Debunking common myths about shoulder pain

Your shoulders are a critical part of your movement each day. From walking to picking objects up to writing, these functions rely on moving your arms and, as a result, using your shoulders.

But if you have shoulder pain, it can make all of these activities (and more) uncomfortable and possibly keep you from engaging in your life in the way you want and deserve.

Despite shoulder pain being one of the most common joint problems, there are a lot of misconceptions surrounding it. Whether it's what causes shoulder pain or what can make it worse, these myths make it difficult to manage shoulder pain properly.

Here are five myths about shoulder pain — and the facts behind them:

1. Shoulder pain is always caused by a one-time injury

One of the more prevalent rumors is that shoulder pain is caused by an injury, like direct trauma to the shoulder or a fractured bone. But shoulder pain can be caused by wear and tear that occurs over time.

"Shoulder injuries are frequently caused by repetitive and excessive overhead motion. This can include movements during sports, like swimming, tennis, weightlifting and baseball," says Christopher Kester, DO, an orthopaedic surgeon at Main Line Health. "But shoulder injuries can also be a result of everyday activities, like hanging curtains, washing walls and gardening."

Reducing your risk of wear-and-tear shoulder injuries includes changing your approach to how you use your shoulders. Athletes can work with a physical therapist to strengthen the shoulder muscles and learn how to rest the shoulder to prevent overuse injury. As for everyday activities, you may need to limit how much you perform overhead motions. In either case, be sure to see your healthcare provider if you're concerned about a shoulder injury.

2. Shoulder problems only develop while you're awake

It's common to think of shoulder injuries as being caused while you're out and about doing any number of things. But shoulder pain can also happen when you're least aware - like during your sleep.

For instance, back sleepers might develop shoulder pain from the way the shoulder sags just a little bit toward the bed. Stomach sleepers can face issues with the rotator cuff (the muscles and tendons around the shoulder joint). And side sleepers aren't free of risk, either. They can develop pain if the shoulder isn't in a neutral position.

"The best way to avoid shoulder pain while you sleep is to keep your shoulder from dipping down and touching your bed. This might involve using another pillow or blanket to prop up your shoulder or to keep it in a neutral position. For stomach sleepers who put their arms under their pillow, it's often best to find another sleeping position altogether," says Dr. Kester.

3. Shoulder problems only show up as pain

Many people are on the lookout for shoulder pain to indicate a shoulder problem. But problems in your shoulder won't always be painful at first. You might also experience:

• Shoulder stiffness
• An inability to rotate the shoulder in both directions
• Decreased strength
• Difficulty completing daily activities
• Popping, cracking, grinding or clicking in your shoulder joint

Unfortunately, the subtleness of these signs may make people push through the discomfort, which can make problems worse or cause more issues down the road.

If you're experiencing any of these signs of a shoulder injury, and your discomfort doesn't improve with rest, ice and over-the-counter anti-inflammatory medications, talk to your healthcare provider about the cause of your pain and how it can be treated.

4. Rest is key if you have arthritis in your shoulders

Rest and activity adjustments are both common courses of treatment for shoulder pain. But if your shoulder pain is a result of arthritis (shoulder joint inflammation), rest can actually make things worse. In avoiding movement completely, you might cause the soft tissues of the shoulder joint to stiffen or tighten. This can lead to more difficulty with motion and, eventually, more pain.

Instead, shoulder arthritis is treated with:

• Shoulder exercises (often guided by a physical therapist)
• Activity adjustments, such as avoiding lifting heavy objects
• Ice or heat (whichever eases the pain more effectively)
• Over-the-counter pain medications
• Injections, such as corticosteroids

In serious cases of shoulder arthritis, your healthcare provider may recommend surgery. One type of shoulder surgery is a total shoulder replacement, which replaces the diseased parts of your shoulder with plastic and metal.

5. Shoulder injuries can only be diagnosed using imaging tests

If you're faced with shoulder pain, you might think that the only way to know what's going on is by using an imaging test, like a magnetic resonance imaging (MRI) scan. While this is one way to diagnose shoulder pain, there's often more to it.

Your healthcare provider will start with a complete physical exam, where they'll look for abnormalities, deformities, swelling and muscle weakness. They'll also test your shoulder's strength and range of motion. In some cases, they will order tests, such as an MRI, X-ray, computed tomography (CT) scan or ultrasound.

If the problem isn't clear through physical examination and other tests, your provider may recommend an arthroscopy. This is a surgical procedure where your provider will use a small camera to look inside the shoulder joint, helping to find the cause of the pain and treat it.

Finding relief from your shoulder pain

One aspect of shoulder pain that is not is myth is that it's both preventable and treatable. Because your shoulder is a critical part of how you move around, it's important to take steps to avoid injury, such as stopping an activity if it's painful, giving your body rest after activities and finding a healthy sleeping position.

If you do experience shoulder pain — especially if it's severe, getting worse or limiting the movement of your arm — talk to your healthcare provider. They can help determine what's causing your shoulder pain and how to treat it, so you can live your life pain-free.

Next steps:

Make an appointment with Christopher Kester, DO
Learn more about orthopaedic care at Main Line Health
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