder. Wearing a strap is one of the most common treatments for rotator cuff injury or impingement.  It can also be used for anyone with arthritic conditions and recovering from surgery. The strap can reduce swelling and provide stability to the shoulder joint.

In conclusion, shoulder pain can cause several problems in your daily life. You may be unable to work out or engage in your favorite activities. In the most severe cases, shoulder pain can cause disability. Many different treatments have been proven to help treat shoulder pain successfully, do not wait any longer, and many different treatments have