Mechanical / structural
- Rotator cuff tendinopathy or tear
- Bursitis
- Arthritis
- Frozen shoulder
- Joint or tendon injury
- Pain referred from the neck or another source
NEXUS PAIN EDUCATION
Shoulder Pain
Understand the anatomy, possible causes, warning signs, and the kinds of evaluation and treatment approaches that may be considered.
Shoulder — interactive 3DDrag/rotate and zoom inside the NIH 3D viewer when supported.
Region-specific educational anatomy. Open the NIH 3D model in a new tab if the embedded viewer is unavailable. This model is for education and does not diagnose the cause of pain.
ANATOMY
Structures involved
Glenohumeral joint, rotator cuff tendons, bursa, acromioclavicular joint and surrounding muscles.
Symptoms can arise from more than one structure. Location alone cannot reliably identify the cause, so history and examination matter.
COMMON POSSIBILITIES
What may cause shoulder pain?
Why symptoms vary
Pain intensity does not always match the amount of structural change seen on imaging. A clinical evaluation considers function, neurologic findings, medical history, and symptom pattern.
Not every case needs imaging
Imaging and diagnostic testing are selected when the history, examination, persistence of symptoms, trauma, neurologic findings, or other clinical factors make them useful.
SYMPTOMS
What patients may notice
- Pain with reaching or lifting
- Night pain
- Weakness
- Reduced motion or stiffness
- Tenderness or swelling
- Pain that travels from the neck may suggest a nerve source
How Nexus may evaluate pain
An evaluation may include symptom history, medication review, functional limitations, physical examination, neurologic assessment when relevant, review of prior records or imaging, and additional testing or referral when clinically indicated.
No medication, injection, imaging study, controlled substance, procedure, or referral is guaranteed.
TREATMENT APPROACHES
Care is matched to the diagnosis and patient.
Conservative care
- Activity modification
- Clinically appropriate pain or anti-inflammatory medication
- Physical therapy and range-of-motion work
- Imaging when indicated
- Selected injections or orthopedic/pain referral
- Surgery for selected tears or advanced joint disease
Medication safety
Medication choices depend on diagnosis, other medical conditions, current medicines, risks, benefits, prior treatment response, and applicable prescribing requirements.
Procedures & referrals
Selected patients may benefit from procedural evaluation or referral to physical therapy, imaging, orthopedics, neurology, spine care, rheumatology, or another specialty depending on findings.
Seek urgent or emergency evaluation when appropriate
Severe symptoms after major trauma, new bowel or bladder dysfunction, new or progressive weakness, fever with severe pain, a hot/red swollen joint, inability to bear weight after injury, chest pain, trouble breathing, or other rapidly worsening symptoms can require urgent assessment. Call 911 for an emergency.
Patient education only. This page does not establish a physician-patient relationship, diagnose the cause of pain, or provide an individualized treatment plan.