Shoulder pain can arise from a variety of causes, which can be broadly categorized into musculoskeletal, systemic, and neuropathic origins.
Musculoskeletal causes
- Rotator cuff disease: This is a common cause of shoulder pain and can be associated with comorbidities such as diabetes, hypertension, and hyperlipidemia
- Impingement: Impingement mechanisms may occur subacromially or internally within the shoulder joint and can be associated with secondary pathologies such as subacromial-subdeltoid bursitis, tendinopathy or tears affecting the rotator cuff or the long head of the biceps tendon, and glenoid labral damage
- Osteoarthritis: Osteoarthritis of the acromioclavicular joint is a common condition causing anterior or superior shoulder pain, especially with overhead and cross-body activities
- Fractures and dislocations: Scapular fracture, clavicle fracture, humeral fracture, and shoulder joint dislocation can all cause shoulder pain
Systemic causes
- Polymyalgia rheumatica: This is a systemic inflammatory disorder that can cause shoulder pain
- Myocardial infarction: Shoulder pain can be referred pain from a myocardial infarction
- Gallstone disease: This can also cause referred shoulder pain
Neuropathic causes
- Hemiplegic shoulder pain: This is common after stroke and may have a neuropathic origin, possibly due to damage to the spinothalamic-thalamocortical system and the parietal cortex
In conclusion, shoulder pain can arise from a variety of causes, including musculoskeletal, systemic, and neuropathic origins. Accurate diagnosis based on history, physical examination, and imaging is crucial for effective management