The shoulder is a complex joint made up of ligaments, tendons, and muscles. Sustaining damage to any of these tissues can result in pain.
Persistent, or chronic, shoulder pain can interfere with a person’s day-to-day activities and quality of life.
This article describes the various causes of chronic shoulder pain and their associated treatment options. It also outlines some exercises that people can perform to help alleviate chronic shoulder pain.
The shoulder is a complex joint that allows for a wide range of movement. However, this complexity makes it susceptible to damage from overuse and injury.
Pain can occur as a result of sustaining damage to any of the structures inside the joint, including the:
- muscles
- tendons
- ligaments
- bones
- cartilage
The term “chronic shoulder pain” refers to shoulder pain that has persisted for longer than 6 months. The pain may be constant, or it may only be present when the shoulder joint is moving.
The treatment options for chronic shoulder pain vary somewhat according to its cause. The sections below outline some potential causes and their associated treatments.
Bursitis
A person who has bursitis of the shoulder may experience the following symptoms:
- a dull, aching pain in the shoulder joint
- swelling, flushing, or tenderness of the shoulder joint
- increased pain when moving or pressing on the joint
Treatment
Treatment for bursitis involves allowing the inflamed bursa to heal. Some other treatment options include:
- resting
- gently stretching
- taking nonsteroidal anti-inflammatory drugs (NSAIDs)
- taking corticosteroids
- taking antibiotics (rare)
- undergoing surgery (rare)
Tendinitis
The term “tendinitis” refers to inflammation of a tendon. The most common form of shoulder tendinitis is rotator cuff tendinitis.
Treatment
Overuse is the most common cause of tendinitis. Treatment can take up to several months and typically involves a combination of the following:
- resting
- modifying normal activities
- taking anti-inflammatory medications
- undergoing physical therapy
- taking corticosteroids
In severe cases, a doctor may recommend surgery. Postsurgical rehabilitation takes time, and complete pain relief may take up to a year.
Tendon tear
Sometimes, a tendon can tear as a result of overuse or acute injury. Common tendon tears of the shoulder area include rotator cuff tears and bicep tendon tears.
Treatment
Treatment for a tendon tear may involve the following:
- applying ice
- taking NSAIDs
- resting the shoulder joint
- undergoing physical therapy
- receiving corticosteroid injections
- undergoing surgery
Injury to the shoulder joint
Shoulder pain can sometimes occur due to a dislocation, a fracture, or another acute injury to the shoulder joint.
Treatment
Treatment for an acute shoulder injury varies depending on the type of injury and its severity.
Some injuries heal on their own. However, surgery may be necessary if the damage is significant or there are torn ligaments that require repair.
Nerve problems
A pinched nerve occurs when a nerve becomes compressed by its surrounding tissues, such as bones, cartilage, or tendons.
Treatment
Some treatment options for a pinched nerve include:
- undergoing physical therapy
- taking pain-relieving medications, such as NSAIDs or corticosteroids
- wearing a cervical collar, to reduce neck movement and prevent further nerve irritation
- undergoing surgery
Arthritis
Two types of arthritis may affect the shoulder and other joints in the body: osteoarthritis and rheumatoid arthritis.
Treatment
Treatment for arthritis of the shoulder usually involves the following:
- resting
- avoiding activities that cause or exacerbate pain
- taking NSAIDs, to alleviate pain and inflammation
- receiving corticosteroid injections into the joint, to temporarily alleviate pain and inflammation
- applying ice or moist heat to the affected joint several times per day
- doing some light exercises, to help manage pain
If the arthritis is severe, a doctor may recommend debridement or joint replacement surgery.
Some people take supplements to treat joint pain, but there is limited evidence to suggest that they are effective for this purpose.
Tumors
Chronic shoulder pain can sometimes occur as a result of a growth within the structures of the shoulder. Such growths may be either
Treatment
Treatment for a tumor within the shoulder depends on whether or not it is cancerous.
Benign, slow growing tumors may not require any treatment. However, a person who has a cancerous tumor may require chemotherapy, radiation therapy, or a combination of these treatments.
A physical therapist can determine which exercises are appropriate for a particular injury.
Below are several exercises that could help improve shoulder strength and mobility.
People who experience severe pain while performing any kind of strengthening or mobility exercise should stop performing it immediately.
Shoulder stretch
Below are some instructions for performing a shoulder stretch:
- Stand up straight.
- Raise the shoulders and hold the position for 5 seconds.
- Squeeze the shoulder blades back and together and hold the position for 5 seconds.
- Pull the shoulder blades downward and hold the position for 5 seconds.
- Relax the shoulders.
A person should repeat these steps 10 times.
Crossover arm stretch
Below are some instructions for performing the crossover arm stretch:
- Using the left hand, grip the area above the elbow of the right arm.
- Gently pull the right arm across the chest, as far as feels comfortable.
- Hold the stretch for 30 seconds.
- Relax for 30 seconds.
- Repeat these steps with the opposite arm.
When performing this exercise, it is important that a person does not pull or put pressure on the elbow itself.
Standing row
The standing row exercise requires the use of a 3-foot-long elastic resistance band with the ends tied together.
Below are some instructions for performing this exercise:
- Attach the loop to a doorknob.
- Hold on to the loop with the right hand.
- Bend the right elbow, keeping the right arm close to the right side of the body.
- Slowly pull the elbow straight back, squeezing the shoulder blades together while doing so.
- Slowly return to the start position.
A person should repeat three sets of eight repetitions on each arm.
Scapula setting
A person performs this exercise while lying face down on the floor. Propping a pillow beneath the forehead can help reduce any discomfort.
Below are some instructions for performing this exercise:
- Lie on the stomach, holding the arms by the sides of the body.
- Gently draw the shoulder blades together and down the back, as far as feels comfortable.
- Ease halfway off from this position, and hold for 10 seconds.
- Relax.
A person should repeat these steps 10 times.
Rest and recovery are essential to prevent shoulder pain from becoming chronic. Continuing to use an irritated shoulder joint can exacerbate the underlying issue and prolong the pain.
Performing gentle exercises may help strengthen the shoulder joint and prevent further injury. However, a person should ask their doctor or physiotherapist for individual advice on which exercises to perform and which to avoid.
A person who experiences chronic shoulder pain, or any type of chronic pain, should see a doctor as soon as possible.
A doctor should assess any pain that impedes a person’s normal activities or reduces their quality of life.
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The shoulder is a complex joint made up of various muscles, tendons, and ligaments. However, this complexity means that the tissues of the shoulder are susceptible to damage.
There are many potential causes of chronic shoulder pain. A person who experiences chronic shoulder pain should see a doctor for diagnosis and appropriate treatment.