Right Shoulder Pain: Causes, Symptoms, and Treatment Options

Right shoulder pain?

Hello doctor, my right shoulder, which is the most prominent area, feels sore and painful.
When I perform a cross-arm stretch, I experience a tearing sensation, and it doesn't feel as smooth as my left shoulder.
I'm wondering if this is related to a previous car accident where I braced myself with my right hand; I was diagnosed with a scaphoid fracture at that time, but my shoulder wasn't assessed.
The fractured area has healed, and I've been doing some rehabilitation.
Sometimes, when I apply heat, it can be too hot, and I still feel a tearing sensation in that part of my right shoulder.
I would like to ask if this situation is normal or if I need to seek further medical attention.
Thank you.

erika, 20~29 year old female. Ask Date: 2015/08/12

Dr. Li Weiqiang reply Rehabilitation

Dear Erika,
Hello, the most prominent area of my right shoulder is where I experience soreness and pain.
When I perform a cross-arm stretch, I feel a tearing sensation, and it doesn't feel as smooth as my left shoulder, which may indicate a strain.
At the time of the injury, there were no symptoms because I sustained a scaphoid fracture from supporting myself with my right hand.
The force from that could have led to a shoulder strain.
The fracture has since healed, and I am undergoing some rehabilitation.
However, during heat therapy, it sometimes gets too hot, and I still experience some tearing sensation in that area of my right shoulder.
I would like to explore other physical therapy options and consult with your physician or physical therapist.
An ultrasound could be arranged for further evaluation to check for any issues.
Thank you.
Wishing you peace and health,
Director of the Rehabilitation Department, Taoyuan General Hospital, Ministry of Health and Welfare
Li Wei-Chiang

Reply Date: 2015/08/12

More Info

Understanding Right Shoulder Pain: Causes, Symptoms, and Treatment Options
Shoulder pain, especially following an injury such as a car accident, can be a complex issue that may involve various structures in the shoulder joint, including muscles, tendons, ligaments, and bones. In your case, the pain and the tearing sensation you experience during stretching could be indicative of a few potential underlying conditions, particularly related to the rotator cuff or other soft tissue injuries.

Causes of Right Shoulder Pain
1. Rotator Cuff Injury: The rotator cuff is a group of muscles and tendons that stabilize the shoulder and allow for a wide range of motion. Injuries to the rotator cuff, such as tears or tendinitis, are common, especially after trauma. Given your history of a car accident and the fact that you mentioned a "tearing" sensation during certain movements, this could suggest a rotator cuff injury.

2. Shoulder Impingement Syndrome: This occurs when the tendons of the rotator cuff become irritated and inflamed as they pass through the shoulder joint. Symptoms often include pain when lifting the arm or performing overhead activities, as well as a feeling of weakness.

3. Bursitis: Inflammation of the bursa, a small fluid-filled sac that reduces friction between tissues, can also lead to shoulder pain. This condition often accompanies rotator cuff injuries and can cause pain during movement.

4. Previous Fractures: You mentioned a previous scaphoid fracture. While this injury primarily affects the wrist, it can lead to compensatory movements that may strain the shoulder over time, especially if the shoulder was used to stabilize or support the body during recovery.

Symptoms to Monitor
- Pain: Persistent pain in the shoulder, especially during specific movements or at night, can indicate an underlying issue.

- Weakness: Difficulty lifting objects or performing daily activities can suggest muscle or tendon damage.

- Range of Motion: Limited ability to move the shoulder freely can be a sign of stiffness or injury.

- Tearing Sensation: This could indicate a strain or tear in the muscles or tendons.

Treatment Options
1. Physical Therapy: Engaging in a structured rehabilitation program can help strengthen the shoulder muscles, improve flexibility, and restore function. A physical therapist can provide specific exercises tailored to your condition.

2. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. If the pain is severe, your doctor may prescribe stronger medications.

3. Heat and Ice Therapy: Applying heat can help relax and loosen tissues, while ice can reduce inflammation and numb sharp pain. Be cautious with heat application to avoid burns.

4. Corticosteroid Injections: If conservative treatments do not provide relief, your doctor may recommend corticosteroid injections to reduce inflammation.

5. Surgery: In cases where there is a significant tear in the rotator cuff or if conservative treatments fail, surgical intervention may be necessary. This is typically considered a last resort after other options have been exhausted.

When to Seek Further Medical Attention
Given your ongoing symptoms and the history of a car accident, it is advisable to consult with an orthopedic specialist. They may recommend imaging studies, such as an MRI, to assess the condition of the rotator cuff and other shoulder structures. If you experience worsening pain, increased weakness, or any new symptoms such as numbness or tingling, you should seek immediate medical attention.

In summary, while some discomfort may be expected following an injury, persistent pain and functional limitations warrant further evaluation. Early intervention can lead to better outcomes and prevent chronic issues.

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