How Can I Tell if Shoulder Pain is Serious?

Estimated Reading Time: 7 minutes

Your shoulder is the most mobile joint in your body with an extensive range of motion. This can cause it to be susceptible to pain.

Most people experience short-lived shoulder pain now and again after over-rotating or over-extending it when doing repetitive shoulder movements such as swimming and painting. If the pain doesn’t go away, it can cause significant problems in your everyday life and you will wonder what is causing it and if the pain is serious.

Shoulder pain can have many causes. It may be due to a fall, an accident, overdoing or over-rotating movements, long-term wear and tear called arthritis, or it can even stem from issues in other parts of your body, called referred pain.

So how do you know if the pain is serious? If you’ve had a severe injury, it’s likely you will seek medical attention for your shoulder pain. But what if you have shoulder pain that seems to be lasting, yet you’re not aware that you have injured a bone, ligament, or tendon?

In this article, we discuss when to see your doctor if you have shoulder pain, how to determine what type of shoulder pain you have, and whether you need surgery for one of the most common conditions for shoulder pain called a torn rotator cuff.


How do I know what type of shoulder pain I have?

Your shoulder can hurt after it has been injured or for no apparent reason. You will want to know if it is nothing to worry about or indicative of a more serious or complex problem.

You can use this general guide to interpret your shoulder pain but you should not self-diagnose.

  • If you have pain and stiffness that does not go away over months or years, you may have a frozen shoulder, osteoarthritis, or rheumatoid arthritis.
  • If your pain is often worse while you use your arm or shoulder, this could suggest you have tendonitis, bursitis, or impingement.
  • If your shoulder feels like it is clicking or locking and your arm is tingling, numb, or weak you may have shoulder instability.
  • If you have pain where your collarbone and shoulder joint meet, this could mean you have a dislocated, stretched, or torn ligament in your acromioclavicular joint (joint at the top of your shoulder).
  • If you have sudden and intense pain and you cannot move your arm or it’s difficult to move it you might have a dislocated shoulder, a broken bone, or a torn or ruptured tendon.

As a layperson, it is tricky to identify the type of shoulder pain you have. Only a trained medical professional can make a formal diagnosis and they will then recommend a treatment plan.

If you see a doctor or physiotherapist for your shoulder pain, they will examine you to work out what's causing it. They will test your shoulder’s range of motion by asking you to move your arms in various ways, such as above your head, across your body, or behind you, and rotating it.

Also, they may refer you for some imaging tests to help find out what is happening to your shoulder. These can include X-rays, an MRI scan, a CT scan, and an arthroscopy. They will then give you a diagnosis of your shoulder pain.


How long should shoulder pain last before seeing a doctor?

There are some things you can do to ease your shoulder pain at home. These include:

  • staying active and gently moving your shoulder
  • taking pain relief to allow you to keep moving, such as over-the-counter painkillers like paracetamol and ibuprofen and heat or cold packs
  • standing straight with your shoulders down and gently back
  • placing a cushion behind your lower back when sitting
  • resting your arm in your lap on a cushion
  • shoulder exercises for six to eight weeks to stop the pain from returning.

It can take two weeks for any of these pain-easing actions to take effect. If your pain is not easing after trying these for two weeks you should see your doctor.

You should see a doctor immediately if you’ve had or have signs of a serious injury such as a broken or dislocated bone, or a torn ligament or tendon.

Signs that you should see your doctor urgently include:

  • sudden or very bad shoulder pain
  • unable to move your arm
  • continuous pins and needles that don’t stop
  • loss of feeling in your arm or shoulder
  • change of shape or badly swollen arm or shoulder
  • your arm or shoulder is hot or cold to touch
  • pain that started after an injury or accident
  • severe pain in both shoulders
  • feel feverish or unwell

It can take six months or longer to recover from shoulder pain.


How can you tell the difference between a torn rotator cuff and an impingement?

You will usually experience different types of pain depending on whether you have a torn rotator cuff or a shoulder impingement.

Impingement causes pain at the top and outer side of your shoulder. This pain often gets worse while using your arm or shoulder or when you lift your arm, especially when you lift it above your head. You may have pain or aching at night and it can affect your sleep. Your arm may also feel weak.

Rotator cuff often causes sudden and acute pain where you cannot or it’s difficult to move your arm. You may feel pain when you lift or lower your arm or when you do specific movements. At night and when resting, you may feel pain, especially if you are lying on your affected shoulder. You may have a crackling or popping feeling when you move your arm in certain positions. Your arm may feel weak when lifted or rotated.


Can you live with a torn rotator cuff without surgery?

Yes, you can live with a torn rotator cuff without surgery if non-surgical treatments are effective. These can include rest, immobilisation, anti-inflammatory medications, steroid (cortisone) injections, and physiotherapy.

However, if you have persistent shoulder pain or weakness that does not improve with non-surgical treatment, then surgery may be recommended. For example, if you have ongoing disturbed nights due to pain and difficulty using your arm to lift and reach, and taking medication for several months and limiting your arm usage is not helping.

Additionally, if you are an active individual and use your arm for overhead work or sports, such as swimmers and tennis players, surgery is usually recommended. This is because many tears cannot heal on their own without surgery.


West Valley Hospital can assess, diagnose and treat your shoulder pain

If you would like a professional assessment of your shoulder pain, we offer convenient appointments without waiting with our expert shoulder surgeons and physiotherapists. You can get a rapid diagnosis of your shoulder pain and non-surgical and surgical treatment options to help relieve your pain as soon as possible.

Our skilled surgeons can give medications and steroid injections as well performing minimally invasive and more complex surgery to relieve shoulder pain. Whilst our experienced physiotherapists can develop a program of exercises and stretches to help relieve your pain, regain strength in your shoulder muscles and increase your flexibility and range of motion to prevent further injury.

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