Shoulder Pain

Restore Shoulder Movement and Get Back to Normal Shoulder

Shoulder pain has a way of interrupting everything — reaching a shelf, fastening a seatbelt, sleeping through the night on your favorite side. Because the shoulder is the most mobile joint in the body, it is also one of the most vulnerable, and one of the hardest to diagnose accurately.

At the Chicago Institute for Neuropathic Pain (CINP), our team led by Dr. Rock approaches shoulder pain the way we approach every pain problem: by finding out exactly what is generating it before deciding how to treat it. That distinction matters more in the shoulder than almost anywhere else, because a significant share of shoulder pain does not originate in the shoulder at all.

What Is Shoulder Pain?

The shoulder is not one joint but a complex of four: the glenohumeral joint where the arm meets the socket, the acromioclavicular joint at the top, the sternoclavicular joint at the collarbone, and the scapulothoracic articulation where the shoulder blade glides across the ribs. Surrounding all of it are the four rotator cuff tendons, the biceps tendon, several bursae, and a dense network of nerves running from the neck into the arm.

Pain can arise from any of these — or from the cervical spine, and simply be felt in the shoulder.

Where Do You Feel Shoulder Pain?

Location is one of the most useful clues we have:

Outer shoulder and upper arm, worse when reaching overhead

……

Typically the rotator cuff or subacromial space

Deep in the front of the shoulder, with stiffness in all directions —

……

Often the glenohumeral joint itself or adhesive capsulitis

Directly on top, at the point of the shoulder

……

Usually the acromioclavicular joint

Radiating past the elbow into the hand, with numbness, tingling or weakness

……

This pattern points to the neck, not the shoulder

Between the shoulder blade and the spine

……

Commonly cervical in origin or myofascial

Get expert shoulder pain treatment at CINP

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Conditions That Cause Shoulder Pain

Shoulder pain can stem from the tendons, the joint surfaces, the bursae, or the nerves supplying the region. Our team specializes in distinguishing between them — including the nerve-related causes that are frequently missed elsewhere.

Medical Conditions Affecting the Shoulder

Rotator cuff tendinopathy and tears

degeneration or tearing of the tendons that stabilize the shoulder; the most common source of shoulder pain in adults

Subacromial impingement and bursitis

inflammation in the space between the cuff and the bone above it

Adhesive capsulitis (frozen shoulder)

progressive stiffening of the joint capsule, notably more common in people with diabetes; if you are managing diabetic neuropathy , you are at elevated risk

Glenohumeral osteoarthritis

wear of the ball-and-socket joint surfaces

Acromioclavicular (AC) joint arthritis

pain localized to the top of the shoulder

Biceps tendinopathy

inflammation of the long head of the biceps tendon at the front of the shoulder

Calcific tendinitis

calcium deposits within the cuff tendons, often acutely and severely painful

Nerve-Related Causes of Shoulder Pain

These are our particular area of expertise, and they are routinely mistaken for shoulder joint problems:
Cervical radiculopathy — a compressed or irritated nerve root in the neck referring pain into the shoulder and arm. Patients are sometimes treated for a rotator cuff problem for months before the neck is identified as the source.
Suprascapular nerve entrapment — compression of the nerve supplying two of the rotator cuff muscles
Parsonage-Turner syndrome (neuralgic amyotrophy) — sudden, severe shoulder pain followed by weakness, caused by inflammation of the brachial plexus
Complex regional pain syndrome (CRPS) — persistent burning pain, swelling and hypersensitivity that can follow shoulder injury or surgery. Learn more about CRPS treatment.
Persistent pain after shoulder surgery — pain that continues or returns despite technically successful repair

Causes of Shoulder Pain

Overuse and repetitive motion

overhead work, swimming, racket sports, painting, construction trades

Age-related degeneration

cuff tendons lose blood supply and elasticity over time; tears become common after 50 and often develop without any injury

Acute injury

falls, dislocations, sudden loads, motor vehicle collisions

Arthritis

osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis

Poor posture and scapular mechanics

forward-shoulder posture narrows the subacromial space and contributes to impingement

Diabetes and thyroid disease

both substantially increase the risk of frozen shoulder

Nerve compression in the neck

cervical disc herniation, foraminal stenosis, or arthritic changes referring pain into the shoulder

Previous surgery

scarring, altered mechanics, or nerve irritation after a repair

What Does Shoulder Pain Feel Like?

Mechanical shoulder pain

a deep, aching pain in the shoulder itself that worsens with specific movements, particularly reaching overhead or behind the back

Referred shoulder pain

pain felt in the shoulder that originates in the neck; often accompanied by numbness, tingling or weakness extending below the elbow

Neuropathic shoulder pain

burning, electric, or shooting pain that may not track with movement at all

Acute pain

days to six weeks, often following a specific injury

Chronic pain

persisting beyond three months, frequently with stiffness and progressive loss of function

Symptoms of Shoulder Pain

Clicking, catching or grinding with movement
Progressive stiffness and loss of range of motion, including when someone else moves the arm for you
Numbness, tingling or weakness extending into the arm or hand
Swelling, warmth or redness around the joint

How Is Shoulder Pain Diagnosed?

