Shoulder pain is a very common reason for which people go to see a doctor. This page is shoulder2meant to provide some information about the common shoulder pains that are caused by muscle or joint issues.

Here is a short and detailed video of the anatomy of the shoulder:

COMMON CAUSES OF SHOULDER PAIN:

  • A muscle tear (either partial or complete)
  • A muscle strain
  • Tendonitis
  • Ligament strain
  • Arthritis
  • A “pinched nerve” in the neck
  • Regardless of the specific cause, the treatment is usually the same for all.

IMPORTANT NOTE: Sometimes people can feel pain the shoulder that is actually redflag2caused by serious heart or lung problems. If you are in doubt, see your doctor as soon as possible, even go to the Emergency Department if need be.

WHAT CAN YOU DO TO IMPROVE YOUR PAIN?

  • Rest. Avoid activities that aggravate the pain.
  • Ice.
  • Stretches. Here are few handouts for general shoulder stretches and exercises that you may find helpful: Handout #1, Handout #2, Handout #3
  • Tylenol (click for more information)
  • Anti-inflammatories, as long as they are safe for you to take. (click for more information).
  • If your pain is persistent over several weeks, then other medications may be helpful, such as Cymbalta, Lyrica, gabapentin, amitiptyline, or nortriptyline. You may have to see your doctor for a prescription for these types of medications.
  • But the #1 suggestion for persistent shoulder pain is PHYSIOTHERAPY.
    • You can choose whatever local physiotherapist you like. You can see a physiotherapist by contacting their office directly. You do not need to see your doctor first.
    • If your private insurance requires a letter from your doctor for Physiotherapy, we can usually do so without the need for a visit. These insurance letters are not covered by OHIP, so a fee applies.
    • OHIP covers physiotherapy under specific situations. Again, no referral is required.
  • Another possible treatment option for certain causes of shoulder pain could be to get a steroid injection (often referred to as a “cortisone shot”) in your shoulder. This is often a treatment that your family doctor can perform.

DO YOU NEED AN XRAY, ULTRASOUND, OR MRI?

In the vast majority of cases, you do NOT require any of these imaging tests. This is because regardless of the cause, the treatment is still the same for all the different causes.

Regardless of whether the cause is from a muscle tear, a strain, tendonitis, arthritis, or a pinched nerve, they all lead to the same treatment suggestions: rest, ice, pain medications, and PHYSIOTHERAPY.

Even if you have a rotator cuff tear, most of the time the orthopaedic surgeons recommend a trial 4-6 weeks of physiotherapy before they would even consider offering a surgery.

Furthermore, physiotherapists are “muscle and joint experts”. They can thoroughly assess you and often figure out what is wrong, even without imaging tests.

The main times when an X-ray or ultrasound are required may be if there was a sudden injury to your shoulder. In these cases, it may be important to rule out broken bones, dislocations, or muscles that have suddenly become torn.

REASONS TO SEE YOUR DOCTOR:redflag2

  • You are concerned your pain could be from something more serious, like a heart or lung problem, as noted above.
  • Your pain is lasting more than 4-6 weeks, despite trying the above recommended treatments.
  • Your pain is caused from a sudden injury or fall, and you are worried that something may be broken or dislocated.
  • If your shoulder is red or significantly bruised.
  • Your pain is severe and not controlled by the above treatments.
  • You are concerned that something else is wrong, or have any other questions or concerns.