Shoulder Pain Without Injury: Top 6 Causes and How to Find Relief

Shoulder pain without a clear cause can be frustrating. You might not recall a specific injury, but several conditions can still lead to discomfort. 

Here’s how to identify what might be causing your pain and ways to find relief, with insights from Joshua Zimmerman, M.D., an orthopedic surgeon with Hackensack Meridian Health. 

Rotator Cuff Tendonitis and Bursitis

Rotator cuff tendonitis happens when the tendons in the rotator cuff — the group of muscles and tendons that surround the shoulder joint — become irritated or damaged. People often think a specific activity caused the problem, but it’s usually age-related changes in the tendon that make it more likely to get damaged during everyday activities.

Similarly, rotator cuff bursitis occurs when the bursa, or lining that cushions the bones and tendons, becomes swollen or irritated. This process is usually related to underlying changes in the tendon. The two conditions are closely related and can occur at the same time.

“While tendonitis can be related to an injury, it’s usually more about the tendon’s condition,” says Dr. Zimmerman. “Some repetitive activities, like tennis, golf, or housework, can worsen it.”

What do rotator cuff injuries feel like?

Symptoms may include: 

• Pain in the upper arm that may worsen with overhead movements or when lying down on the shoulder at night. 
• Stiffness, especially when lifting or moving the arm. 
• Swelling in the shoulder.
• Difficulty with everyday tasks like fastening buttons or placing objects in high places

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How are rotator cuff injuries treated?

Rest, ice, and anti-inflammatories can help relieve discomfort. 

If you have symptoms of rotator cuff tendonitis and bursitis, it’s important to talk to a doctor about your treatment options. 

Rotator Cuff Tears

The same overuse that leads to tendonitis can also cause rotator cuff tears. However, rotator cuff tears can also happen after a single injury. 

What are the symptoms of a rotator cuff tear? 

• Pain is often the most noticeable symptom. “The pain of a tear is more of an aching or throbbing discomfort that can interrupt sleep,” says Dr. Zimmerman.
• Muscle weakness may also occur.
• Joint stiffness or tenderness is also common.
  
  

How are rotator cuff tears treated?

Treatment options may include: 

• Physical therapy
• Anti-inflammatory medications
• Steroid injections. 

If your symptoms are severe or the result of an injury, your doctor might consider surgery. 

Arthritis

Arthritis can also cause significant shoulder pain, even if you don’t have a history of injury. Your doctor should review your medical history to check for any past injuries.

What are the symptoms of arthritis in the shoulder? 

Symptoms of shoulder arthritis may look different for everyone. They might include: 

• Joint pain, which may be mild at first and turn severe as the disease progresses. 
• Stiffness and difficulty with range of motion. Joint stiffness may be worse in the morning and make everyday tasks more difficult. 
• Popping, grating, or cracking noises when moving the shoulder. 
• Redness and warmth of the skin around the shoulder. 
• Difficulty sleeping because of shoulder pain. 
  
  

How is arthritis treated? 

Your doctor will typically start by treating your symptoms with medication, physical therapy, or injections. “Surgery can help,” says Dr. Zimmerman. “But we explore other options first.”

If you have arthritis, your doctor will likely refer you to a rheumatologist. 

Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder occurs when inflammation in the lining of the ball-and-socket joint causes the shoulder capsule to thicken and tighten, leading to pain and stiffness.

There’s no known cause, and while some experts believe it’s more common in women, Dr. Zimmerman sees it equally in men and women.

What are the symptoms of frozen shoulder? 

Symptoms of adhesive capsulitis can include: 

• Pain and stiffness. The pain may be a dull ache or a deep pain. Your shoulder may feel like it’s “frozen” in place.
• Difficulty sleeping because of the pain.
• Swelling may occur. 
  
  

How is frozen shoulder treated? 

While frozen shoulder typically gets better on its own within one or two years, a doctor can help you find ways to manage your pain with a combination of medication, physical therapy and injections. 

Calcific Tendonitis

Like frozen shoulder, calcific tendonitis has no identifiable cause — but can be very painful. It occurs when calcium deposits build up in the muscles or tendons, which can be seen on X-rays.

What are the symptoms of calcific tendonitis? 

The symptoms of calcific tendonitis may come on suddenly. They may also come and go over time. 

• Sudden or severe pain, often radiating down the arm. The pain is often worse when lifting the arm.
• Stiffness, which may limit your range of motion. 
• Trouble sleeping because of shoulder pain. 
  
  

How is calcific tendonitis treated? 

If you’re diagnosed with calcific tendonitis, your doctor may prescribe anti-inflammatory medications or steroid injections. Rarely, surgery may be required. 

Spinal Issues

“Your shoulder may hurt, but it may not be the result of a shoulder problem in the first place,” says Dr. Zimmerman. 

Sometimes, cervical spine or disc issues can cause shoulder pain, especially if the discomfort is centered around your shoulder blades. 

If you think spinal issues may be causing your shoulder pain, it’s important that you talk to a doctor. They may refer you to a spine specialist to discuss your options. 

Is it time to see a doctor about your shoulder pain?

Ready to get answers about your shoulder pain? Schedule an appointment with a Hackensack Meridian health doctor online or by calling 800-822-8905.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

Sources:

• American Academy of Orthopedic Surgeons
• Journal of Orthopedics & Traumatology