Overview

how the shoulder works

Your shoulder is a ball-and-socket joint, but a shallow one: the ball at the top of your arm bone rests against a socket on the shoulder blade not much deeper than a golf tee. That shallowness is what lets you reach overhead, behind your back, and across your body. It also means the shoulder depends on soft tissue for its stability: a rim of cartilage around the socket, a capsule of ligaments, and the four rotator cuff tendons that hold the ball centered while you move. Most shoulder pain starts in one of those soft tissues, not the bone.

What Usually Causes Shoulder Pain

the usual suspects

Rotator cuff tears

The four tendons that lift and turn your arm can fray or tear, with age or with an injury. Pain reaching overhead and at night is the classic story.

Frozen shoulder

The capsule around the joint tightens on its own. The shoulder gets stiff and painful in every direction, then slowly thaws.

Shoulder arthritis

The smooth cartilage on the ball and socket wears down. The joint grinds, stiffens, and aches with use.

Impingement and bursitis

Tendons and a small cushion get pinched under the bony roof of the shoulder. Hurts most at chest-to-ear height.

Instability and dislocation

The ball slips or pops out of the socket, usually after an injury in a younger, active patient.

See every shoulder problem we treat →

When to Come In

timing and warning signs

Most shoulder soreness settles in a week or two with rest and over-the-counter pain relievers. Come in sooner if the pain followed a fall or hard hit, you cannot lift the arm, the shoulder looks out of place, the pain wakes you night after night, or you have a fever along with the pain.

What Your Visit Looks Like

exam first, imaging second

Your visit starts with a conversation and a hands-on exam. Where it hurts, what makes it worse, and what your arm can and cannot do tell us most of the story. We take X-rays in the office the same day if we need them. An MRI is ordered only when the answer would change the plan. Most shoulder pain gets better without surgery: activity changes, physical therapy, and sometimes an injection.

How We Treat Shoulder Pain

non-operative first, surgery when it counts

Most shoulder pain gets better without an operation. The usual path is activity changes, a structured course of physical therapy to restore motion and strengthen the muscles that steady the joint, and an injection when inflammation is keeping you from making progress. We give those steps time and measure whether they are working.

Surgery enters the conversation when the problem is structural (a torn tendon that will not heal, a joint worn bone-on-bone, a shoulder that keeps dislocating) or when a full course of non-operative care has not given you your life back. When that is the right step, your OSI surgeon performs it. See the shoulder operations we perform or browse non-operative care.