Shoulder Pain Causes and When to See an Orthopedic Doctor

Shoulder pain is almost invariably due to a rotator cuff problem, impingement, bursitis, frozen shoulder, arthritis or a dislocation. Mild pain from overuse will generally resolve with a few days rest. If the pain persists for more than two weeks, wakes you up at night or restricts the range of movement of your arm then it should be seen by an orthopaedic doctor at KK Care Hospital or another trusted hospital near you.

The shoulder is the most mobile joint in the body and as such is the most commonly injured. This guide looks at the common causes, the warning signs and who you should see.

Common Shoulder Pain Causes

The shoulder is a ball and socket joint, held in place by muscles, tendons, ligaments and cartilage. Damage to any of those structures can lead to pain.

• Rotator cuff injury. The rotator cuff is a group of muscles and tendons that lift and rotate the arm. A strain or tear will result in pain when reaching upwards or lifting and weakness in the arm.
• Shoulder impingement. The rotator cuff tendons get impinged between the bones of the shoulder. This results in pain and inflammation, particularly when lifting the arm.
• Bursitis. The bursae are small fluid filled sacs which act as cushions for the joint. When they become inflamed you find even the simplest of movements are sore.
• Frozen shoulder. Adhesions form around the joint and lead to restricted movement. Stiffness develops gradually and makes simple things like dressing, combing your hair or reaching behind you very difficult.
• Arthritis (the cartilage that covers the ball and socket wears down over time) resulting in pain, stiffness and a loss of range of motion.
• Dislocation. The humerus (upper arm bone) dislocates from the socket. This results in immediate pain, swelling, bruising and in some cases numbness.
• Shoulder separation (ligaments connecting the clavicle and scapula are torn). There may be a bump on the top of the shoulder.
• Cartilage tear. An injury to the cartilage around the rim of the joint leads to catching, weakness and pain when you go over the head.

Not all shoulder aches start in the shoulder. A pinched nerve in the neck can send pain right down into the shoulder and arm. Problems with the heart and the gallbladder can also manifest as shoulder pain. That’s why it’s so important to consider the location of the pain, when it occurs and all the other associated symptoms.

Shoulder Pain Symptoms to Watch For

Symptoms vary from person to person. The most common are:

• Pain at rest or during movement
• Swelling or a visible lump
• Stiffness or inability to move the shoulder
• Muscle spasm
• Numbness or tingling in the arm or hand
• Weakness in the shoulder or arm
• Clicking or catching with movement

When Should I See a Doctor for Shoulder Pain

See a doctor if the shoulder pain doesn’t improve after a week or two of rest or if it keeps coming back. An early assessment will go a long way to preventing a minor problem becoming a long-term one.

Book an appointment with an orthopedic specialist if:

• Pain continues even after rest
• Pain is present when the arm is at rest or disturbs your sleep
• Pain increases with movement or keeps getting worse
• You feel numbness, tingling, or weakness down the arm
• You can see swelling, a lump, or a change in the shape of the shoulder
• You cannot lift your arm or do daily tasks like dressing or lifting a bag
• Pain began after a fall, accident, or sports injury

Go to the Emergency Room Immediately If

• Shoulder pain comes with chest pain or pressure, sweating, nausea, or shortness of breath
• The shoulder looks out of place after a fall or accident
• You have severe pain with fever, redness, and a hot, swollen joint
• You cannot move the arm at all after an injury

Left shoulder pain with chest discomfort can be a sign of a cardiac issue. Don’t just wait it out.

What Doctor to See for Shoulder Pain

For the vast majority of shoulder problems the right doctor is an orthopaedic surgeon. Orthopaedic surgeons are the specialists who are trained in the treatment of bones, joints, tendons, ligaments and muscles. They are in a position to diagnose the cause of the shoulder pain and can offer treatments which a GP may not be in a position to offer.

If you are unsure who to see for shoulder pain, this table helps:

Doctor	Best for
General physician	First check for mild pain, and referral if needed
Orthopedic doctor	Rotator cuff tears, frozen shoulder, arthritis, dislocation, persistent pain
Physiotherapist	Rehabilitation, strength, and mobility after diagnosis
Emergency or cardiology care	Shoulder pain with chest pain or breathlessness
Spine specialist or neurologist	Neck-related pain with arm numbness or tingling

If you’re wondering what type of doctor to see for shoulder pain that’s been going on for more than a couple of weeks, you want to see an orthopaedic doctor. You don’t necessarily need a referral to get an appointment with one. At KK Care Hospital, you can also consult the shoulder specialist in Pimpri Chinchwad at our dedicated Shoulder Clinic.

What to Expect at Your Orthopedic Appointment

Your first visit will be a full assessment to establish the cause of your pain. This will normally involve:

• Medical history. When did the pain start? What makes it worse? Any previous injuries?
• Physical examination: your doctor will check for tenderness, strength and stability.
• Range of motion tests (you move your arm in all different directions to find where the pain or stiffness starts).
• Imaging if required. X-rays will show the bones, an MRI will show the soft tissue (tendons, cartilage etc).

Wearing a loose or sleeveless top makes the examination easier. Please bring any previous scans or reports.

Shoulder Pain Causes and Treatment Options

Treatment will depend on the aetiology and severity. Most people will initially be managed with non-surgical care.

• Rest, ice and pain relief. A short period of rest and the use of anti-inflammatory medication (as prescribed by your doctor) will help to control the early inflammation.
• Physiotherapy (stretching and strengthening exercises) to restore movement and support the joint is the main form of treatment for impingement and frozen shoulder.
• Injections. Cortisone injections into the joint or into the surrounding tissue can be used to reduce pain and inflammation when other measures have failed.
• PRP therapy (platelet-rich plasma) uses your own blood platelets to promote the healing of injured tendons and soft tissue. Your doctor will decide whether it’s appropriate for your particular situation.
• Shoulder arthroscopy. A minimally invasive procedure which uses a small camera to look inside the joint and repair the tissue. Smaller incisions generally lead to less scarring and a faster recovery.
• Shoulder replacement (reserved for severe arthritis or major joint damage where other options have failed to provide relief).

Frequently Asked Questions

Q: What are the most common causes of shoulder pain?

A: Rotator cuff injuries, impingement, bursitis, frozen shoulder, arthritis and dislocations are the commonest causes. Neck problems and referred pain from other organs can also be the cause.

Q: Who should I see for my shoulder pain?

A: Start with an ortho if the pain is ongoing or due to an injury. For mild pain a GP can look you over initially and refer you on if appropriate.

Q: When should I see a doctor for shoulder pain?

A: If the pain persists for more than one to two weeks, gets worse, interferes with sleep or is accompanied by weakness, numbness or swelling then you should see a doctor. Get to an emergency department if it’s associated with chest pain.

Q: Can shoulder pain just go away on its own?

A: Mild strains will often settle with rest and some gentle movement. Pain due to a tear, frozen shoulder or arthritis will generally require assessment and treatment by a doctor.

Book a Shoulder Pain Consultation at KK Care Hospital