What causes shoulder pain?

The most common cause of shoulder pain is tendinitis, affecting one of the four tendons contributing to shoulder stability and forming the rotator cuff.

Pain intensity varies. It can be mild discomfort with specific movements, affect all movements, or be constant, even at rest.

The shoulder is one of the body's most complex joints, its function complicated by its five different joints.

It's prone to stress and trauma, in sports and daily life. Most arm movements involve the shoulder, connecting the humerus, scapula, and clavicle.

Supplied by the brachial artery with significant blood flow, the shoulder is pain-sensitive, with diverse causes.

Types of shoulder pain

Left shoulder pain

Left shoulder pain presents these symptoms:

• Outer pain often involves the rotator cuff, caused by bursitis or tendinitis;
• Posterior pain can involve the trapezius muscle; sometimes caused by bursitis or muscle contracture;
• Anterior pain can result from tendinitis or impingement syndrome, often from biceps joint problems;
• Upper pain generally involves muscles, cartilage, or ligaments and may be inflammatory;

Right shoulder pain

Similarly, right shoulder pain can present:

• Outer pain often involves the rotator cuff, caused by bursitis or tendinitis;
• Posterior pain may involve the trapezius muscle; sometimes due to bursitis or muscle contracture;
• Anterior pain can result from tendinitis or impingement syndrome, often from biceps joint problems;
• Upper pain generally involves muscles, cartilage, or ligaments and may be inflammatory;

A specialist can usually determine the cause of pain and movement difficulty through simple tests.

Multiple causes may contribute to the pain.

Shoulder pain at night

Shoulder pain at night is common, sometimes resolved with anti-inflammatory drugs without specialist intervention.

It can indicate tendon or soft tissue problems, possibly linked to neck problems.

Identifying the exact cause of shoulder pain isn't always easy, as any imbalance in the stabilizing elements (tendons, ligaments, muscles) can cause pain.

Shoulder pathologies

Shoulder impingement syndrome

Pain originates from supraspinatus muscle tendon compression during arm elevation and return.

Raising the arm beyond a certain angle narrows the space between the humeral head and acromion, where the subacromial bursa protects the rotator cuff tendons.

This syndrome can progressively thin tendons, leading to rupture. Early diagnosis is important.

Calcific tendinitis

Calcific tendinitis involves progressive calcification deposition in tendons. While often asymptomatic, it can become extremely painful.

Mild cases can resolve spontaneously, but treatment is often necessary for intense or continuous pain, or risk of tendon damage.

Rotator cuff tear

A frequent cause of shoulder pain and upper limb dysfunction in adults. It can result from trauma, wear and tear from manual work or sports, or poor blood supply, especially in older patients.

The supraspinatus muscle tendon is most often injured. Pain radiates to the arm and usually affects the biceps.

Prompt treatment is necessary to prevent worsening, complete rupture, ankylosis, and more radical interventions.

Shoulder dislocation

Loosened or damaged ligaments, tendons, and muscles compromise shoulder stability.

This usually results from injury (luxation).

It can be caused by joint hyperlaxity from repeated micro-trauma. Surgery may be necessary, though physiotherapy can resolve milder cases of instability.

Frozen shoulder

Frozen shoulder or adhesive capsulitis occurs when thickened joint tissues restrict arm movement, without trauma or stress.

Movement range is limited, and pain intensifies when pushing limits.

Causes include autoimmune diseases (like diabetes), tendon lesions or deterioration, or previous trauma.

Secondary adhesive capsulitis develops from another pathology.

Arthroscopic surgery to treat shoulder pain

Arthroscopic surgery is less invasive than open techniques, avoiding large cuts, significant aesthetic impact, and lengthy recovery.

Powerful microscopes provide excellent visualization, ensuring precision and diagnostic accuracy.

Shoulder pathologies often require surgery. When possible, arthroscopic intervention is usually the best option for resolving pain and restoring joint function.