The Painful Shoulder

Pain is the most common presenting symptoms of conditions of the shoulder.   Depending on where the pain is and where the pain is referred too will lead you to a diagnosis of a problem.

Pain felt over the outer aspect of the arm is very typical of sub acromial impingement. The pain often travels down the outer side of the arm to the elbow but rarely goes below the elbow. Causes of sub acromial impingement include a sub acromial bursitis, calcific tendonitis or a rotator cuff tear.

Pain felt directly on the top of the shoulder often indicates problems with the joint between the collar bone and the shoulder blade, which is called the acromioclavicular joint (also known as the A C J ).  The main causes of pain are arthritis of the joint or problems after dislocation of the joint.

Pain felt at the front of the shoulder indicates problem with the biceps tendon or referred pain from the acromioclavicular joint (ACJ).

Pain felt deep inside the shoulder both front and back often indicates problem inside the joint such as a frozen shoulder or shoulder arthritis.

Pain felt around the back of the shoulder blade or pain coming down the back of the arm into the hand often indicates sources outside the shoulder such as neck problem.  The neck should be examined as part of any assessment of the shoulder.

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