Minor shoulder problems, such as sore muscles and aches and pains,
are common. Shoulder problems develop from everyday wear and tear, overuse, or
an injury. They can also be caused by the natural process of aging.
Your shoulder joints move every time you move your arms. To better
understand shoulder problems and injuries, you may want to review the anatomy
and function of the
shoulder. The shoulder is a ball-and-socket joint with
three main bones: the upper arm bone (humerus), collarbone (clavicle), and shoulder blade (scapula). These
bones are held together by muscles,
ligaments. The shoulder joint has the greatest
range of motion of any joint in the body. Because of
this mobility, the shoulder is more likely to be injured or cause problems. The
acromioclavicular (AC) joint, which lies over the top
of the shoulder, is also easily injured.
Shoulder problems can be
minor or serious. Symptoms may include pain, swelling, numbness, tingling,
weakness, changes in temperature or color, or changes in your range of motion.
Shoulder injuries most commonly occur during sports activities, work-related
tasks, projects around the home, or falls. Home treatment often can help
relieve minor aches and pains.
Sudden (acute) injury
Injuries are the most common
cause of shoulder pain.
A sudden (acute) injury may occur from a
fall on an outstretched arm, a direct blow to the shoulder, or abnormal
twisting or bending of the shoulder. Pain may be sudden and severe. Bruising
and swelling may develop soon after the injury. If nerves or blood vessels have
been injured or pinched during the injury, the shoulder, arm, or hand may feel
numb, tingly, weak, or cold, or it may look pale or blue. Acute injuries
Bruises (contusions), which occur when small
blood vessels under the skin tear or rupture, often from a twist, bump, or
fall. Blood leaks into tissues under the skin and causes a black-and-blue color
that often turns purple, red, yellow, and green as the bruise
Injuries to the tough, ropy fibers (ligaments) that
connect bone to bone and help stabilize the shoulder joints (sprains).
Injuries to the tough, ropy
fibers that connect muscle to bone (tendons).
Separation of the shoulder, which occurs when the
outer end of the collarbone (clavicle) separates from the end (acromion) of the
shoulder blade because of torn ligaments. This injury occurs most often from a
blow to a shoulder or a fall onto a shoulder or outstretched hand or
Damage to one or more of the four tendons that cover the
shoulder joint (torn rotator cuff), which may occur from a direct blow
to or overstretching of the tendon.
Broken bones (fractures). A break may occur when a bone is twisted,
struck directly, or used to brace against a fall.
pushing bones out of their normal relationship to the other bones that make up
the shoulder joint (subluxation or
You may not recall having a specific
injury, especially if symptoms began gradually or during everyday activities.
Overuse injuries occur when too much stress is placed on a joint or other
tissue, often by overdoing an activity or through repetition of an activity.
Overuse injuries include:
Inflammation of the sac of fluid that cushions
and lubricates the joint area between one bone and another bone, a tendon, or
the skin (bursitis).
Inflammation of the tough,
ropy fibers that connect muscles to bones (tendinitis).
Bicipital tendinitis is an inflammation of one of the
tendons that attach the muscle (biceps) on the front of the upper arm bone
(humerus) to the shoulder joint. The inflammation usually occurs along the
groove (bicipital groove) where the tendon passes over the humerus to attach
just above the shoulder joint.
frozen shoulder, which is a condition that limits
shoulder movement and may follow an injury.
movements, which may cause tendons to rub or scrape against a part of the
shoulder blade called the acromion. This rubbing or scraping may lead to
abrasion or inflammation of the
rotator cuff tendons (also called
Other causes of shoulder symptoms
Overuse and acute
injuries are common causes of shoulder symptoms. Less common causes of shoulder
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First aid for a suspected broken bone
Control bleeding. Apply steady, direct
pressure for a full 15 minutes. Use a clock—15 minutes can seem like a long
time. Resist the urge to peek after a few minutes to see whether bleeding has
stopped. If blood soaks through the cloth, apply another one without lifting
the first. If there is an object in the wound, apply pressure around the
object, not directly over it.
Remove all bracelets or rings. It may
be difficult to remove the jewelry after swelling develops. See a picture of how
to remove a ring that won't come off easily.
bone is sticking out of the skin, do not try to push it back into the skin.
Cover the area with a clean bandage.
If a cast or splint is applied, it is
important to keep it dry and to try to move the uninjured parts of your limb as
normally as possible to help maintain muscle strength and tone. Your doctor
will give you instructions on how to
care for your cast or splint.
Home treatment for minor symptoms
Home treatment may
help relieve pain, swelling, and stiffness.
If your injury does
not require an evaluation by a doctor, you may be able to use home treatment to
help relieve pain, swelling, and stiffness. It may take up to 6 weeks or longer
before your symptoms are gone. Use
rest, ice, compression, and elevation (RICE) for home
Rest and protect an
injured or sore area. Stop, change, or take a break from any activity that may
be causing your pain or soreness.
reduce pain and swelling. Apply
ice or cold packs immediately to prevent or minimize swelling. Apply the ice
or cold pack for 10 to 20 minutes, 3 or more times a day.
