People say it’s bursitis, but you’ve got a sharp pain in the shoulder when you lift the arm. You don’t feel pain in any other circumstance, and you’ve had bursitis before, which is not how it feels. Nobody can describe the pain as you do because you’re the one handling the symptoms, but what if you haven’t found the correct answer? What is causing shoulder pain when you lift the arm?
Shoulder pain is a common complaint among people of all ages and both genders. It can be caused by many different things, including overuse, injury, or arthritis. It is more common in older adults, but young weightlifters also feel the symptom every once in a while. So, everyone won’t have the same cause, and even if we have two people reporting pain when lifting their arms, the diagnosis might not be the same.
Leaving all misconceptions behind, this article will answer the question laid down in the title and give you five conditions that cause pain when lifting the arm. That way, you’ll be more likely to identify the cause and rule out others. Throughout this process, it is essential to find a doctor who will listen to your symptoms and help you figure out the problem and how to treat it. Remember that they are trained to do so and can help you find the correct diagnosis by using additional tests and maneuvers in their physical exam.
What causes shoulder pain when lifting the arm?
When you come to the doctor with shoulder pain, they will probably ask you to move your arms around to evaluate when you feel pain and to what extent. Pain when lifting the arm is a characteristic of shoulder pain that can be found in different ailments. Each one has different causes. That’s why it is important to describe your symptoms as accurately as possible and complete the maneuvers your doctor recommends to reach an accurate diagnosis.
The diagnostic options your doctor will likely want to rule out if you have pain when lifting the arm include bursitis, rotator cuff injuries, shoulder impingement syndrome, adhesive capsulitis, and cervical spinal nerve compressions.
Let’s review the most critical aspects of each:
1. Shoulder impingement syndrome:
This is also a common cause of shoulder pain when you lift your arm. Shoulder impingement syndrome is a type of shoulder injury that occurs when the soft tissues of the shoulder become trapped under the bone of the shoulder.
It usually happens after an injury or overuse of the articulation. The shoulder blade starts rubbing on the upper edge of the shoulder socket, and the soft tissues are trapped in between. That’s why it is called impingement because the tissue is compressed between bones, and the nerve endings perceive the sensation as pain.
2. Rotator cuff injuries:
Rotator cuff sprains and tears are the most common cause of shoulder pain among young patients who actively do weightlifting at the gym. Rotator cuff injuries are also common among athletes who play contact sports such as football, hockey, and basketball. They are injuries to the tendons and muscles that move the shoulder. The tendons can become completely torn or detached from the bone.
This can occur due to an overuse injury, trauma, or another event. It can also be caused by a bone spur that is pressing on the rotator cuff. The pain often comes from the shoulder blade and is usually worse when you are lying down or sleeping on the affected side; and some patients can have a very severe problem and compromise their shoulder movement altogether.
So, if you have a lot of pain in your shoulder after working out or receiving a direct hit, your doctor will probably try to rule out a rotator cuff injury. These cases are usually not relieved only by resting and taking painkillers. Thus, we encourage you to come to the doctor and talk to them about your symptoms.
3. Shoulder bursitis:
Bursitis is inflammation of the bursa sac, which is located at the bottom of your shoulder. It is a fluid-filled sac that protects the tendons, muscles, ligaments, and other joint structures that attach to your bones. It is also responsible for helping your arm move freely and cushions all the components of your shoulder joint to avoid rubbing bone against bone through the formation of synovial fluid.
Bursitis is a common cause of shoulder pain. The pain of bursitis is usually worse when you lift your arms overhead or carry things and is often relieved by putting your arm down and resting. If you have bursitis, you may also have a swollen area at the top of your shoulder where the shoulder blade and the acromion meet. This area is called the acromioclavicular joint.
4. Adhesive capsulitis:
This ailment features painful inflammation of the capsule, a fibrous, tough band of tissue around the shoulder joint. Adhesive capsulitis causes the shoulder to stiffen up. It results from chronic or sustained inflammation in the shoulder, especially after surgery or another procedure. The shoulder may become stiff and painful, especially when moving your arm.
