Your shoulder is one of the most mobile joints in your body, and is also one of the most complex. It relies on a precise balance of muscles, tendons, bones and cartilage to function properly. When any of these structures are injured or worn down, you may experience shoulder pain, limited movement or even complete loss of function.
“Most shoulder conditions are caused by falling, car accidents or overusing the shoulder,” says Paul B. McLendon, M.D., a shoulder surgery specialist with Riverside Orthopedic Specialists. “They are more common in older adults or athletes like tennis or baseball players.”
Understanding the root cause of shoulder pain is key to finding the right treatment. Below are 10 of the most common shoulder and upper arm conditions orthopedic surgeons diagnose and treat.
1. Rotator Cuff Tears
The rotator cuff is made up of muscles and tendons that work together to support shoulder stability and allow you to raise and rotate your arm. Rotator cuff tears can develop in several ways:
- Repetitive overhead motions such as painting, swimming or lifting weights
- Sudden trauma like falling on an outstretched arm or being involved in a car accident
- Gradual degeneration that happens naturally with age, especially in people over 60
These tears may range from minor fraying to complete tendon rupture, often depending on the cause and how long the damage has been present.
Common signs: Shoulder weakness, pain when lifting and trouble sleeping on the affected side
Common Treatments:
- Non-surgical: reduced activity, physical therapy, over-the-counter or prescription anti-inflammatory medication and corticosteroid injections to reduce pain and inflammation.
- Surgical: Arthroscopic rotator cuff repair to reattach the torn tendon to bone
- Recovery Tip: Using a sling followed by structured rehabilitation is critical for full recovery
2. Shoulder Arthritis
Arthritis in the shoulder leads to joint inflammation, stiffness, and pain that worsens with activity. Several types can affect the shoulder:
- Osteoarthritis – due to long-term joint wear
- Rheumatoid arthritis – an autoimmune disease causing chronic inflammation
- Post-traumatic arthritis – develops after shoulder injury or surgery
- Avascular necrosis (AVN) – caused by a loss of blood flow to the bone
Common Treatments:
- Non-surgical: Activity modification, heat/ice, NSAIDs, corticosteroid injections, physical therapy
- Surgical: Shoulder replacement surgery (anatomic or reverse total shoulder arthroplasty), especially for advanced joint damage
- Supportive Care: Occupational therapy and assistive devices to support daily activity
3. Rotator Cuff Arthropathy
If a significant or long-term rotator cuff tear isn’t addressed, it can eventually lead to a condition known as rotator cuff arthropathy. In this condition, the shoulder joint becomes unstable, and the bones begin to rub against each other, resulting in pain, limited mobility, and joint degeneration.
Common Treatments:
- Conservative: Pain management, physical therapy and joint injections
- Surgical: Reverse shoulder replacement is often recommended to restore function when the rotator cuff is non-repairable
- Rehabilitation: Focuses on strengthening the deltoid muscle to compensate for rotator cuff loss
4. Proximal Humerus Fractures
A proximal humerus fracture is a break near the top of your upper arm bone, which is a common injury after a fall or motor vehicle accident, especially in older adults with low bone density.
Symptoms: Sudden pain, swelling, bruising and an inability to lift the arm
Common Treatments:
- Mild/Non-displaced fractures: Arm immobilization with a sling, followed by physical therapy
- Severe/displaced fractures: Open reduction and internal fixation (ORIF) using plates and screws or shoulder replacement for complex breaks
- Bone Health Management: Osteoporosis treatment may be recommended for prevention
5. Labral Tears
The labrum is the ring of cartilage that surrounds your shoulder socket and helps keep the joint stable. A tear in this tissue can cause clicking, catching or instability in the shoulder, particularly when lifting or rotating the arm. This injury is often seen in athletes or individuals with repeated shoulder strain.
Common Treatments:
- Non-surgical: Rest, anti-inflammatory medications, and targeted physical therapy
- Surgical: Arthroscopic labral repair to reattach torn cartilage
- Rehabilitation: Gradual return to overhead activity and sport-specific training
6. Proximal Biceps Tendon Tears and Tendinopathy
The long head of the biceps tendon connects your upper arm to your shoulder. Overuse or aging can lead to inflammation (tendinopathy) or even partial or full-thickness tears.
Signs: Pain in the front of the shoulder, tenderness and difficulty lifting
Common Treatments:
- Tendinopathy: Ice, rest, physical therapy, and corticosteroid injections
- Partial or full tears: Biceps tenodesis or tenotomy depending on severity and cosmetic preference
- Post-op Care: Emphasizes restoring range of motion and arm strength
7. AC Joint Arthritis (Acromioclavicular Joint)
The acromioclavicular (AC) joint connects your collarbone to the top of your shoulder. Over time, this small joint can develop arthritis, leading to localized pain, swelling and discomfort during overhead motion or cross-body movements. This condition is especially common in middle-aged adults and weightlifters.
Common Treatments:
- Non-surgical: Ice, NSAIDs, corticosteroid injections and physical therapy
- Surgical: Distal clavicle excision (Mumford procedure) to remove the end of the collarbone
- Lifestyle Tips: Avoidance of repetitive lifting and shoulder strain
8. Subacromial Impingement
Subacromial impingement occurs when the rotator cuff tendons become compressed under the acromion (part of the shoulder blade), usually due to inflammation or overuse.
Symptoms: Sharp pain during arm elevation, weakness, and difficulty sleeping
Common Treatments:
- Initial care: Rest, anti-inflammatory medications, activity modification
- Physical therapy: Focused on scapular stabilization and posture correction
- Surgical Option: Arthroscopic subacromial decompression if conservative care fails
9. Distal Biceps Tendon Ruptures
The distal biceps tendon connects your biceps muscle to your elbow. Although rare, a rupture can occur during heavy lifting or sudden trauma. This causes the biceps to retract upward, creating a visible bulge near the shoulder and intense pain near the elbow.
Common Treatments:
- Younger or active patients: Surgical reattachment of the tendon to restore strength and endurance
- Older or less active patients: Non-surgical treatment may be sufficient, though arm strength may be reduced
- Recovery: Full range of motion typically returns within 3-6 months
10. Triceps Tendon Ruptures
The triceps muscle, located at the back of the upper arm, extends the elbow. If the tendon attaching this muscle to the elbow ruptures, you may lose the ability to straighten your arm. This is more likely in athletes or those who experience sudden, forceful elbow trauma.
Common Treatments:
- Partial tears: Conservative treatment with bracing and physical therapy
- Complete tears: Surgical repair using suture anchors or transosseous tunnels
- Rehabilitation: Gradual strengthening with avoidance of heavy lifting for several months
When to See a Shoulder Specialist
If you’re dealing with persistent shoulder or upper arm pain, weakness, or reduced range of motion, don’t wait. Early diagnosis and treatment can prevent long-term damage and improve your recovery.
“Our goal is to help each patient return to the activities they enjoy with less pain and better function,” says Dr. McLendon.
Schedule an appointment online so you can be evaluated right away.
Riverside OrthoConnect, our Orthopedic urgent care option, has next business day appointment availability in most cases.
