Do you have shoulder pain or arm pain? If your shoulder hurts, you are not alone.
Shoulder pain is a really common problem, and one of the main reasons patients see Dr Constantin. It can be caused by a number of different conditions, and working out the right cause is the first step to the right treatment.
Common causes of shoulder pain
- Arthritis: wear of the cartilage in the ball-and-socket joint, causing a deep ache, stiffness and pain at night.
- Rotator cuff tears: damage to the tendons that lift and turn the arm, causing pain on the outside of the shoulder, night pain and weakness.
- Frozen shoulder: inflammation and usually temporary scarring of the joint capsule, causing severe pain and stiffness in all directions.
- Long head of biceps problems: inflammation or tearing of the biceps tendon, causing pain at the front of the shoulder. These are sometimes called SLAP tears.
- Subacromial bursitis: inflammation around the rotator cuff, causing pain when lifting the arm.
- Acromioclavicular (AC) joint problems: arthritis or injury of the small joint on top of the shoulder, where the collarbone meets the shoulder blade.
Shoulder pain that comes from the neck
It is important to know that shoulder pain does not always come from the shoulder. Problems in the neck, such as a disc or arthritis pressing on a nerve, can cause pain that is felt in the shoulder. This is called referred pain, and the nerve irritation is called cervical radiculopathy. The C5 and C6 nerves are the ones most likely to refer pain to the shoulder.
Clues that the pain may be coming from the neck include:
- neck pain or stiffness, or pain that changes when you move your neck
- pain that spreads down the arm, especially below the elbow
- pins and needles, numbness or weakness in the arm or hand
- a shoulder that moves freely but still hurts
Occasionally, shoulder pain comes from both a shoulder problem and a neck problem at the same time. As we get older, wear and tear (degenerative changes) can affect both the shoulder and the neck, so it is not unusual for more than one problem to be contributing to your pain. This is why Dr Constantin examines both, and why treating one problem may not fully settle the pain.
How Dr Constantin finds the cause
Dr Constantin will ask about your symptoms and examine your shoulder and neck. Depending on what he finds, you may need an X-ray, ultrasound or MRI of the shoulder.
Occasionally, when Dr Constantin examines a patient and finds that the pain may not be coming from the shoulder, this is investigated further with an MRI of the neck (cervical spine) and, if needed, a review by a spine surgeon.
When to see a shoulder surgeon
See your GP about a referral to Dr Constantin if:
- your shoulder pain has not improved after 6 weeks of treatment such as physiotherapy
- pain is waking you at night
- you cannot lift your arm, or it feels weak
- the pain started after a fall, injury or dislocation
- your shoulder is becoming stiff
Frequently asked questions
Why does my shoulder hurt?
The most common causes are rotator cuff problems, arthritis, frozen shoulder, subacromial bursitis, long head of biceps problems and AC joint problems. Shoulder pain can also come from the neck, when a disc or arthritis presses on the C5 or C6 nerve. If your shoulder hurts and it is not settling, Dr Constantin can examine your shoulder and neck to find the cause.
Why does my arm hurt?
Pain from the shoulder is often felt in the upper arm rather than the shoulder itself, usually on the outside of the arm above the elbow. This is common with rotator cuff problems and bursitis. Pain that spreads below the elbow, or comes with pins and needles, numbness or weakness in the hand, is more likely to be coming from a nerve in the neck. Dr Constantin will examine your shoulder and neck to work out which it is.
Can a neck problem cause shoulder pain?
Yes. A disc or arthritis in the neck pressing on the C5 or C6 nerve can cause pain that is felt in the shoulder. If Dr Constantin thinks your pain may be coming from your neck, he may arrange an MRI of your neck and, if needed, a review by a spine surgeon.
Why is my shoulder pain worse at night?
Night pain is common with rotator cuff problems, frozen shoulder and arthritis. Lying on the shoulder puts pressure on inflamed tissues. If night pain is not settling, it is worth having your shoulder assessed.
What scans will I need?
It depends on the likely cause. An X-ray shows arthritis and bone problems, an ultrasound shows the tendons and bursa, and an MRI gives the most detail of the tendons, cartilage and labrum. Dr Constantin will let you know which scans are needed after examining you.
Do I need surgery for shoulder pain?
Most people with shoulder pain get better without surgery, with physiotherapy, activity changes, medicines or an injection. Surgery is considered when these have not helped or when there is a problem, such as some rotator cuff tears, that is unlikely to heal on its own.
Do I need a referral?
Yes. You'll need a referral from your GP or another specialist to see Dr Constantin. See Referrals.
Book an appointment
If you have shoulder pain that is not settling, Dr Constantin can assess your shoulder and neck and explain your options. Please contact Dr Constantin for an assessment, or call (02) 9409 0503.
If you need surgery, it will be performed at the Mater Hospital (private health insurance, DVA, workers compensation and CTP) or Canterbury Hospital (Medicare).
Related pages
The information on this page is general in nature and is not a substitute for individual medical advice. Recovery timeframes are a guide only and will be tailored to you.
Book a shoulder assessment
A GP or specialist referral is needed to claim a Medicare rebate. Consultations are available in North Sydney, Kogarah and Miranda.