Why Pain Location Matters
The location of shoulder pain can reveal important clues about its cause. Pain in the front, top, side, or back of the shoulder often signals different conditions such as tendonitis, arthritis, or rotator cuff injuries. In some cases, the discomfort may be referred pain from the spine, neck, or even the heart. A shoulder pain chart can help visualize these patterns, but an evaluation at Andrews Institute is essential to determine the true source and provide the right treatment.
Front of Shoulder Pain
Pain in the front of the shoulder often comes from issues with the rotator cuff tendons or the biceps tendon, which attach at the front of the joint. Tendonitis, bursitis, or frozen shoulder (adhesive capsulitis) can all make lifting or rotating the arm forward painful and limit range of motion. These problems may develop gradually from overuse or appear suddenly after an injury. Physicians often see this pattern in athletes, weightlifters, and people who perform repetitive overhead motions.
Top of Shoulder Pain
Pain concentrated at the very top of the shoulder is commonly linked to the acromioclavicular (AC) joint, where the collarbone meets the shoulder blade. Injuries to this joint, such as sprains or separations, can cause swelling and tenderness directly on top of the shoulder. Over time, wear-and-tear changes in the AC joint may also lead to impingement syndrome, where tissue becomes pinched during arm movement. Patients at Andrews Institute often notice this pain most when reaching overhead or across the body.
Side of Shoulder Pain
Discomfort along the outside of the shoulder usually points to rotator cuff injuries, frozen shoulder, or osteoarthritis. Pain in this area often radiates partway down the arm and may feel worse at night, sometimes disrupting sleep. This type of pain is especially common in patients who have difficulty lifting the arm sideways or performing daily activities like dressing or reaching for items on a shelf.
Back of Shoulder Pain
Pain in the back of the shoulder can have several causes, ranging from muscle strain to structural issues. Poor posture, rotator cuff tears, or scapular dyskinesis (abnormal shoulder blade movement) are frequent culprits. In some cases, pinched nerves in the neck or upper spine can also create pain that feels like it is coming from the back of the shoulder.
Diffuse or Multi-Area Pain
When pain spreads across the entire shoulder or affects multiple areas, it often signals more complex problems such as a large rotator cuff tear, glenohumeral arthritis, or referred pain from another part of the body. Because diffuse pain can be harder for patients to pinpoint, it highlights the importance of a professional exam.
Common Causes of Shoulder Pain
Shoulder pain can stem from many different issues, ranging from everyday wear and tear to sports injuries or underlying health conditions. Some of the most common causes include:
- Rotator cuff injuries – Tears or inflammation in the tendons that stabilize the shoulder joint, often leading to pain when lifting the arm or reaching overhead.
- Arthritis – Degenerative changes in the shoulder joint that create stiffness, reduced mobility, and aching pain.
- Bursitis and tendonitis – Irritation or inflammation of the small fluid sacs and tendons in the shoulder, which can develop after repetitive use or strain.
- Frozen shoulder (adhesive capsulitis) – Thickening of the shoulder capsule that limits movement and causes gradual pain and stiffness.
- Referred pain – Problems in the neck, spine, or even the heart that show up as shoulder pain, reminding patients that not all discomfort comes from the joint itself.
Understanding these causes helps highlight why it’s so important to look beyond symptoms and get a clear diagnosis. What feels like a minor injury may actually point to something that requires specialized care, and catching it early often leads to better long-term outcomes.
How Shoulder Pain is Diagnosed
Pinpointing the true cause of shoulder pain involves more than knowing where it hurts. A physician will start with a detailed health history and physical exam, checking strength, range of motion, and specific movements that may trigger pain. Depending on the findings, imaging such as X-rays, ultrasound, or MRI may be ordered to get a clear look at bones, tendons, and soft tissues. This step is especially important for identifying injuries like rotator cuff tears or arthritis that may not be obvious from symptoms alone. At Andrews Institute, diagnostic tools and expert evaluation work hand in hand to ensure patients receive an accurate diagnosis and the right treatment plan from the start.
When to See a Doctor and How Andrews Institute Can Help
Shoulder pain that lingers or worsens over time is a clear sign it’s time to see a doctor. More urgent evaluation is needed if you notice a visible deformity, sudden loss of movement, intense pain with swelling or bruising, or pain paired with chest discomfort or shortness of breath, which could indicate a heart-related emergency. Other red flags include tingling, numbness, or systemic symptoms like fever and unexplained weight loss.
At Andrews Institute, patients receive care from specialists who combine thorough exams with advanced imaging to pinpoint the source of shoulder pain. With expertise in minimally invasive techniques and evidence-based treatments, the team provides personalized care plans designed to reduce pain, restore mobility, and help patients return to their daily activities with confidence.