Persistent Shoulder Pain can be from any of these categories:
1. Structural Shoulder Pain is often as a result of injury. These conditions often require imaging and even Lidocain injections to determine the source of pain. Cause of shoulder pain should be determined promptly as it interferes with sleep. Having severe pain combined with sleep deprivation can quickly become disabling. These conditions include:
1. Subacromial bursitis
2. Shoulder impingement
3. Rotator cuff tear
4. AC joint arthritis
5. Scapulothoracic syndrome
6. Osteoarthritis
7. Biceps tendonitis
8. Fracture
9. Adhesive capsulitis (Frozen shoulder)
10. Labral tear
11. Dislocation
12. Suprascapular neuropathy
13. Instability
2. Inflammatory shoulder Pain can be the cause of shoulder pain with less pain and fairly good range of motion during the day. It usually causes more pain at night and will have painful range of motion at night as well. Inflammatory shoulder pain is usually caused by the following conditions:
1. Polymyalgia Rheumatica
2. Seronegative Arthritis
3. Psoriatic Arthritis
4. Rheumatoid Arthritis
5. Spondyloarthropathy
6. Lyme disease
7. Crystal Diseases such as Milwaukee Shoulder
3. Referred Shoulder Pain can be hard to distinguish from actual shoulder pathology. These conditions may cause more of a constant pain with little variation with activity and also the time of day. These conditions require careful history and detailed examination for diagnosis. Otherwise the can become a long term source of ongoing pain. Conditions below all can cause referred pain:
1. Cervical Radiculopathy especially C 6 and C 7 root compressions
2. Diaphragmatic irritation
3. Suprascapular neuropathy
4. Herpes Zoster
5. Thoracic outlet syndrome
6. Myocardial Infarction
7. Brachial plexuses
8. Pneumonia
9. Spinal Cord lesion
10. Pulmonary embolism
11. Lung cancer
12. Axillary venous thrombosis
13. Hepatobiliary disease
14. Spinal stenosis
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