What Causes Sudden Shoulder Pain Without Injury?

If persistent shoulder pain is affecting your daily life, it is time to visit a doctor to find out what is causing this discomfort and what you can do about it. Identifying the reasons behind the pain in your shoulder and starting treatment as soon as possible can help you return to your routine activities within no time. At Pain Management NYC, Dr. Leon Reyfman examines your shoulders and the connecting joints and muscles carefully, determines the reasons behind the sudden pain, and comes up with treatment options that provide quick and lasting relief.

Our shoulders are complex joints that allow us to raise our arms above our heads and perform tasks like lifting and throwing. Because we use them so often, our shoulders are incredibly prone to injury.

Sudden shoulder pain can occur with an injury, but injuries are not the only reason our shoulder might hurt. Years of wear and tear wreak havoc on the tissues within the joint, causing pain and mobility issues. Several other reasons, including arthritis, bursitis, and some underlying medical conditions, can cause shoulder pain. The condition may have progressed slowly up to the point when you first feel pain.

Here are 12 possible causes of sudden shoulder pain without an injury:

Osteoarthritis

Osteoarthritis is a progressive form of arthritis associated with aging, but it can also result from an injury such as a shoulder dislocation, sports injury, or fracture. Most people do not experience symptoms in the early stages, but as OA progresses, you will feel pain, and it becomes hard to move the shoulder, or reach behind your back. You may also hear a crackling sound or a feeling known as crepitus or popping joints.

OA can affect one or both joints in the shoulders, the acromioclavicular (AC) joint and the glenohumeral joint.

AC Joint Pain

Osteoarthritis in the shoulder most commonly leads to AC joint pain. The acromioclavicular joint is the part of your shoulder where your collarbone and shoulder blade meet. It contributes to your joint’s mobility, such as raising your arm overhead.

Arthritis in the AC joint develops when the smooth cartilage between your scapula and collarbone wears down, becoming thin and rough. This can cause pain and inflammation near the top of your shoulder, in the joint when the end of your bones rub. The pain limits the motion of the arm. Symptoms of AC joint arthritis usually worsen over time and with specific motions such as lifting objects overhead or crossing your arms.

AC joint pain mainly affects the top of the shoulder but may radiate to the side of the neck too. You may also hear clicking or snapping when moving your shoulder.

Glenohumeral Joint Pain

Glenohumeral or shoulder arthritis is a common source of pain and disability that results from damage to the cartilage surfaces of the glenohumeral joint, the shoulder’s ‘ball-and-socket’ structure.

Glenohumeral joint pain is a symptom of OA. It will mainly affect the side or back of the shoulder and may feel as if it is deep in the joint. The pain may worsen with weather changes.

Rheumatoid Arthritis

It is an inflammatory condition that causes joint pain and swelling. RA is an autoimmune disease. It means the body’s immune system mistakenly attacks the tissues it is supposed to protect. In this case, the immune system attacks the joint lining, or synovium, that lubricates the shoulder joint and damages the cartilage of surrounding tissues. As a result, you feel pain and stiffness in your shoulders.

RA in the shoulder can cause pain throughout the shoulder and will likely affect both shoulders. You may also notice skin discoloration, warmth, and swelling.

Rotator Cuff Tendonitis

The rotator cuff is a group of muscles and tendons that hold the shoulder joint in place. Rotator cuff tendonitis is inflammation of these tendons or connective tissues that help the shoulder to move. The condition is also called an impinged shoulder or impingement syndrome and occurs after some injury, damage, or irritation of the tendons due to repetitive shoulder movements, genetics, or old age.

This condition can be very painful and causes swelling throughout the shoulders. You will feel shoulder stiffness and pain when lowering or raising the arm. Pain may be worse at night.

Rotator Cuff Bursitis

Rotator cuff or subacromial bursitis is an inflammatory condition that causes localized pain toward the front and side of the shoulder. It results from inflammation and swelling of the bursa, a sac of fluid that helps cushion the joint and reduces rubbing and friction as your muscles, tendons, and bones move around.

Overuse of the shoulder and repetitive overhead activities such as painting ceilings or keeping the joint in an awkward position can aggravate the bursae and cause irritation, leading to swelling and inflammation that results in bursitis. The skin may also feel warm. The pain does not tend to radiate.

Rotator Cuff Tears

It is a tear or detachment, either full or partial, of a rotator cuff tendon that links the bones to the shoulder joint. A rotator cuff tear can result from an injury such as falling on an outstretched arm, or repeated motion, but the muscle and tendon damage can also result from long-term inflammation.

A partly torn or damaged tendon cannot hold the humerus properly in place, which leads to friction between the humerus and the shoulder joint or glenoid socket, resulting in pain. If you experience shoulder pain at night that makes it difficult to fall asleep or jolts you awake, you may have a tear in one or more of your rotator cuff tendons.

Insufficient Blood Supply to the Humerus

Insufficient supply of blood to the shoulder bone can lead to severe pain in the shoulder. Some conditions can affect the blood flow to the shoulder bone or avascular necrosis (AVN). Bone cells cannot thrive without a regular blood supply, and it causes the shoulder bones and joints to collapse, resulting in severe pain.

Factors that increase the risk of AVN include steroid use, sickle cell disease, and a history of traumatic shoulder injury.

Calcific Tendonitis

Your shoulder pain may be a result of calcific tendonitis, a condition when deposits of calcium phosphate crystals build up in the rotator cuff tendons. Calcific tendonitis does not have any symptoms, but it can lead to pain, reduced motion of the joint, stiffness, and tendon damage over time.

Doctors do not know exactly why calcific tendonitis occurs, but it has been linked with diabetes and gout.

