It’s Not All Humerus : Shoulder Pain

Although most shoulder problems are relatively short-lived, discomfort or pain from shoulder problems can indicate a more complex issue. To understand shoulder pain, we begin with a review of how the shoulder works and functions in the human body.


What is the shoulder? 


The shoulder is a ball-and-socket joint1,2 made by the connection of the humerus, or the arm bone, in a shallow socket known as the glenoid fossa. The glenoid fossa is part of another bone called the scapula, more commonly known as the shoulder blade. In the front of the shoulder lies the clavicle, also known as the collar bone. On one end of the collarbone is the marriage of the clavicle with another part of the scapula called the acromion. This joint is called the acromioclavicular joint.  On the other end of the clavicle is the sternum, commonly known as the breastbone, which forms another joint: the sternoclavicular joint.


Around the shoulder bones is a complex arrangement of muscles, tendons, and the glenohumeral shoulder joint2 itself, lending to the versatility of the shoulder to engage in elevation, rotation, scaption, and other ranges of motion3. This interplay of muscle, bone and joint makes the shoulder the most mobile joint in the entire human body, allowing us to catch basketballs, brush our teeth, and reach overhead for groceries on the top shelf!


How do shoulder muscles work?


The flexibility of the shoulder joint is also what makes it prone to instability and injury. Muscles help provide much-needed support to the shoulder:


  • Trapezius is a thick muscle that extends down the spine and across the back of the neck and shoulders into the arm.
  • Serratus anterior spans the first eight ribs and helps elevate the scapula, such as throwing a punch.
  • Deltoid is a large, triangular muscle spanning the glenohumeral joint and is shaped like a shoulder pad.
  • Pectoralis major is located along the front of the chest and connects the collarbone to the middle of the chest region.
  • Rhomboid major connects the second, third, fourth, and fifth vertebrae to the scapula.


Rotator cuff muscles also have tendons that connect muscle to bone, giving the shoulder its wide range of motion and providing further stability for the joint. These are:

  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscapularis


Other supportive muscles of the shoulder include the biceps brachii, known as the biceps, the latissimus dorsi, pectoralis minor, and triceps.


The shoulder joint also has a fibrocartilaginous piece of connective tissue called the labrum; several fluid-filled sacs called bursae absorb friction, a joint capsule, and a matrix of connective and supportive ligaments.


Where does shoulder pain come from?


Shoulder pain may come from the shoulder joint itself or any of these surrounding structures. Sometimes, shoulder pain does not arise from the shoulder and instead comes from an organ inside the body elsewhere. This is known as referred pain.


The cause and the type of the shoulder pain are essential to determine as not all shoulder pain is felt equally. Pain coming from the shoulder joint can worsen with activity or movements of the arm or shoulder compared with other causes. For example, pain while playing overhead sports, elevating the arm, or engaging in repetitive activities can vary in type and severity compared to the tight, squeezing sensation accompanying a heart attack.


You may find it beneficial to keep a journal and catalog the type of pain you experience with your shoulder, any activities that aggravate or accompany the pain, the time of day it is felt, and if you have any changes in moving your arm (range of motion).


Common causes of shoulder pain include age and repetitive motion, such as performing overhead motions like painting or throwing a ball. The muscles and tendons of the rotator cuff can become inflamed, and these inflammatory components are irritating to the local soft tissues, resulting in pain. Other common causes include damage to the shoulder muscles, including muscle tears, inflammation of the tendons (tendinitis), torn cartilage, sprains, and more.


However, the causes for shoulder pain are varied. They will depend on a specific mechanism of injury or trauma or if the pain was preceded (caused by) repetitive movements. Sometimes, the pain is insidious, with no identifiable cause for shoulder pain inside the actual shoulder. This can occur when the source of the pain is coming from somewhere else other than the shoulder, such as an impingement or “pinch” of the nerves from the neck.  Although pain exists in the shoulder region in situations like these, the cause is further up in the body.


What are the most common shoulder injuries?


In America about 18 million people per year are affected by shoulder pain, according to a 2019 review.  Rotator cuff tears are the most frequent cause of shoulder pain.


