Shoulder pain


Four weeks ago, I fell hard on my shoulder, with soreness and limited motion coming on. Two weeks later, I reinjured it again, with same results. It hurt most raising it above my head and trying to turn over in bed. It is better now, but I have a popping noise in it when moving it around. I have more range than before, but still the occasional sharp pain and popping noise.

Please advise.

Thank you,

Dear Mike,

Shoulder injuries can be painful and even disabling. We don't realize how essential our shoulders are until they start giving us trouble.

Since you've been having pain and limited motion for four weeks, it's time to see your health care provider. S/he will want to know a number of things:

  • Does your shoulder feel stiff?
  • How limited is your current range of motion at the shoulder joint?
  • Does your shoulder feel unstable — as if it might slide out of the joint socket?
  • Does your shoulder feel weak?
  • Can you function normally, or is your shoulder causing you to cut back on any of your usual activities?

Some of the possible shoulder injuries you could be dealing with include:

  • A partially dislocated or unstable joint
    Without treatment to place or pop your shoulder back into its proper position, you could ultimately experience a complete shoulder dislocation, an incredibly painful condition. Furthermore, leaving your shoulder joint in an abnormal position places stress on the other supporting and neighboring structures, possibly causing complications, such as nerve injury, injury to the blood vessels in the area, a frozen shoulder, or arthritis of the shoulder joint.
  • Rotator cuff injury
    The rotator cuff is the complex band of muscles, tendons, and ligaments that support the shoulder joint. Injury to any or all of these structures usually causes pain and decreased shoulder mobility.
  • Frozen shoulder
    When a shoulder injury or condition causes pain and decreases movement of the joint, scar tissue can grow within the joint area, further restricting movement. This can be the start of a cycle of pain and disability leading to further pain and further disability.

Each of these conditions can be either temporarily or permanently debilitating. They also can turn into chronic, or recurring, problems. But because each of these conditions can also be effectively treated, you'll want to consult your health care provider immediately — to avoid further complications and to regain as much function as possible, as quickly as possible.

Depending on what your health care provider learns during the physical examination of your shoulder, you might need X-rays or other studies to determine the kind of injury you have. Treatment will depend on the specific type and severity of your shoulder injury. Some of the kinds of things your health care provider might recommend include:

  • Anti-inflammatory medications, such as ibuprofen, acetaminophen, and naproxen sodium
  • Application of ice
  • Heat with heating pads
  • Special strengthening exercises
  • Consultation with a physical therapist for specialized treatments, such as ultrasound
  • Massage, from a licensed massage therapist or a physical therapist
  • Steroid injection at the joint
  • A period of immobilization in a sling
  • Surgical repair of damaged structures
  • As a last resort, a complete shoulder replacement

It's a good idea to see your health care provider soon. Sometimes, people downplay their pain and/or decreased range of motion until the disability begins to seem to be their normal state. Depending on the nature and severity of your injury, with treatment and rehabilitation therapy you might be able to recover fully from your shoulder injury and regain complete function. However, recovery from a shoulder injury is often a relatively lengthy process. For example, recovery from a shoulder dislocation can take anywhere from a couple of weeks to six months; recovery from a rotator cuff tear may take about six months; recovery from a frozen shoulder can take up to two years. You'll want to get started on treatment and rehabilitation as soon as possible, to more quickly regain functioning and to try to avoid further, more serious complications.

Last updated Jul 24, 2014
Originally published Apr 02, 2004

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