Understanding Shoulder Pain: Symptoms and Causes

Dr. James - Orthopaedic Surgeon in Singapore

Written by Dr James Tan

Shoulder pain is a common issue that affects Singaporeans of all walks of life, from office workers hunched over desks to athletes swinging rackets on the court. As the body’s most mobile joint, the shoulder is susceptible to injuries, overuse, and conditions like arthritis, leading to discomfort that can hinder daily tasks like lifting bags or reaching for items. Whether it’s a nagging ache, stiffness, or sharp pain, understanding the symptoms and causes of shoulder pain is the first step toward relief. 

Causes Of Shoulder Pain

Shoulder pain can be caused by an acute injury, repetitive movements, trauma, or chronic conditions. These causes can include:

Rotator Cuff Injuries

One of the most common causes of shoulder pain is a rotator cuff injury. The rotator cuff is a group of muscles and tendons that stabilise the shoulder joint.

  • Causes: Repeated overhead motions (e.g., in swimming, tennis, or weightlifting), age-related wear and tear, trauma.
  • Symptoms: Pain when lifting the arm, weakness in the shoulder, difficulty with overhead movements, and discomfort at night.

Shoulder Impingement

Shoulder impingement, another common cause of shoulder pain, occurs when the tendons of the rotator cuff are pinched or compressed during shoulder movements, causing inflammation and pain.

  • Causes: Repetitive overhead activities (e.g., throwing, painting, swimming) and poor posture.
  • Symptoms: Pain when lifting the arm, tenderness in the front or side of the shoulder, and difficulty reaching behind the back.

Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder is characterised by stiffness and pain in the shoulder joint, which can progressively worsen and lead to a limited range of motion.

  • Causes: Often occurs after periods of immobility (e.g., after surgery or injury) or due to some medical conditions like diabetes or thyroid disorders.
  • Symptoms: Gradual onset of stiffness, difficulty moving the shoulder, and pain that worsens over time, especially during sleep.

Read more about frozen shoulder treatment by a specialist doctor.

Shoulder Dislocation

A dislocated shoulder occurs when the upper arm bone (humerus) is forced out of its socket (glenoid), usually as a result of trauma or injury.

  • Causes: Sports injuries, falls, accidents, or high-impact trauma.
  • Symptoms: Severe pain, visible deformity in the shoulder, swelling, and inability to move the arm.

Tendonitis

Tendonitis in the shoulder occurs when the tendons become inflamed due to overuse, injury, or ageing. It is most common in the rotator cuff tendons.

  • Causes: Repetitive overhead movements, overuse injuries, or age-related degeneration of the tendons.
  • Symptoms: Pain and tenderness around the shoulder joint, especially when moving the arm, and swelling or a clicking sensation.

Bursitis

Bursitis occurs when the bursae—small, fluid-filled sacs that cushion the shoulder joint—become inflamed. This condition often accompanies tendonitis and can restrict shoulder movement.

  • Causes: Repetitive motions, prolonged pressure on the shoulder, injury, or infection.
  • Symptoms: Swelling, warmth, and tenderness in the shoulder, along with pain when moving the arm.

Labral Tear

The labrum is the cartilage that surrounds the shoulder socket and helps stabilize the joint. A tear in the labrum can lead to shoulder pain and instability.

  • Causes: Trauma, repetitive overhead movements, or degeneration over time.
  • Symptoms: Pain, instability or feeling that the shoulder could “pop out,” limited range of motion, and a catching or clicking sensation in the shoulder.

Arthritis

Shoulder arthritis, most commonly osteoarthritis, occurs when the cartilage in the shoulder joint wears down over time, leading to pain and stiffness.

  • Causes: Age-related wear and tear, previous shoulder injuries, or inflammatory conditions such as rheumatoid arthritis.
  • Symptoms: Pain, stiffness, swelling, and a reduced range of motion, particularly during activity.

Fractures

Fractures of the bones in the shoulder (e.g., humerus, clavicle, or scapula) can result from direct trauma or falls.

  • Causes: Falls, accidents, or high-impact sports injuries.
  • Symptoms: Severe pain, swelling, bruising, and inability to move the shoulder or arm.

Referred Pain from the Neck

In some cases, shoulder pain may originate from problems in the neck, such as herniated discs or cervical spine issues. This is known as referred pain.