Shoulder muscle injuries can result from:

  • Traumas: a fall, blow to the shoulder, or a car accident
  • Age-related degeneration
  • Repetitive overuse
  • Repeated overhead use of the shoulder in sports
  • Occupations that include vibration
  • Constant computer or phone use
  • Poor posture


Some other causes of shoulder pain include:

  • Autoimmune disease
  • Bone spurs
  • Broken arm
  • Broken collarbone
  • Bursitis
  • Cervical radiculopathy
  • Deconditioning
  • Dislocated shoulder
  • Frozen shoulder
  • Impingement (nerve)
  • Impingement (tendon)
  • Muscle strain
  • Muscle tears
  • Myocardial infarction (heart attack)
  • Osteoarthritis
  • Referred pain from gallbladder or heart disease
  • Rotator cuff injury
  • Sprains
  • Tendinitis
  • Thoracic outlet syndrome
  • Torn cartilage


When do I see a doctor?


Shoulder pain accompanied by shortness of breath, difficulty breathing, or a sense of tightness in the chest requires immediate medical attention. Call 999 or emergency medical assistance. You may ask someone to drive you to urgent care or an emergency room if your shoulder pain is caused by an injury and has:

  • Intense pain
  • Sudden swelling
  • A joint that appears deformed
  • Sudden and/or severe loss of movement


Make an appointment with your primary care doctor if your shoulder pain has swelling, tenderness, redness, or warmth around the joint.5


Mild shoulder pain often goes away in a day or two. It can be treated at home by avoiding aggravating activities such as heavy lifting, using over-the-counter pain relievers, and icing the affected area. If pain continues beyond self-care measures, is mild to moderate in severity, and lasts for more than a few days, give your toke on Trent and Newcastle chiropractor a call to schedule an appointment for a detailed examination.

David Hemingway

Had a great consultation followed by my first hr session. Very positive, friendly and informative. Hope to carry on
David Hemingway


I don’t know what I’d do without my monthly appointment. My movement vastly improved and there has been a reduction in persistent when I discovered this clinic.

Greg Methven

After being diagnosed with BPPV Vertigo I was really suffering and after not really making any progress with the Betahistine prescribed by the Doctor at the Royal Stoke I decided to see Dr Finn, who has previously resolved other muscular and skeletal injuries for myself and my family. With BPPV Vertigo being an issue with the inner ear I wasn’t sure if this was something he could resolve promptly ? The clinic fitted me in really quickly and after just two short visits my BPPV was fully resolved. After spending so much time on 111 and at the hospital I was relieved at how swiftly and efficiently Dr Finn resolved my BPPV, which was really bad. I can fully recommend this clinic for this and other treatments in a professional and effective manner. 10/10
Greg Methven

Stephen Banks

First class service from Rob and team
Stephen Banks

Richard Moth

My wife was suddenly in real pain around her hip area and upon making a phone call to Newcastle Chiropractic was given an immediate appointment. With a total of no more than 20 minutes she was feeling a lot less pain and doing gentle walking as recommended by Rob. She’s very grateful with a lot less pain and feeling mobile again.
Richard Moth

John Nyansera

The staff members handle their clients professionally.
John Nyansera

Linda Machin

I first started seeing Rob in 1998 when he took over from Jane Hvas at the Brampton Clinic. I have now been a patient of Robs for 25 years. I don't know what I would have done without the treatment and support I have re eived from him. He's simply the best.
Linda Machin

Francesco Alfano

Dott. Burcu Cetinkaya is the best chiropractor I've ever been treated by, and I've had many. Since the first visit at the clinic I've been examinated and listened very carefully about my problems and I've been given a personalised plan of treatment and exercises straight away. I've been checked vertebra by vertebra and rettified my posture, basically if there is a problem she will find out and I've never been so happy with my back, my problems they're gone and my posture is the best ever. I can't thank dott. Burcu enough even if an emergency occurred she has been always available and makes me feel safe.
Not the last the ladies on reception are the kindest ever. The clinic service is a 5 star ???? all round. Thank you ???? ???? ????????
Francesco Alfano

Paul Proffitt

Should have come to Newcastle chiropractic a year ago save wasting a year trying get sorted with the NHS, Came to Newcastle Chiropractic and was met by friendly staff and Dr Burcu who couldn’t help enough, don’t know where I would have been with out the help I have received from Dr Burcu.
Excellent practice 11/10 all day.
Paul Proffitt