For the first 48 hours after an injury,
avoid things that might increase swelling, such as hot showers, hot tubs, hot
packs, or alcoholic beverages.
After 48 to 72 hours, if swelling is
heat and begin
gentle exercise with the aid of moist heat to help
restore and maintain flexibility. Some experts recommend alternating between
heat and cold treatments.
Compression, or wrapping
the injured or sore area with an elastic bandage (such as an Ace wrap), will
help decrease swelling. Wear a
sling for the first 48 hours after the injury, if it
makes you more comfortable and supports your shoulder. If you feel you need to
use a sling for more than 48 hours, discuss your symptoms with your
Elevate the injured or sore area on
pillows while applying ice and anytime you are sitting or lying down. Try to
keep the area at or above the level of your heart to help minimize
Gently massage or rub the area to relieve pain and
encourage blood flow. Do not massage the injured area if it causes
Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.
Be sure to follow these
safety tips when you use a nonprescription medicine:
Carefully read and follow all directions
on the medicine bottle and box.
Shoulder range of motion or strength in the joint
decreases or does not return to normal.
Symptoms do not improve
despite home treatment.
Symptoms become more severe or
The following tips may prevent shoulder
problems or injuries.
General prevention tips
Stay in good overall physical shape. Strengthen
your wrist, arm, shoulder, neck, and back muscles to help protect and decrease
stress on your shoulder. Do stretching and range-of-motion (ROM) exercises for
your arms and shoulders.
Maintain good posture. Stand straight and
relaxed, without slumping.
Warm up well and stretch before any
activity. Stretch after exercise to keep hot muscles from shortening and
Wear protective gear during sports or recreational
activities, such as roller-skating or soccer.
Wear your seat belt
when in a motor vehicle.
Do not use alcohol or other drugs before
participating in sports or when operating a motor vehicle or other
Don't carry objects that are too
Avoid catching falling objects.
Use a step
stool. Do not stand on chairs or other unsteady objects.
correct body movements or positions during activities, such as lifting, so that
you do not strain your shoulder. Do not lift objects that are too heavy for
Avoid overusing your arm doing repeated movements that can
bursa or tendons. In daily routines or hobbies, think
about the activities in which you make repeated arm movements. Try alternating
hands during activities such as gardening, cooking, or playing musical
rest, ice, compression, and elevation (RICE) for home
Avoid keeping your arms out to the side or raised
overhead for long periods of time, such as when painting a ceiling. If you must
do these things, take frequent breaks, and use RICE for home treatment.
Consider consulting a sports-training specialist if you are a
competitive or serious recreational athlete. The specialist can recommend
training and conditioning programs to prevent shoulder problems or
Make sure your child's backpack is the right size with
good support. Carrying heavy backpacks may increase the risk of shoulder
problems or injury.
If you feel that activities at your workplace
are causing pain or soreness from overuse, call your human resources department
for information on alternative ways of doing your job or to discuss equipment
modifications or other job assignments.
To prevent falls in your home, remove raised
doorway thresholds, throw rugs, and clutter. For more information, see
To prevent falls in
babies and toddlers, use stair gates to block stairways. Use gates at the top
and bottom of the stairs, and use the gates properly. For more information, see
tips to prevent falls in babies and toddlers.
Keep bones strong
Eat a nutritious diet with enough
vitamin D, which helps your body absorb calcium.
Calcium is found in dairy products, such as milk, cheese, and yogurt; dark
green, leafy vegetables, such as broccoli; and other foods. For more
information, see the topic
Exercise and stay active.
It is best to do weight-bearing exercise for at least 2½ hours a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. In addition to weight-bearing exercise, experts recommend that you do resistance exercises at least 2 days a week. Exercises that are not weight-bearing, such as swimming, are good for your general health. But they do not work your muscles and bones against gravity and so they do not stimulate new bone growth. Starting these exercises at any age will help prevent bone loss. But if you stop exercising, your bones will begin to thin. Talk to your doctor about an exercise program that is right for you. Begin slowly, especially if you have been inactive. For more information, see the
Don't drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink a day if you are a woman. People who drink more than this have a higher risk for
weakening bones (osteoporosis). Alcohol use also
increases your risk of falling and breaking a bone.
Stop or do not
start smoking. Smoking puts you at a much higher risk for developing
osteoporosis. It also interferes with blood supply and healing. For more
information, see the topic
Shoulder injuries such as bruises,
fractures, or dislocations may be caused by
abuse. Suspect possible abuse when an injury cannot be
explained or does not match the explanation, repeated injuries occur, or the
explanations for the cause of the injury change. Seek help if:
You suspect abuse. Call your local child or
adult protective agency, police, or a doctor, nurse, or
How this information was developed to help you make better health decisions.