If you take out the tissue to examine it, you will find a buildup of scar tissue that forms on the shoulder joint. This scar tissue develops over time and is progressive, reducing the elasticity of the capsule as it continues growing and making the joint stiff. That’s why this condition is also known as frozen shoulder, and it is seen mainly in older people with a history of trauma or interventions in their shoulders.
5. Cervical spinal nerve compression:
As the name implies, cervical spinal nerve compressions occur when the neck’s spinal nerves are pinched between the muscles and bones of the neck. This condition is most common in people who have had previous neck injuries and those with baseline problems with the spinal cord. It may also happen in patients with severe posture or spinal deformity problems. C
ervical spinal nerve compressions are often overlooked as a possible cause of shoulder pain because they are not as common as the ailments mentioned above. However, it has some characteristics, signs, and symptoms you won’t find elsewhere. As it happens with most nerve compression syndromes, this one will also trigger referred and radiating pain, and patients often experience tingling and numbness in their upper extremities.
It is essential to get a diagnosis because you may need to change your lifestyle if you want to control pain. You may need to do some exercises to improve your posture and strengthen your neck muscles. You may also need to avoid any activities that could cause your neck muscles to become tight.
When to seek help
In most cases, it is a good idea to talk to your doctor when you experience the following symptoms.
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- Shoulder pain that is very severe. This can be a sign of a serious injury, such as a dislocation or a fracture.
- Shoulder pain that continues for more than two weeks.In mild cases, shoulder pain goes away with rest and ice. But if you continue feeling the symptoms for two weeks or more, we recommend talking to your doctor. It can also be a sign of a complicated shoulder problem, such as septic shoulder bursitis.
- Shoulder pain that interferes with your daily life.Seek medical attention immediately if you feel shoulder pain interferes with your everyday life. If you feel your quality of life is decreasing, it is a good idea to get a diagnosis.
- Pain that radiates into your neck or down your arm. All types of radiating pain should be reported because they are probably triggered by nerve-related problems, and they are unlikely to respond to over-the-counter pain medications.
- Pain that occurs after a fall or trauma. Talk to your doctor if you received a direct hit on your shoulder and feel that the pain is out of proportion. You should also come to the doctor immediately if you received high-energy trauma, such as a car accident or falling from a motorcycle.
- Swelling in your shoulder: The shoulder joint is deep within many layers of tissue. Thus, it is unlikely that it will become swollen due to a joint problem. When it happens, it is probably because the inflammation is very severe and warrants medical attention.
⇒ Now, let’s discuss treatment options for pain relief.
Treatment options for pain relief
We went through different causes of shoulder pain when lifting the arm. For each one, you can try a set of remedies and treatments. Others are common for all shoulder pain causes, especially those treatments to control pain symptoms. So, let us start by going through the most common treatments to relieve shoulder pain, which is almost the same regardless of the diagnosis:
A) Physical therapy:
Physical therapy and rehabilitation are fundamental, especially when the cause of shoulder pain is due to chronic disease. When you go to a physical therapist, he will check your range of motion and muscle strength and elaborate a plan accordingly to treat your problem.
This type of rehabilitation is used to help you regain strength and range of motion in your arm. It consists of passive and active motion exercises that stimulate your muscles and help you strengthen your articulation. They also help with flexibility and improve the range of motion. Altogether, these exercises may reduce the pain you feel progressively.
B) Oral therapy with NSAIDs:
This is the most common treatment you will find in a doctor’s office. This is because it is a quick and easy way to reduce pain and inflammation.
If you take these medications as instructed, you will be able to get rid of pain, reduce inflammation, and improve your range of motion. You may have heard about the risks associated with using NSAIDs. They are also known as non-steroidal anti-inflammatory drugs. It is true that they can cause stomach ulcers and heartburn. However, you can prevent these problems by taking the proper dosage and following the instructions on the label.
