Symptoms A-Z

Severe Shoulder Pain Symptoms, Causes & Common Questions

Understand severe shoulder pain symptoms, including 10 causes & common questions.

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Contents

  1. Symptoms
  2. Causes
  3. 10 Possible Severe Shoulder Pain Conditions
  4. Treatments and Relief
  5. Questions Your Doctor May Ask
  6. Statistics
  7. References

Severe Shoulder Pain Symptoms

Most cases of shoulder pain are due to an acute injury and thus the cause of the pain is easily identifiable. Even a chronic injury, which happens over time due to wear and tear, usually has an obvious cause.

However, due to the complexity of the nervous system, it is possible for a condition occurring elsewhere in the body to register as pain in the shoulder. This can happen even when there is nothing wrong in the shoulder at all. When it does occur, it can indicate a serious problem, and so this kind of shoulder pain should be seen by a medical provider as soon as possible [1].

Common characteristics of severe shoulder pain are

If you're experiencing severe shoulder pain it is likely that it can be described by the following.

  • A deep, aching pain: This usually gets worse with any sort of movement of the shoulder [2].
  • Sharp or grinding pain with movement
  • A dull, burning pain: This may be present even when not moving the arm, or when lying down to sleep.

Duration of symptoms

Your severe shoulder pain symptoms may also be described by their onset and duration.

  • Acute pain: This comes on suddenly.
  • Chronic pain: This is pain that has been present for six months or more.

Who is most often affected by severe shoulder pain

People who can be described by the following characteristics are more likely to experience severe shoulder pain.

  • Athletes
  • People over 50: Wear-and-tear injuries happen most often to people over age 50.
  • Anyone doing physical labor or heavy fitness training
  • Anyone with osteoporosis: This is a loss of calcium from the bones with subsequent weakening.
  • Anyone who has had shoulder replacement surgery [3]

Is severe shoulder pain serious?

Severe shoulder pain — aside from being distressing — may not indicate a life-changing issue but rather a temporary injury. This, of course, depends on the cause.

  • Mildly serious: Chronic pain may not seem serious but can certainly interfere with quality of life and should definitely be treated as soon as possible [4].
  • Moderately serious: An acute injury that causes severe shoulder pain should be seen in an emergency room.
  • Serious: Shoulder pain that seems to have no apparent cause can be "referred," or caused by something in another part of the body. This can be a serious symptom and must be seen by a medical provider right away. An example is referred pain from angina or a heart attack.

Severe Shoulder Pain Causes

Acute injury

Acute injuries can result in severe shoulder pain, such as the following:

  • A fracture or crush injury to any part of the shoulder socket, collarbone, or upper arm bone
  • Dislocation of the ball of the upper arm bone from the shoulder socket
  • Tearing of the ligaments or cartilage in the shoulder joint

Post-traumatic conditions that cause damage to the joint may also include:

  • Loss of cartilage after an injury: This can lead to further wear.
  • Loss of adequate blood supply to the joint
  • Scar tissue forming anywhere within the joint

Chronic injury

Severe shoulder pain may occur over time due to the following.

  • Wearing away of the cartilage in the shoulder: This can occur from overuse or repetitive strain injury.
  • Pain from bone-on-bone contact
  • Pain from bone spurs: This can result from long-term wear.

Autoimmune illnesses

These are conditions where the body's own protective immune system turns against itself for no apparent reason. These may have a hereditary and/or a viral component.

  • Inflammation of the membranes surrounding the shoulder joint: Causing destruction of the cartilage [5]
  • Inflammation of the nerves and muscles around the shoulder joint: Especially following any injury

Complications from shoulder replacement surgery

The following may be occurring if you have had shoulder replacement surgery:

  • Loosening, wear, or shifting of the replacement hardware [6]
  • Infection around the hardware

Referred shoulder pain from other causes

If the shoulder pain occurs in a woman of childbearing age, and is accompanied by severe pain in the abdomen and vaginal bleeding, this may be a life-threatening medical emergency and must be treated immediately [7].