  • Causes: Nerve compression in the neck or cervical spine conditions.
  • Symptoms: Pain radiating from the neck to the shoulder, numbness, tingling, or weakness in the arm.

Diagnosis

For any kind of shoulder pain treatment in Singapore, the first step is to confirm the diagnosis. A qualified shoulder pain specialist in Singapore can diagnose the underlying cause and suggest treatment accordingly. The shoulder specialist can evaluate your physical condition, ask questions about the pain and injury, and carry out a physical exam. He may order additional tests such as electromyography and other nerve conduction tests to rule out any neurological disorders involving pinched nerves from slipped or herniated discs in the spine. An MRI is recommended if the doctor suspects any problems related to soft tissues, muscles, and tendons.

To learn the difference between an x-ray MRI, and a CT scan, check out this article.

Types of Shoulder Pain

As part of the diagnosis, a Singapore shoulder specialist will determine the type of shoulder pain before he can recommend an effective treatment plan.

Acute Shoulder Pain

This refers to the sudden onset of pain, usually associated with an injury. It can result in sharp, shooting pains that restrict the range of motion of the arm. Pain increases with movement and may be accompanied by swelling and inflammation.

Chronic Shoulder Pain

This usually manifests slowly and gradually over time with a dull and mild ache. The pain can cause low shoulder mobility over time. Although patients may feel a mild ache when resting, they may experience pain flare-ups from time to time.

shoulder pain anatomy

Frequently-Asked Questions

What are the home remedies for shoulder pain?

Shoulder pain can cause significant difficulty in one’s life and daily activities. In case of minor shoulder sprains, home remedies can help aid healing and result in fast recovery. These home remedies include applying ice on the affected area, restricting the movement of the affected arm, using an arm sling, and giving the shoulder joint as much rest as possible.

Why is shoulder health important?

Shoulder health is important not only for athletes and sportsmen but for all kinds of individuals. A healthy shoulder enables you to carry out the daily activities of life with ease and enhances the sense of enjoyment and fulfilment in one’s life. It improves the quality of life and physical performance while reducing the risk of shoulder injuries.

Why do I experience shoulder pain after waking up?

If you do not have any history of shoulder injury but experience pain after waking up in the morning, the main culprit in most cases will be your sleeping position. People who sleep on their sides often experience pain as their rotator cuff tendons may become impinged. Most of the time, discomfort should resolve in a couple of days. However, if you continue to experience pain even after a week, you should get it checked by the qualified Dr James Tan.

When is shoulder pain an emergency?

You should always consult your doctor to get properly diagnosed and treated in case of any shoulder pain. However, if you feel intense pain while moving or when you lift your arm, accompanied by swelling and/or fever, it is an emergency that needs to be evaluated by the concerned shoulder specialist. If the skin of the shoulder area appears red or blue, it is also considered an emergency.

Sometimes, shoulder pain could also be a referred pain that may be a sign of a heart attack. Such pain could spread to your arms and shoulders. Thus, it is always good to be safe and see a specialist doctor in Singapore.

How can shoulder pain be prevented?

Maintaining good shoulder health through exercises, adopting an active lifestyle, maintaining good posture, and using the right lifting techniques can help in preventing shoulder pain and related injuries.

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About The Author

Dr James Tan Chung Hui's Background

Dr James Tan is a skilled orthopaedic surgeon in Singapore who has more than 10 years of experience in sports surgery and exercise medicine. Apart from partnering with the industry to introduce various treatment techniques, Dr Tan has treated athletes from the Singapore National Teams and professional footballers from the Singapore Premier League and the Young Lions.

Dr Tan specialises in treating sports injuries of the knee, shoulder and elbow joints, as well as cartilage and meniscus surgery. He is a member of the elite Asian Shoulder and Elbow Group and a founding member of the Singapore Shoulder and Elbow Surgery Society.

dr james tan

Medical Education and Affiliations

MBBS | NUS

Member of the Royal College of Surgeons of Edinburgh (MRCS)

MMed (Orthopaedics) | NUS

Fellow of Royal College of Surgeons (Edinburgh)

Adjunct Assistant Professor | NUS, LKC

Senior Consultant Orthopaedic Surgery, Sports and Exercise Medicine

Head of Department | Orthopaedic Surgery and Sports Medicine Centre

Awards

Principal Investigator of Tissue Engineering

National Medical Research Council grants

Collaboration with Scientists at NTU, TUM, A*Star, Osteopore & Trendlines Medical Singapore

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