These medications are very effective in reducing pain when it is associated with inflammation, and one of the reasons why everyone uses them is that you can take them orally, but they can also be administered intravenously if your symptoms are more severe. Talk to your doctor before taking them if you are pregnant or breastfeeding, and use them only for short periods of time.
C) Intraarticular injections:
These injections are used to treat the inflammation and damage in the shoulder joint and act more rapidly and for a more extended period than NSAIDs. They are usually given to relieve the pain and improve the shoulder function in patients with more severe symptoms that do not improve with oral treatment.
It should be administered by a doctor with experience in this type of treatment because it is much more complex than an intramuscular application. In this case, sometimes doctors prefer to administer intraarticular injections with an ultrasound scan to make sure they are reaching the exact spot where the drug should be injected. They will give you the correct injection to relieve your shoulder pain, which can include only one drug or a combination.
It is usually a corticosteroid, but recent studies show promising results using hyaluronic acid and platelet-rich plasma to improve joint function.
D) Temperature therapy:
A cold compress or ice pack is an excellent way to reduce the pain, and that’s true for almost every type of joint pain, including shoulder symptoms. It can be applied directly to the painful area but using a towel or cloth before applying the ice pack. It is one of the best ways to treat shoulder pain because it is inexpensive and very safe, easy to do, and free.
Depending on your symptoms, you can use either cold or hot temperatures. Cold temperatures will work better if your problem is more likely to be inflammation. Warm temperatures will be best if you want to relieve muscle tension and increase the blood flow to the area. The best way to warm your shoulder is by taking a hot bath. It relaxes the muscles and helps the shoulder to heal. You can also soak in a warm shower or soak in a hot tub.
Specific shoulder pain treatments
In most cases, pain management works better when combined with specific treatments for each condition. We mentioned different causes of shoulder pain above, and now we’re going through each one and exploring your specific therapeutic options:
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- Shoulder bursitis: Besides pain management, doctors can also use surgical treatments and antibiotic therapy to solve the problem. Antibiotic therapy is required in cases of septic bursitis. In other words, when an infectious disease causes inflammation. Surgical treatment for shoulder bursitis involves drainage of the inflamed bursa or incision when the damage is very extensive.
- Rotator cuff injuries: In these cases, physical therapy is essential to achieve a complete recovery. In some cases, immobilization is required to heal the injury. In others, patients may need a surgical repair of the rotator cuff.
- Shoulder impingement syndrome: This condition responds to subacromial injections, and there are different protocols on how to apply them and what drugs to use for better results. Surgical treatment may also be recommended when the symptoms do not improve, and more recent treatments have been proposed, including high-intensity laser therapy with very good results.
- Adhesive capsulitis: The mainstream therapy in these cases is releasing the capsule when it is attached to the surrounding tissue through a surgical procedure known as arthroscopic capsular release. Another technique that works for some patients is extracorporeal shockwave therapy.
- Cervical spinal nerve compression: Decompression therapy and surgery are essential in these cases. The former is based on exercises and manual therapy to decompress the area, and the latter involves a surgical intervention to release the affected nerve. Cervical epidural steroid injections also work to numb the affected nerve and provide immediate relief.
Lifestyle changes you can implement to reduce pain
- Make sure you’re in good physical shape but be careful when lifting heavy weights or doing shoulder exercises.
- Take regular breaks if you’re constantly doing overhead handwork as a part of your job.
- If you’re working at a desk, make sure you’re not doing anything that puts pressure on your shoulder. Use an ergonomic desk and chair. Adjust them, so you don’t have to raise your hands to reach the keyboard.
- Try using a standing desk. If you’re using a computer all day, you’ll see the benefit in using one of those electric desks you can change heights to alternate between standing and sitting.
- Stretch regularly. Sometimes muscle tension contributes to shoulder pain. So, do some stretchings every once in a while and listen to your doctor’s advice on this because sometimes it is better to leave your shoulder immobilized for a day or two.
- Get help from employers or coworkers if you’re constantly doing overhead work as a part of your job.
- Correct your posture when sitting, walking, standing, and sleeping. Remember that many cases of nerve-related problems are the result of posture issues.