Digestive disorders can also result in shoulder pain, such as the following.

  • Abdominal pain with nausea and vomiting after meals: Especially after eating spicy or high-fat foods
  • Gas or constipation: Or any other distress in the digestive tract
  • Cardiac disorders: Angina usually occurs in the chest but may radiate to the neck, left shoulder, left arm or back.

Rare and unusual causes

A tumor of the lung may have shoulder pain as one of the symptoms.

10 Possible Severe Shoulder Pain Conditions

The list below shows results from the use of our quiz by Buoy users who experienced severe shoulder pain. This list does not constitute medical advice and may not accurately represent what you have.

Rotator cuff tendonitis

The rotator cuff is an arrangement of muscles and tendons that holds the head of the upper arm bone within the shoulder socket. Rotator cuff tendinitis is the resulting condition when these muscles and tendons become inflamed or damaged.

The dominant symptom is a nagging, aching pain in the upper arm and shoulder that gets worse when raising the arms or reaching backward. You may also experience shoulder swelling and have difficulty lifting or rotating your arm.

Early treatments include resting the affected shoulder, applying ice, and taking over-the-counter pain medication. Stretching and cortisone injections may be recommended by your medical provider. In cases where tissue damage or bone spurs are present, surgery and follow-up exercises may be needed in order to have a full recovery.

Rarity: Common

Top Symptoms: pain in one shoulder, dull, achy shoulder pain, shoulder pain that gets worse at night, difficulty moving the shoulder, shoulder pain from overuse

Symptoms that always occur with rotator cuff tendonitis: pain in one shoulder

Urgency: Primary care doctor

Frozen shoulder (adhesive capsulitis of the shoulder)

Frozen shoulder is also called adhesive capsulitis of the shoulder. The "shoulder capsule" is the strong web of connective tissue which holds the ball joint of the upper arm inside the socket of the shoulder blade. If this connective tissue is damaged, scar tissue – or adhesions – may form and cause the shoulder capsule to become tight, painful, and inflexible.

The condition can happen if an injury to the shoulder forces it to stay immobilized while healing. Additional risk factors may be diabetes, thyroid abnormalities, and heart disease.

Symptoms include gradual worsening of the ability to move the shoulder, due to increasing pain and stiffness in the outer shoulder and upper arm.

Diagnosis is made through physical examination, with simple tests to measure how far the shoulder can move, as well as imaging such as x-ray or MRI.

Treatment involves physical therapy to help restore range of motion; over-the-counter, nonsteroidal anti-inflammatory drugs to ease pain; and sometimes cortisone injections to the shoulder joint. Surgery may be needed in some cases.

Rarity: Common

Top Symptoms: spontaneous shoulder pain, stiff shoulder, dull, achy shoulder pain, shoulder pain that gets worse at night, difficulty moving the shoulder

Symptoms that always occur with frozen shoulder (adhesive capsulitis of the shoulder): stiff shoulder

Urgency: Primary care doctor

Shoulder arthritis

Shoulder arthritis is inflammation of the shoulder joint, where the upper arm bone (humerus) meets the shoulder blade (scapula) and collarbone (clavicle). This inflammation can be caused by osteoarthritis or "wear-and-tear," injury to the shoulder joints, rotator cuff injuries, or rheumatoid arthritis.

Symptoms include shoulder pain that may get worse with movement or while sleeping, shoulder stiffness or limited mobility, as well as warmth, redness, or swelling of the shoulder area.

Treatment depends on the severity of your discomfort but may include rest, methods to alleviate pain, exercises to strengthen and stabilize the shoulder, steroid injections, and surgery.

