What Causes Shoulder Pain? 5 Common Reasons You Should Know
What causes shoulder pain? The answer ranges from rotator cuff injuries and arthritis to trauma, nerve-related issues from your neck, and poor posture – with many shoulder pain cases stemming from problems outside the shoulder itself, making accurate diagnosis essential for effective treatment.
Understanding what causes shoulder pain helps you recognize your specific situation and make informed decisions about treatment before temporary discomfort becomes chronic dysfunction.
1. Rotator Cuff Injuries and Overuse
The most common shoulder pain culprit involves the rotator cuff – four muscles and their tendons stabilizing your shoulder joint and controlling arm movement.
Tendinitis
Rotator cuff tendinitis develops when tendons connecting muscles to bones become inflamed from repetitive overhead activities, poor mechanics, or gradual degeneration.
Common causes:
- Throwing sports (baseball, tennis, volleyball)
- Overhead work (painting, construction, shelf stocking)
- Weightlifting with poor form
- Swimming with improper technique
Symptoms: Gradual onset pain, worse with overhead reaching, difficulty sleeping on affected side, weakness lifting or rotating arm.
Strains: Muscle or Tendon Tears
Rotator cuff strains involve partial or complete tears in muscles or tendons from sudden force or chronic degeneration.
How they occur:
- Sudden lifting of heavy objects
- Catching yourself during falls
- Gradual deterioration from years of use
- Acute injury during sports
Key distinction: Tendinitis is inflammation; strains involve actual tissue damage.
Repetitive Motion Consequences
Modern life creates perfect conditions for rotator cuff problems:
- Hours at computers creating rounded shoulders
- Poor lifting mechanics at work or gym
- One-sided activities (carrying bags, holding phone)
- Inadequate rest between repetitive tasks
These cumulative stresses eventually exceed tissue capacity, creating injury without any single traumatic event.
2. Shoulder Arthritis and Degeneration
Age-related wear and tear gradually breaks down shoulder cartilage, creating pain, stiffness, and reduced function.
Osteoarthritis: Cartilage Breakdown
Glenohumeral osteoarthritis (shoulder joint arthritis) develops when protective cartilage covering bone ends deteriorates, allowing bone-on-bone contact.
Risk factors:
- Previous shoulder injuries
- Years of repetitive overhead work
- Age (more common after 50)
- Genetic predisposition
Symptoms: Deep, aching pain; morning stiffness lasting 30+ minutes; grinding or clicking sensations; progressive loss of range of motion.
Age-Related Changes
Degenerative changes aren’t inevitable but become more common with age:
- Cartilage loses water content and elasticity
- Tendons become less flexible and more prone to tears
- Bone spurs develop around joint edges
- Lubricating synovial fluid decreases
Impact on Daily Function
Arthritis progressively limits:
- Reaching overhead (cabinets, washing hair)
- Behind-the-back movements (fastening bra, tucking in shirt)
- Carrying groceries or lifting objects
- Sleeping comfortably
Early intervention slows progression and maintains function longer.
3. Injuries: Falls, Accidents and Trauma
Acute traumatic injuries create immediate, severe shoulder problems requiring prompt evaluation.
Dislocations: Joint Separation
Shoulder dislocation occurs when the upper arm bone pops out of the shoulder socket – usually from falls, car accidents, or contact sports.
Why shoulders dislocate easily: Your shoulder sacrifices stability for mobility. It’s the most mobile joint but also the most prone to dislocation.
Complications: First-time dislocations often damage surrounding ligaments and cartilage, increasing future dislocation risk. Some people develop chronic instability requiring surgical repair.
Fractures: Broken Bones
Shoulder fractures involve breaks in the clavicle (collarbone), scapula (shoulder blade), or humerus (upper arm bone).
Common causes:
- Direct impact from falls
- Car accidents
- High-impact sports collisions
- Osteoporosis-related fractures in older adults
Red flags: Severe pain, visible deformity, inability to move arm, swelling, bruising.
Sudden Force Injuries
Even without fractures or dislocations, sudden force creates:
- Ligament sprains (AC joint separations)
- Muscle tears
- Soft tissue contusions
- Nerve compression or damage
All traumatic shoulder injuries require professional evaluation – imaging often reveals damage not apparent from external examination.
4. Nerve-Related Shoulder Pain (Often From the Neck)
Here’s what surprises most people: your shoulder pain may not originate in your shoulder at all.
Pinched Nerves Creating Referred Pain
Cervical radiculopathy – nerve compression in your neck – commonly refers pain into shoulders, mimicking rotator cuff problems.
How it happens:
- Herniated cervical discs pressing on nerve roots
- Bone spurs narrowing nerve exit spaces
- Degenerative changes in cervical spine
- Forward head posture increasing nerve compression
Distinguishing features: Neck-origin shoulder pain often includes numbness/tingling down the arm, worse with certain head positions, accompanied by neck stiffness.
Cervical Spine Misalignment
Spinal misalignments (subluxations) in your neck create muscle imbalances affecting shoulder function:
When cervical vertebrae shift out of proper alignment, they alter nerve signals to shoulder muscles. Some muscles become overactive and tight while others weaken – creating abnormal shoulder mechanics and eventual pain.
Why This Matters for Treatment
Treating only the shoulder when the problem is in your neck wastes time and money while allowing the real issue to worsen. Comprehensive evaluation identifying the true pain source ensures appropriate, effective treatment.
As a chiropractor Tampa residents trust for thorough assessments, I always evaluate both neck and shoulder when patients present with shoulder pain – because the connection is so common.
5. Poor Posture and Daily Habits
Modern lifestyle creates perfect conditions for developing shoulder problems through cumulative postural stress.
Desk Work and Forward Head Posture
Hours at computers create rounded shoulders and forward head positioning:
For every inch your head moves forward, it adds approximately 10 pounds of pressure on your neck and shoulder muscles. This chronic strain eventually creates pain, trigger points, and dysfunction.
Common desk-related shoulder problems:
- Upper trapezius tension and pain
- Rotator cuff imbalances
- Thoracic outlet syndrome (nerve/vessel compression)
- Scapular dyskinesis (abnormal shoulder blade movement)
Sleeping Position Impact
Your sleeping position affects shoulder health:
- Side sleeping: Direct pressure on the down-side shoulder for 6-8 hours nightly can irritate rotator cuff tendons and bursa.
- Stomach sleeping: Requires turning head to one side, twisting neck and creating asymmetric shoulder positioning.
- Pillow height: Too high or too low creates neck strain affecting shoulder muscle balance.
Repetitive Overhead Activity
Even non-work activities contribute:
- Painting or home repairs
- Gardening and yard work
- Playing with children (lifting, tossing)
- Reaching into high cabinets repeatedly
The key: Not the activity itself but the volume, frequency, and mechanics. Poor technique during repetitive tasks accelerates wear and tear.
See more: Shoulder Pain and Chiropractic Care: A Holistic Approach to Relief
Get Answers About Your Shoulder Pain
What causes shoulder pain in your specific case? The only way to know for certain is comprehensive evaluation by practitioners who understand the complex relationship between your neck, posture, and shoulder function.
At Chiropractic Care Centre, we’ve spent over 20 years helping Tampa residents identify and treat the root causes of shoulder pain – not just temporarily masking symptoms.
Stop guessing about your shoulder pain. Schedule your thorough evaluation today. We’ll assess your neck, posture, and shoulder mechanics; identify exactly what’s creating your symptoms; and create a treatment plan addressing the real problem – whether it’s in your shoulder or somewhere else entirely.
