What Causes Shoulder Pain? Learn the Causes, Symptoms, and Physiotherapy Treatment Approaches
Shoulder pain is one of the most common problems found among working-age individuals, athletes, and older adults. Many people initially experience fatigue or soreness around the neck, upper shoulder, and shoulder area after working in front of a computer, lifting heavy objects, or playing sports. However, over time, the symptoms may not improve and may become worse, causing difficulty lifting the arm fully or pain radiating down the arm.
In reality, shoulder pain is not caused only by muscles. It may also be related to tendons, the shoulder joint, the nervous system, as well as abnormalities of the cervical spine and body movement patterns. A detailed assessment to identify the cause is therefore important to ensure treatment addresses the root cause and reduces the chance of recurrence.
Causes of Shoulder Pain
1. Neck and Shoulder Muscle Tightness from Repetitive Use
Sitting in front of a computer for a long time, looking down at a mobile phone, or driving continuously for several hours can cause the muscles around the neck, shoulders, and scapula to work excessively. This can lead to muscle tightness and trigger points, resulting in shoulder pain or pain radiating to the neck.
2. Rotator Cuff Tendinopathy
The tendons that help control shoulder joint movement may become inflamed due to repetitive use, heavy lifting, or sports activities. This can cause pain when lifting the arm, combing hair, reaching for objects above shoulder level, or reaching behind the back.
3. Frozen Shoulder
Frozen shoulder occurs when the shoulder joint capsule becomes thickened and tight, causing reduced shoulder movement. Patients often experience pain along with difficulty lifting the arm fully, especially during nighttime or after waking up.
4. Shoulder Osteoarthritis
This is commonly found in older adults or individuals who have heavily used their shoulder joints for a long period of time. It can result in shoulder pain, difficulty moving the shoulder joint, and possible clicking or sounds during movement.
5. Problems from the Cervical Spine and Nerves
Some cases of shoulder pain do not originate directly from the shoulder joint but may result from nerve compression in the neck. This can cause pain radiating down the arm, numbness, or muscle weakness.
6. Movement and Structural Dysfunction
Muscle imbalance around the scapula, trunk, and core muscles may cause the shoulder joint to receive more stress than normal, resulting in chronic pain and recurrent symptoms.
What Types of Shoulder Pain Should Be Assessed?
If you experience the following symptoms, you should receive an assessment by a physiotherapist:
- Shoulder pain lasting longer than 2 weeks, even after resting without improvement
- Unable to fully lift the arm or limited shoulder movement
- Pain when reaching for objects, lifting objects, or reaching movements
- Pain radiating down the arm or associated numbness
- Severe pain during nighttime or pain that interferes with sleep
- Recurrent pain from work activities or sports
If symptoms occur after an accident, such as falling, shoulder deformity, inability to lift the arm, or suspected fracture, medical attention should be sought immediately.
Shoulder Pain Assessment at PS Center
At PS Center, we believe that effective treatment begins with an accurate assessment. Physiotherapists will analyze both the painful area and the factors contributing to the symptoms in order to identify the true cause.
1. Detailed History Taking
The physiotherapist will ask about:
- Characteristics and location of the pain
- Duration of symptoms
- Activities that cause pain
- Occupation and daily shoulder usage
- History of injury or surgery
- Associated symptoms such as numbness, weakness, or frozen shoulder
2. Physical Assessment
Assessment of the muscle and shoulder joint system includes:
- Shoulder joint range of motion
- Muscle strength
- Muscle and tendon tightness
- Nervous system function
- Coordination between the neck, scapula, and shoulder joint
3. Posture & Movement Analysis
The physiotherapist will analyze movement patterns and body posture, such as:
- Working posture
- Computer usage
- Lifting objects
- Exercise activities
- Scapular and shoulder joint movement patterns
To identify contributing factors causing symptoms and design an individualized treatment program.
If abnormalities are found that are outside the scope of physiotherapy care or there are indications requiring further examination, the physiotherapist will recommend consultation with a physician for appropriate diagnosis and treatment.