Rarity: Uncommon

Top Symptoms: spontaneous shoulder pain, shoulder pain that gets worse at night, difficulty moving the shoulder, swollen shoulder

Symptoms that always occur with shoulder arthritis: spontaneous shoulder pain

Urgency: Primary care doctor

Pinched nerve in the neck

A pinched nerve in the neck is also called cervical radiculopathy. It means that a nerve in the neck, at a point where it branches off from the spinal cord, is being compressed by the surrounding bones, muscles, or other tissues.

It can be caused by a traumatic injury, such as from sports or an automobile accident, especially if the injury results in a herniated disk. It may also arise from the normal wear and tear of aging.

Symptoms include sharp, burning pain with numbness and tingling from the neck to the shoulder, as well as weakness and numbness into the arm and hand.

Diagnosis is made through patient history, physical examination, and simple neurological tests to check the reflexes. Imaging such as x-ray, CT scan, or MRI may be done, as well as electromyography to measure nerve impulses in the muscles.

A pinched nerve in the neck often improves with simply a few days or weeks of rest. Physical therapy, nonsteroidal anti-inflammatory drugs, and steroid injections into the spine can all be very helpful.

Rarity: Common

Top Symptoms: pain in one shoulder, spontaneous shoulder pain, pain that radiates down arm, pain in the back of the neck, severe shoulder pain

Urgency: Primary care doctor

Brachial plexopathy (shoulder nerve issue)

The brachial plexus is a web of nerves between the neck and shoulder, connecting the spinal cord nerves to the arm. There is one web on each side of the neck. Any injury that forces the shoulder to stretch down, and the neck to stretch up and away, can damage these nerves and cause brachial plexopathy.

Sports injuries and car accidents are often involved. Inflammation, tumors, and radiation treatment can also damage the brachial plexus.

Milder symptoms include numbness and weakness in the arm, with a shocklike stinging or burning sensation. A more severe injury can cause paralysis and loss of feeling in the arm, with pain in some parts of the arm, hand, and shoulder.

These symptoms should be seen by a medical provider since permanent damage can result if the injuries are not treated.

Diagnosis is made through electromyography (EMG) testing, CT scan, MRI, and sometimes angiogram.

Treatment usually involves rest and physical therapy. Surgery may be necessary to remove scar tissue or repair the damaged nerves.

Rarity: Uncommon

Top Symptoms: pain in one arm, shoulder pain that shoots to the arm, arm weakness, numbness in one arm, shoulder pain

Symptoms that never occur with brachial plexopathy (shoulder nerve issue): pain in the front middle part of the neck

Urgency: Primary care doctor

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Non-specific shoulder pain

Non-specific shoulder pain, also called NSSP, means that the cause of pain in the shoulder is not immediately obvious.

There are many structures in and around the shoulder. The pain may be from a condition or injury in the joint itself, or in any of the bones, muscles, tendons, and ligaments surrounding it. Anything from a broken arm to arthritis can cause shoulder pain.

Symptoms include pain that worsens with movement of the arm and shoulder, especially following overuse, or injury. Swelling, redness, joint deformity, inability to move the arm, or severe pain should be seen right away by a medical provider.

Shoulder pain with shortness of breath and/or pain or tightness in the chest can be signs of a heart attack. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination and through x-ray or CT scan.

Treatment usually begins with rest and over-the-counter, nonsteroidal anti-inflammatory pain relievers. Further care will be determined by medical providers once the exact cause of the pain has been determined.

Rarity: Common

Top Symptoms: shoulder pain

Symptoms that always occur with non-specific shoulder pain: shoulder pain

Urgency: Self-treatment

Biceps tendonitis

Biceps tendonitis is a painful inflammation of the tendon connecting the biceps muscle to the bones of the shoulder. Biceps tendonitis is usually caused by overuse, especially repetitive throwing-type motions of the arm. It can also be caused by pre-existing shoulder injuries, sudden force or older age.

Symptoms include a throbbing, aching pain in the shoulder that may radiate down the arm. Any throwing, lifting, or pulling movement may produce pain in the shoulder.

