Understanding Different Types of Shoulder Pain

Whether it is aching, sharp, radiating, or burning, shoulder pain is a sign that something is wrong. The type of pain you feel will depend on the shoulder problem you have, as well as other factors, such as your unique anatomy, posture, habits, and lifestyle.

Read on to learn about 4 different types of shoulder pain and the conditions that typically cause them. While reading, keep in mind that:

• Your shoulder pain may be caused by more than one problem. For example, it’s not unusual to have both arthritis and bursitis in the same shoulder.
• One shoulder problem can cause two or more types of pain. For example, a rotator cuff tear may cause constant, aching shoulder pain along as well as sharp pain that occurs during certain movements.

For these reasons, identifying the underlying cause of shoulder pain can be tricky. The information presented here is based on generalizations. Only a trained medical professional can make a formal diagnosis and recommend a treatment plan.

1. Aching shoulder pain

Several conditions can cause dull, aching shoulder pain. This pain may be constant and feel deep and/or difficult to pinpoint. The pain may also make it hard to sleep.

• Rotator cuff tears often cause aching pain and weakness that gets worse with activity and better with rest.¹Requejo-Salinas N, Lewis J, Michener LA, et al. International physical therapists consensus on clinical descriptors for diagnosing rotator cuff related shoulder pain: A Delphi study. Braz J Phys Ther. 2022;26(2):100395. doi:10.1016/j.bjpt.2022.100395 If you have a rotator cuff tear, you probably have a hard time lifting your arm overhead.

  See Rotator Cuff Injuries: Symptoms

• Rotator cuff tendonitis or tendinopathy may result in an aching pain felt at the top of your shoulder/outside of your upper arm. Repetitive movements typically make the pain worse.

  See What Is the Difference Between Tendonitis, Tendinosis, and Tendinopathy?

• Frozen shoulder often causes aching shoulder pain that gets noticeably worse over time, peaking 2 to 9 months after it begins.²Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ. 2005;331(7530):1453-1456. doi:10.1136/bmj.331.7530.1453 However, it’s worth noting that for many people, the main symptom of frozen shoulder is sharp or even shooting pain, especially when the condition first appears. While pain may vary, a sure sign of this condition is the gradual loss of passive range of motion.

  See Frozen Shoulder Symptoms

• A SLAP tear can cause aching pain at either the back or front of the shoulder. You may notice certain movements trigger worse pain along with a popping, clicking, grinding, or locking sensation.

  See SLAP Tear Symptoms

• Shoulder arthritis (glenohumeral osteoarthritis) may cause deep, achy pain and stiffness, typically at the back of the shoulder.²Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ. 2005;331(7530):1453-1456. doi:10.1136/bmj.331.7530.1453 Symptoms may come and go depending on the time of day and activity levels.

  Read more about Shoulder Osteoarthritis on Arthritis-health.com

• Polymyalgia rheumatica (PMR) causes shoulder pain that feels like a severe muscle ache, similar to that caused by the flu or vigorous exercise. The pain may affect both shoulders.

  Read more about Polymyalgia Rheumatica Symptoms on Arthritis-health.com

If your aching shoulder pain persists for more than a couple of weeks, consider making an appointment with your primary care physician or orthopedist.

2. Sharp shoulder pain

If certain movements trigger sharp or piercing shoulder pain, you may have developed frozen shoulder (described above), shoulder impingement syndrome or AC joint arthritis.

• Shoulder impingement syndrome may cause a sharp or pinching pain at the outside (lateral side) of your shoulder when the arm is raised.

  See Shoulder Pain: Is it Shoulder Impingement?

• AC joint arthritis (acromioclavicular joint osteoarthritis) may cause sharp pain at the front and top of the shoulder, where the collarbone (acromion) meets the shoulder blade (scapula). Pain may be triggered during certain movements, such as performing a bench press, raising the arm overhead, or reaching across the body.

  Read more about Acromioclavicular Arthritis Symptoms on Arthritis-health.com

While not common, AC joint arthritis occasionally causes radiating pain that travels up the neck.²Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ. 2005;331(7530):1453-1456. doi:10.1136/bmj.331.7530.1453

3. Shooting (radiating) shoulder pain

Damaged or pinched nerves may cause shooting or radiating pain that travels down the arm or up the neck. You may also feel numbness, pins-and-needles, or a burning sensation.

• A pinched nerve can cause pain that travels from the neck or shoulder into the arm or hand. You may also feel weakness or a pins-and-needles sensation in your hand or arm.

  Read more about Cervical Radiculopathy Symptoms on Spine-health.com

• Brachial plexus injuries are caused by trauma and affect the network of nerves that travel through the neck, shoulder, arm, and hand. Numbness, pins and needles, and weakness may be felt along with the pain. Some brachial plexus injuries are called stingers.

  See Stinger Injuries: What You Should Know

• Brachial plexus neuritis is caused by inflammation. It may result in pain, tingling, numbness, and/or weakness in the neck, chest, or shoulder that travels into the arm or hand. This condition is relatively rare and may affect both sides of the body.³Al Khalili Y, Jain S, Lam JC, et al. Brachial Neuritis. [Updated 2022 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499842/

  Read more about Brachial Neuritis Symptoms on Spine-health.com

Keep in mind that nerve problems aren’t the only conditions that can cause shooting pain. For example, both rotator cuff problems and shoulder impingement may cause shooting pain, particularly in the upper arm.

4. Warm or burning shoulder pain

If you notice your shoulder pain feels warm, hot, or burning, you’re probably experiencing inflammation. That’s a sign that your immune system is working to defend the body against infection or repair damaged tissue. Several shoulder conditions involve inflammation, including these three.

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Reference: 7 Possible Causes of Pain Under Your Shoulder Blade

• Shoulder bursitis, caused by an irritated and inflamed bursa, may cause burning pain. An inflamed bursa may swell and contribute to shoulder impingement syndrome.

  Read more about Shoulder Bursitis Symptoms on Arthritis-health.com

• Rheumatoid arthritis (RA) is associated with joint warmth, inflammation, swelling, and pain. RA typically affects small joints in the hands and feet but can also affect big joints, like the shoulder.

  Read more about Rheumatoid Arthritis Symptoms on Arthritis-health.com

• Infection in or around the shoulder joint can cause it to feel painful and hot. If your shoulder appears red or swollen, feels warm to the touch, and/or you have a fever, you’re advised to contact a doctor.

Of these three conditions, shoulder bursitis is most likely to be associated with repetitive motion.

Be aware of other symptoms

If you have shoulder pain, take note of any other symptoms you’re experiencing, such as joint weakness, stiffness, and/or limited range of motion. What triggers your symptoms? Are they worse at certain times of the day? Does anything make your shoulder feel better? This information can help your physician provide you with an accurate diagnosis.

You’re advised to seek medical attention immediately if you experience:

• Severe pain or numbness
• Uninterrupted numbness
• Severe weakness
• Difficulty controlling movement in your hand, arm, or shoulder

If severe pain, numbness, and weakness are absent but pain affects both sides of the body, urgent care is advised.

Learn more:

A Broken Shoulder: Scapula Fracture

7 Possible Causes of Pain Under Your Shoulder Blade on Spine-health.com