Chronic painful shoulder: causes, diagnosis, treatment: Femme Actuelle Le MAG

Have you been experiencing shoulder pain for at least three months? This pain (also called scapulalgia) is also accompanied by stiffness, reduced mobility of the shoulder, and a loss of muscle strength? It is then a chronic pain, which generally occurs from the age of 50 and in the second half of life.

1. How is a shoulder made?

As detailed in Sports Clinic, the shoulder is a complex joint. It is made up of several essential anatomical structures that work together to perform its functions.

The shoulder is thus made up of four joints (glenohumeral, acromioclavicular, sternoclavicular, scapulothoracic), ligaments, as well as muscles and tendons. The mobility of the shoulder is notably due to the coordinated action of the four muscles of the rotator cuff, which attach to the head of the humerus and cover it like a cuff, indicates the Reims University Hospital.

The shoulder, a highly stressed and very mobile joint, remains fragile. Over time, lesions are common.

2. What causes chronic shoulder pain?

Scapulalgia (painful shoulder) represents an increasingly frequent complaint with age, more than half of which are linked to a rotator cuff injury, details the Swiss Medical Review. Shoulder involvement represents 30% of cases of musculoskeletal disorders (MSD).

And most of the time, this is explained by a professional activity favoring peri-articular lesions and MSDs. Several types of professions are concerned:

  • professions requiring specific postures: arms in the air, repeated shoulder movements.
  • professions requiring significant muscular effort, particularly when carrying heavy loads.

In total, according to Ameli.frthere are seven sectors of professional activity which are particularly affected by musculoskeletal disorders: transport and logistics, commerce, agri-food, construction and public works, cleanliness, metallurgical industry, personal assistance and care, particularly within establishments accommodation for dependent elderly people.

Sport can also be a determining factor: handball, tennis, or volleyball place strain on the shoulder, particularly when throwing, while sports such as football or rugby can give rise to microtrauma.

3. Diagnosis of chronically painful shoulder

But then, how do you get diagnosed? As the website indicates, chronic painful shoulder disorder requires careful examination by a specialized health professional.

Several parameters will need to be taken into account: asymmetry of the shoulders (a drooping shoulder), a loss of muscular volume in the painful shoulder (a leaner shoulder), as well as an evaluation of the mobility of the shoulder in all the axes.

Most of the time, a medical imaging assessment, exploring the bones, tendons and muscles, is recommended. It combines classic radiography for the study of bones and the detection of peri-articular calcifications with ultrasound for the analysis of peri-articular structures. If surgery is planned, an MRI, MRI arthrography or CT arthrography may be prescribed.

4. Painful shoulder: management and treatment

Only 50% of newly diagnosed shoulder pathologies are resolved within six months, underlines the Swiss Medical Review.

The main recommended treatments for chronically painful shoulder are rest, medicinal treatments, non-steroidal anti-inflammatories, analgesics, local infiltrations of corticosteroids, functional rehabilitation, elimination of unsuitable actions, or even adjustment or a change of workstation.

In any case, if the treatment seems ineffective and the pain does not disappear, consult your doctor for additional tests.

Sources: Swiss Medical Review,, Clinique du Sport, CHU Reims

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