The diagnosis is made through physical examination and ultrasound, and possibly with CT scan and/or MRI.

Treatment begins with rest, ice, over-the-counter pain relievers, and physical therapy. It may also include injections of local anesthetic and/or corticosteroids into the biceps tendon sheath. Surgery may be needed in some cases.

Rarity: Rare

Top Symptoms: pain in one shoulder, pain in the front of the shoulder, spontaneous shoulder pain, dull, achy shoulder pain, shoulder pain that gets worse at night

Symptoms that always occur with biceps tendonitis: pain in the front of the shoulder

Urgency: Primary care doctor

Acromioclavicular (ac) shoulder joint injury

The shoulder is made up of three bones - the shoulder blade (scapula), collar bone (clavicle), and arm bone (humerus). The acromioclavicular (AC) joint is a joint that is in the front of the shoulder, where the collar bone and shoulder blade meet. This joint is stabilized by ligaments, which can tear if the two bones are separated from one another. This is most commonly caused by falling on the shoulder.

Rarity: Rare

Top Symptoms: constant shoulder pain, pain in one shoulder, shoulder pain from an injury, shoulder pain near the end of the collarbone, difficulty moving the shoulder

Symptoms that always occur with acromioclavicular (ac) shoulder joint injury: shoulder pain near the end of the collarbone, constant shoulder pain

Urgency: Primary care doctor

Biceps tendon rupture

The biceps muscle in the upper arm is anchored at the top by two separate tendons. One connects to the shoulder blade and one connects to the top of the shoulder joint. If one of these tendons is strained enough to completely tear it in two, this is called a rupture.

The injury is most common in people over age 40, especially after years of overuse of the shoulder. The person may have had episodes of biceps tendinitis in the past, which is a sign of fraying and damage to the tendon. In younger people it is primarily an acute sports injury, from weightlifting or from falling.

Symptoms include a pop or snap at the top of the shoulder, with sharp pain. There may soon be bruising halfway down the upper arm with obvious "balling up" of the partially disconnected muscle.

Diagnosis is made through patient history, physical examination, x-rays, and sometimes MRI.

Treatment involves over-the-counter anti-inflammatory medication; rest; ice; and physical therapy. Surgery may be done in some cases.

Rarity: Uncommon

Top Symptoms: pain in one shoulder, pain in the front of the shoulder, spontaneous shoulder pain, dull, achy shoulder pain, shoulder pain that gets worse at night

Symptoms that always occur with biceps tendon rupture: pain in the front of the shoulder, pain in one shoulder

Urgency: Primary care doctor

Shoulder strain

Shoulder strain means that the muscles and/or the tendons in the shoulder have been overstretched to the point of damage and sometimes partial tearing. (A "sprain" means that ligaments have been damaged.)

Because of its wide range of motion, the shoulder is a relatively unstable joint that is vulnerable to injury. A sudden overloading, especially after long periods of overuse, can finally cause some degree of tearing to the muscle fibers and/or the tendons.

Shoulder strains are most often sports injuries, or are caused by strenuous physical labor.

Symptoms include sudden sharp pain followed by swelling, bruising, and ongoing tenderness.

Diagnosis is made through patient history, physical examination, and sometimes ultrasound.

Treatment involves a short period of rest, followed by gradually increasing exercise to regain strength and prevent stiffness and weakness of the muscles and tendons. Physical therapy will be tailored to the individual and some skills, such as for sports, may need to be relearned. Improving posture while sitting, and adjusting techniques for work and sports, can help prevent recurrence of the strain.

Rarity: Uncommon

Top Symptoms: pain in one shoulder, pain in the front of the shoulder, shoulder pain from overuse, shoulder pain from an injury, sports injury

Symptoms that always occur with shoulder strain: pain in one shoulder

Symptoms that never occur with shoulder strain: arm weakness, arm numbness

Urgency: Phone call or in-person visit

Severe Shoulder Pain Treatments and Relief

At-home treatment

Severe shoulder pain remedies that you can try at home, such as while waiting for your appointment, include the following.

