Shoulder Pain

What are the most Common Reasons for Shoulder Pain?

Many people suffer from shoulder pain. It can be a debilitating condition that affects many aspects of your life. In this post, we will take a look at the common causes of shoulder pain and how you can go about treating it. Keep reading to learn more!

Shoulder Pain problems fall into 4 major categories

  • Tendon inflammation (bursitis or tendinitis) or tendon tear
  • Mobility issues: Instability (too loose) or Adhesive Capsulitis (Frozen Shoulder – too stiff)
  • Arthritis
  • Fracture (broken bone)

Other much less common causes of shoulder pain are tumors, infection, and nerve-related problems.

Common Reasons Shoulder Pain

Bursitis (-itis means inflammation)

Bursae are small, fluid sacs that act as cushions between bones and the overlying soft tissues, and help reduce friction between the gliding tissue over the bone.

Sometimes, excessive use of the shoulder or altered mechanics leads to inflammation of the bursa between the rotator cuff and the bony cap of the shoulder known as the acromion. Impingement occurs when the top of the shoulder blade (acromion) puts pressure on the underlying soft tissues when the arm is lifted away from the body. As the arm is lifted or reaching away, the acromion rubs, or “impinges” on the rotator cuff tendons and bursa. This can lead to bursitis and tendinitis, causing pain and limiting movement.

Bursitis often occurs in association with rotator cuff tendinitis, since the bursa and the cuff tendons are intimately adjoined. The shoulder’s soft tissue can become inflamed and painful to the point where daily activities, such as combing your hair or getting dressed, or reaching away, at or above shoulder level, may become difficult.


A tendon is a cord that connects muscle to bone, for the muscle to move the bones/joints.  The tendons can be inflamed either acutely, due to sudden injury or recent increase in repetitive activity, or can be chronic, due to chronic poor ergonomics or due to intrinsic degeneration.  The most commonly affected tendons in the shoulder are the four rotator cuff tendons and one of the biceps tendons. The rotator cuff muscles and their tendons cover the ball of your shoulder and provides motion and stability of the ball in the shoulder socket. 

Tendon Tears

Splitting and tearing of tendons may result from acute injury or degenerative changes in the tendons from long-term overuse and wear and tear. These tears may be partial or may completely separate the tendon from its attachment to bone. In most cases of complete tears, the tendon is pulled away and recoiled from its attachment to the bone. Rotator cuff and biceps tendon injuries are among the most common of these injuries.


Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of a sudden injury or from overuse. Shoulder dislocations can be partial (subluxation) or a complete dislocation when the ball comes all the way out of the socket.

Once the ligaments, tendons, and muscles around the shoulder become loose or torn, dislocations can occur repeatedly. Recurring dislocations, which may be partial or complete, cause pain and unsteadiness when you raise your arm or move it away from your body. Repeated episodes of subluxations or dislocations lead to an increased risk of developing arthritis in the joint, and a traumatic dislocation can cause a concomitant cuff tear also.

Frozen Shoulder (Adhesive Capsulitis)

The shoulder capsule is the soft tissue balloon that surrounds the entire joint.  In frozen shoulder, the capsule gets inflamed and thickens and becomes stiff and tight. Thick bands of tissue — called adhesions — develop.

The hallmark signs of this condition are severe pain and stiffness, diminishing the ability to move your shoulder, as if there were a physical block to motion.


Shoulder pain can also result from arthritis. The most common type of arthritis in the shoulder is osteoarthritis. Osteoarthritis develops slowly and the pain it causes waxes and wanes, and worsens over time.  Other types of arthritis can be related to rotator cuff tears, infection, or an inflammation of the joint lining (synovium).


Fractures are broken bones. Shoulder fractures commonly involve the clavicle (collarbone), humerus (upper arm bone), and scapula (shoulder blade).  Shoulder fractures in older patients are often the result of a fall from standing height or outreached hand. In younger patients, shoulder fractures are often caused by a high energy injury, such as a motor vehicle accident or contact sports injury.  Fractures often cause severe pain, swelling, and bruising about the shoulder.

If you’re “shouldering” pain, don’t suffer. We’re here for you, to help you release the burden of shoulder pain, and move forward to healing and optimizing function, to be back to doing anything and everything you hope to do. Call us today on 808-521-8170 or contact us by completing this form. We are located at Medical Arts Building, Kamalani Tower, 1010 South King Street, Suite 401 Honolulu, HI 96814

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