A Pinched Nerve in the Shoulder or Spine

Pinched or compressed nerves in other parts of the body, such as the shoulder, neck, and upper back, can also cause shoulder pain.

Some symptoms of a pinched nerve in the shoulder include:

• Weakness in the shoulder and arm
• Numbness and tingling in the hands
• Pain

Cervical radiculopathy refers to a compressed or irritated nerve in the upper back, known as the cervical spine. The nerve can become pinched as it branches out from the spine. It can also cause symptoms similar to a pinched nerve in the shoulder.

Cervical radiculopathy usually results from an injury, but it can affect elderly people as their spine becomes dried out and compressed.

Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) refers to three related syndromes involving compression of the nerves, arteries, and veins in the lower neck and upper chest area. This compression causes pain in the arm, shoulder, and neck. The area just above the collarbone may be tender.

Possible causes of TOS are:

• Tumors that press on a nerve
• Poor posture
• Changes in bone formation
• Repetitive arm movements

This condition is more common in females and may occur in pregnancy.

Adhesive Capsulitis or Frozen Shoulder

Also known as a frozen shoulder, adhesive capsulitis is an inflammatory condition that leads to pain and stiffness in the shoulder with a reduced range of motion.

It often results from injury, but there is no clear reason why a frozen shoulder occurs. It may occur when inflammation in the shoulder leads to fibrosis and adhesions in the joint. The inflammation causes the pain, while the adhesions and fibrosis make it difficult to move the shoulder.

People with arthritis of the neck or cervical spondylosis, diabetes, and thyroid problems are at higher risk of having this problem. Sometimes, use of certain medications can also cause a frozen shoulder.

Heart Problems

This type of pain is known as referred pain, as the problem exists somewhere else in the body other than where you feel the pain.

Your shoulder pain can be a result of some cardiac problems such as:

• A heart attack
• Reduced blood flow to the heart
• Pericarditis, or inflammation around the heart
• Digestive problems

You may be having shoulder pain due to:

• Gallstones
• Pancreatitis
• Gas after abdominal surgery

Other causes of sudden shoulder pain
Some underlying causes of shoulder pain can include:

• Pneumonia
• Paget’s disease of the bone
• Herpes zoster or shingles

When to See a Doctor for Your Shoulder Pain?

Shoulder pain is not uncommon. It can result from injuries related to the daily wear and tear of the joint. However, when this pain begins to affect basic activities, such as reaching up to wash your hair, it is time to see a pain doctor.

Sudden shoulder pain that is severe, persistent, and continues to worsen needs medical attention. If your shoulder pain is accompanied by chest pain and breathing difficulty, it must be checked by a doctor immediately, as it may be a sign of a heart attack.

Early intervention can help to prevent your pain from worsening and causing any complications. A combination of physical therapy, rest, and other at-home remedies can often resolve the problem.

How to Know if It Is Shoulder Pain or a Heart Attack?

A heart attack occurs when the flow of blood to the heart is severely reduced or blocked.

Symptoms of a heart attack include:

• Chest pain, pressure, or tightness
• Pain that may spread to arms, neck, jaw, or back
• Nausea and vomiting
• Sweaty or clammy skin
• Heartburn or indigestion
• Shortness of breath
• Coughing or wheezing
• Lightheadedness or dizziness
• Anxiety that can feel similar to a panic attack

Shoulder pain is a potential indicator of a heart attack, but it can also indicate tissue, nerve, or joint damage at the shoulder. If you are experiencing unusual shoulder pain and suspect a heart attack, call your doctor immediately or rush to your nearest emergency room to prevent severe consequences.

Given how serious the potential causes for sharp pain in your shoulder could be, your doctor will examine your shoulder, press on it to check for tender areas, and test the strength in various places. He may also examine the neck and chest to rule out other causes.

Treatment of Shoulder Pain

Treatment for shoulder pain without injury solely relies on its causes. While most cases of shoulder pain can be managed by simple treatment, complex cases may require surgery.

Your doctor will assess your symptoms and examine you carefully. They may even perform an X-ray or an MRI to see the structures in the joint and find any tissue damage before making an accurate diagnosis and recommending the best treatment options to relieve your pain.

Your doctor may recommend:

• Changes in activity or use of the shoulder
• Physical therapy
• Use of nonsteroidal anti-inflammatory drugs, such as ibuprofen
• Corticosteroid injections in some cases
• Applying heat or cold therapy or both alternately
• Medications to address an underlying condition
• Shoulder surgery if it is the only way to ease the pain

There are many reasons for shoulder pain without any injury. You may not notice the pain in its early stages or consider it serious, but if left untreated, these conditions worsen over time.

Do not let shoulder pain keep you from living a full life – Pain Management NYC today and schedule an appointment with Dr. Leon Reyfman for personalized pain management strategies and the highest quality care. Dr. Reyfman focuses on determining the specific causes of your shoulder pain and comes up with treatments that provide lasting pain relief, restore your joint movement, and help you continue with your routine activities as before.

Boleslav Kosharskyy, MD, is a top-rated, best-in-class interventional pain management doctor. He is board-certified in Anesthesiology, Interventional Pain Medicine, and Palliative Care.

Dr. Kosharskyy is an Associate Professor of Anesthesiology and Rehabilitation Medicine at Albert Einstein Medical College. He’s also the Associate Medical Director of Pain Medicine and Director of Anesthesia for the Joint Replacement Center at Montefiore Medical Center and Albert Einstein Medical College.

He is an active member of the American Society of Anesthesiology (ASA), the American Society of Regional Anesthesia and Pain Medicine (ASRA), and the New York State Society of Anesthesiologists (NYSSA)