  • Hot or cold packs to the painful area: This depends on which seems most helpful to you.
  • NSAIDs: Taking over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve), or aspirin.

When to see a doctor

You should schedule an appointment to see your physician for the following.

  • Constant, unrelenting pain in the shoulder joint
  • Inability to move the arm due to pain
  • Discussion of physical therapy for chronic pain

When it is an emergency

Seek immediate treatment in the emergency room or call 911 if the severe shoulder pain is accompanied by:

  • Abdominal pain and vaginal bleeding in a woman of childbearing age
  • Acute distress in a person who has an implanted defibrillator: The pain may indicate that the defibrillator is malfunctioning.
  • Pain, redness, and fever in someone who has had a shoulder replacement or other shoulder surgery
  • One-sided facial symptoms, exhaustion, and weight loss

Questions Your Doctor May Ask About Severe Shoulder Pain

To diagnose this condition, your doctor would likely ask the following questions:

  • How would you explain the cause of your shoulder pain?
  • Can you fully move your shoulders around?
  • Where exactly is your shoulder pain?
  • Have you ever been diagnosed with diabetes?

The above questions are also covered by our A.I. Health Assistant.

If you've answered yes to one or more of these questions

Take a quiz to find out why you're having severe shoulder pain

Severe Shoulder Pain Symptom Checker Statistics

People who have experienced severe shoulder pain have also experienced:

  • 8% Pain In One Shoulder
  • 5% Pain In The Back Of The Neck
  • 4% Pain In One Arm

People who have experienced severe shoulder pain were most often matched with:

  • 33% Rotator Cuff Tendonitis
  • 33% Frozen Shoulder (Adhesive Capsulitis Of The Shoulder)
  • 33% Shoulder Arthritis

People who have experienced severe shoulder pain had symptoms persist for:

  • 36% Over a month
  • 23% Less than a week
  • 19% Less than a day

Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

Severe Shoulder Pain Symptom Checker

Take a quiz to find out why you're having severe shoulder pain

References

  1. Referred Shoulder Pain. C.S. Mott Children's Hospital: Michigan Medicine. Updated Sept. 23, 2018. Mott Children's Link
  2. Bursitis, Tendinitis, and Other Soft Tissue Rheumatic Syndromes. University of Washington Medicine: Orthopaedics and Sports Medicine. UW Medicine Link
  3. Bjørnholdt KT, Brandsborg B, Søballe K, Nikolajsen L. Persistent pain is common 1-2 years after shoulder replacement. Acta Orthop. 2015;86(1):71-7. NCBI Link
  4. Wahl AK, Rustøen T, Rokne B, et al. The complexity of the relationship between chronic pain and quality of life: a study of the general Norwegian population. Qual Life Res. 2009;18(8):971-80. NCBI Link
  5. Amaya-Amaya J, Rojas-Villarraga A, Mantilla RD, et al. Rheumatoid arthritis. In: Anaya JM, Shoenfeld Y, Rojas-Villarraga A, et al., editors. Autoimmunity: From Bench to Bedside [Internet]. Bogota (Colombia): El Rosario University Press; 2013 Jul 18. Chapter 24. NCBI Link
  6. Kumar M, Thilak J. Infected shoulder joint with loose Suture Anchor in the joint after Bankart's Repair- A Case Report. J Orthop Case Rep. 2016;6(2):6-8. NCBI Link
  7. Bleeding During Pregnancy. The American College of Obstetricians and Gynecologists. July 2016. ACOG Link
  8. Gahremanpour A, Saeed M, Birnbaum Y. Evaluation of Chest Pain after Implantable Cardioverter-Defibrillator Placement. Tex Heart Inst J. 2017;44(3):226-227. Published June 1, 2017. NCBI Link