At CINP, diagnosis comes before treatment. Dr. Rock begins with a detailed history and a physical examination that includes specific provocative testing to isolate which structure is involved, then uses targeted studies as needed:

X-rays

to assess joint space, arthritic change, calcific deposits and bone anatomy

Ultrasound

dynamic, real-time imaging of the rotator cuff and bursae, performed in-office. Because it images the shoulder in motion, ultrasound can reveal impingement that a static scan misses.

MRI

for detailed assessment of tendon tears, labral injury and soft tissue

CT scan

for detailed bone anatomy where relevant

EMG and nerve conduction studies

when nerve involvement is suspected, to distinguish cervical radiculopathy and peripheral nerve entrapment from a primary shoulder problem

Diagnostic injections

a targeted, temporary numbing injection into a specific structure. If pain resolves, we have confirmed the source. If it doesn't, we look elsewhere. This is often the most decisive test available and it is central to how we work.

Treatment Options for Shoulder Pain

CINP is a non-surgical practice. Our focus is on precise, image-guided, outpatient treatment:

Image-guided injections and nerve blocks

ultrasound-guided subacromial, glenohumeral, AC joint and biceps sheath injections; suprascapular nerve blocks

Capsular distension (hydrodilatation)

for adhesive capsulitis, stretching the contracted capsule under image guidance

Radiofrequency ablation

for chronic shoulder pain, targeting the articular sensory branches of the suprascapular and axillary nerves; an option for patients who are not surgical candidates

Cervical injections

when the neck is the true source, epidural or selective nerve root injections address it directly

PRP therapy

platelet-rich plasma for selected rotator cuff tendinopathy

Neuromodulation

peripheral nerve stimulation or spinal cord stimulation for CRPS and refractory upper-limb pain

Medication management

targeted, carefully monitored, including medications specific to nerve pain

Coordinated physical therapy

rehabilitation is essential to lasting shoulder recovery, and we work directly with your therapist

For an accurate shoulder pain diagnosis, visit CINP — the best pain clinic near you

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When to See a Shoulder Pain Specialist

Consider a specialist evaluation if you:

Seek urgent care

for shoulder pain following significant trauma, visible deformity, inability to move the arm at all, or shoulder pain accompanied by chest pain or shortness of breath.

FAQs About Shoulder Pain

What are the most common causes of shoulder pain?

Rotator cuff problems are the leading cause in adults, followed by subacromial impingement and bursitis, adhesive capsulitis, and arthritis. A meaningful proportion of shoulder pain, however, actually originates in the neck.

Can neck problems cause shoulder pain?

Yes, and this is one of the most commonly missed diagnoses in shoulder care. Irritation of the C5 or C6 nerve roots refers pain directly into the shoulder and upper arm. If your pain extends below the elbow, or comes with numbness, tingling or weakness, the neck should be evaluated. CINP specializes in exactly this distinction.

Do I need surgery for a rotator cuff tear?

Not necessarily. Many partial-thickness tears and degenerative tears are managed successfully without surgery using targeted injections and structured rehabilitation. Large, acute, or retracted full-thickness tears in active patients are more likely to need surgical repair, and we will refer you when that is the right answer.

How long does frozen shoulder last?

Adhesive capsulitis typically progresses through freezing, frozen and thawing phases and can take one to three years to resolve on its own. Treatment — including image-guided injection and capsular distension — can meaningfully shorten that course and reduce pain along the way.

Why does my shoulder hurt more at night?

Lying down reduces the subacromial space and removes the gravity assistance that keeps the joint decompressed during the day. Night pain is one of the most characteristic features of rotator cuff pathology, and it is one of the symptoms patients report improving first with treatment.

Can shoulder pain be treated without surgery?

In most cases, yes. Image-guided injections, nerve blocks, radiofrequency ablation, regenerative options and rehabilitation resolve or substantially improve the majority of shoulder pain we see. CINP is a non-surgical practice, and we refer to a surgeon when surgery is genuinely indicated.

Why is ultrasound guidance important for shoulder injections?

The shoulder contains several closely adjacent structures — the subacromial space, the joint, the biceps sheath and the AC joint are all within a few centimeters of one another. Injections placed by feel alone miss their target more often than most patients realize. Guidance ensures the medication reaches the structure we intend to treat.

What should I expect at my first appointment?

A thorough history, a hands-on examination with specific tests to localize the problem, review of any imaging you already have, and a clear explanation of what we think is going on. If further testing is needed, we will arrange it. You will leave with a plan.