The shoulder is the body’s most complex and mobile joint, making it vulnerable to a range of problems at any age. Ilya Voloshin, chief of the Shoulder and Elbow Division in University of Rochester orthopaedics, notes that aging and everyday wear and tear often cause shoulder pain, though acute traumatic injuries also occur. Tendons weaken with age and repetitive use, and overuse, poor conditioning, or lack of warm-up can produce inflammation.
Acute injuries include falling, hoisting heavy objects like a grocery bag, yardwork, and sports such as tennis or golf. Pain may also be referred from nerves — for example neck arthritis or carpal tunnel syndrome — or arise from habits like sleeping on the side, lifting improperly, or poor desk posture that narrows the rotator cuff space and causes impingement.
Common diagnoses are rotator cuff disease (the most frequent), frozen shoulder, impingement, and tendonitis. Rotator cuff problems can cause sharp pain when reaching backward or to the side and a dull ache that worsens at night because the shoulder is harder to stabilize when lying down. Frozen shoulder follows reduced movement and scar tissue formation; about 80% of cases improve without surgery.
External impingement is pressure between the rotator cuff tendon and the acromion and can lead to bone spurs, while functional impingement stems from nerve issues, posture, or anatomy that narrows the subacromial space. Initial treatment often includes over-the-counter anti-inflammatories and physical therapy; cortisone injections may help. Braces are useful to immobilize fractures, dislocations, or post-surgery shoulders but are not always helpful for other problems. Seek medical care if an acute injury leaves you unable to raise your arm. If pain and loss of function persist over 4–6 weeks, MRI and surgical referral may be appropriate. Surgery is considered after failed non-operative care or for full-thickness rotator cuff tears; shoulder replacement may be an option for devastating injuries or unreparable anatomy, and it can restore motion, relieve pain, and allow easier post-op rehabilitation than some repairs.
Difficult words
- tendon — Strong tissue connecting muscle to bone.tendons
- rotator cuff — Group of shoulder muscles and tendons.rotator cuff disease, rotator cuff problems, rotator cuff tendon
- impingement — Condition where structures are pressed together.External impingement, functional impingement
- frozen shoulder — Stiffness with reduced shoulder movement.
- cortisone injection — Medicine injected to reduce inflammation and pain.cortisone injections
- scar tissue — Fibrous repair tissue after injury or surgery.scar tissue formation
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- What activities or habits mentioned in the article could increase shoulder problems, and how might you change them?
- The article says about 80% of frozen shoulder cases improve without surgery. What factors would you consider before choosing surgery or continued non-operative care?
- How could physical therapy and simple treatments reduce the need for surgery for shoulder conditions? Give examples from the article.
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