SHOULDER PAIN
How We Treat Your Shoulder Pain
At Singapore Paincare, we understand that pain is deeply personal, what you feel may not always match what scans show. That’s why we developed Painostic®, our proprietary diagnostic approach that blends medical history, physical signs, posture, and pain patterns to identify the underlying cause of your pain.
With these insights, we create personalised treatment plans, prioritising minimally invasive techniques for faster, longer-lasting relief—helping you regain comfort and quality of life.
Shoulder Pain
Causes of Shoulder Pain?
The shoulder is made up of three main bones: the humerus (upper arm), the scapula (shoulder blade), and the collarbone. Where these bones meet, a group of muscles and tendons—known as the rotator cuff—helps keep the shoulder stable and allows it to move smoothly.
The rotator cuff is made up of four muscles and their tendons. If any of these muscles or tendons become strained, irritated, or injured, it can affect how your shoulder moves and often leads to pain.
In general, shoulder pain can be caused by problems with the bones, the joint itself, or the surrounding muscles and tendons. Bone-related issues might include fractures to the humerus, scapula, or collarbone. Joint problems can involve conditions like rheumatoid arthritis, osteoarthritis, or dislocations. But in many cases, shoulder pain comes from soft tissue problems such as tendinitis, bursitis, or muscle and tendon tears.
Types of Shoulder Injuries
TENDINITIS
Tendinitis happens when a tendon, the tissue that connects muscle to bone, becomes irritated or inflamed. This is often due to repetitive or strenuous movements like throwing, lifting, or carrying heavy objects. Tendinitis can develop suddenly (acute) or build up over time (chronic), and usually leads to pain and limited movement.
BURSITIS
Bursitis is the inflammation of the bursa, which is a small, fluid-filled sac that cushions the space between bones, tendons, and muscles around the shoulder. When healthy, the bursa helps everything glide smoothly. But when it becomes inflamed, movement can be painful, especially when a tendon or muscle slides over the irritated area. Bursitis often feels similar to tendinitis, and the two conditions can happen together.
ARTHRITIS
Arthritis in the shoulder typically refers to osteoarthritis, a condition where the joint wears down over time. This wear and tear can come from aging, repeated movements, or past injuries. It is especially prevalent in people who play sports like baseball or tennis, or work in physically demanding jobs.
It’s important to note that joint degeneration doesn’t always mean arthritis or pain. But once inflammation sets in, movement becomes uncomfortable, and people naturally start to use the shoulder less. Over time, this can lead to more stiffness and further reduce range of motion.
SHOULDER SPRAIN
A shoulder sprain happens when the muscles or ligaments around the shoulder joint—especially the rotator cuff—are overstretched or torn. Minor sprains might result from overuse or a sudden strain and may cause mild discomfort. More serious sprains, such as a full ligament tear, can lead to sharp, ongoing pain and noticeable weakness in the arm. These injuries are often the result of direct trauma, such as a car accident or a fall onto an outstretched arm. Unlike bone fractures, sprains don’t show up on X-rays. An MRI is usually needed to assess the extent of the damage.
SHOULDER GIRDLE SYNDROME (PARSONAGE-TURNER SYNDROME)
Also known as brachial neuritis, this is a nerve-related condition that causes sudden, intense pain in the upper arm and shoulder. Once the pain starts to ease, usually over a few days or weeks, muscle weakness in the shoulder, arm, or even the hand often follows.
This condition is linked to inflammation or damage in the brachial plexus, the network of nerves that runs from the neck to the arms. When these nerves are affected, it can disrupt normal muscle control. Parsonage-Turner syndrome is rare and often mistaken for other spinal conditions like cervical spondylosis or nerve root compression. Its exact cause is still not fully understood.
SHOULDER IMPINGEMENT SYNDROME
Shoulder impingement occurs when the tendons in the shoulder get pinched by nearby bone structures, especially during movement. This often leads to a sharp, fleeting pain when lifting the arm or lowering it back down. Some people also feel weakness or reduced shoulder mobility.
The most common cause is a bony overgrowth on the acromion, a part of the shoulder blade. This narrows the space where a key tendon, the supraspinatus, moves. Repeated friction can irritate the tendon, causing inflammation (tendinitis), swelling, or even a tear over time. Impingement is often related to overuse and may start off subtly before progressing to more serious issues if left untreated..
Symptoms of Shoulder Pain
Shoulder pain can show up when you press on the injured area, lie on the affected side, or move your arm — especially when lifting or changing clothes. Depending on the cause, the pain might be mild and occasional or sharp and constant. It may affect just one shoulder or both.
SWELLING AND TENDERNESS
The injured area is often tender to touch. If the pain is caused by sudden trauma, like a fall or car accident, swelling can appear quickly. In more severe cases, you might also notice bruising or changes in skin colour. Significant swelling can make the shoulder look shiny, feel warm, and cause the skin to stretch tightly. These signs may indicate the need for further medical care.
INSTABILITY
A serious shoulder sprain or degenerative conditions like osteoarthritis can lead to joint instability. This makes the shoulder feel weak or loose, and increases the risk of dislocation or painful movement. Instability can also speed up joint wear and make everyday activities more difficult.
RESTRICTED MOVEMENT
Ongoing pain or injury can limit how much you can move your shoulder. You may find it hard to reach behind your back or lift your arm overhead. In some cases, the shoulder becomes so stiff and contracted that it feels almost “frozen,” significantly affecting your range of motion.
A Message about Shoulder Pain
Shoulder pain is usually a sign that something isn’t working as it should. There are many possible causes, and if the pain isn’t managed early, it can lead to stiffness and reduced movement. This can sometimes develop into a condition known as frozen shoulder. At that point, treatment becomes more difficult. Only about 1 in 5 people fully recover from the frozen phase, while others may continue to experience long-term tightness and limited motion.
It’s a common misconception that shoulder pain is always due to bone spurs. In reality, even a minor sprain can trigger a cycle of ongoing discomfort. If left untreated, this can lead to muscle weakness, worsening joint function, and eventually a stiff, contracted shoulder that’s much harder to rehabilitate..
Diagnosing Shoulder Pain
At Singapore Paincare, diagnosis and treatment are guided by our proprietary Painostic® methodology—a structured, patient-centred approach designed to identify the true cause of pain. Painostic goes beyond standard assessments by combining clinical findings, posture analysis, pain patterns, and personal treatment goals. It recognises that pain may be functional (related to nerves, muscles, and movement) or structural (from tissue or joint damage), and that imaging alone may not always tell the full story.
This diagnostic process typically includes a thorough physical exam, symptom review, and when appropriate, imaging or nerve studies. These are interpreted in context, not in isolation, to ensure your care reflects both what’s visible and what you’re feeling. The result is a clear diagnosis and a personalised roadmap for relief, with a strong preference for minimally invasive treatments over surgery
Treatments for Shoulder Pain
Non-surgical Treatments for Shoulder Pain
CONSERVATIVE TREATMENT
For many cases of shoulder pain, initial treatment can be simple and non-invasive. Resting the shoulder, using a support or brace, and applying ice can help reduce swelling and discomfort. Over-the-counter medications like Panadol or anti-inflammatory drugs can also ease pain caused by minor sprains or strains.
Physiotherapy is often recommended to support recovery, especially when stiffness or reduced mobility is an issue. Guided exercises and techniques can help restore movement and improve the function of the rotator cuff.
WHEN PAIN PERSISTS
If shoulder pain continues for more than six weeks, it may require additional medical treatment to support healing. At this stage, targeted injections are sometimes used to reduce inflammation and promote tissue repair.
CORTISONE INJECTION
Cortisone is a powerful anti-inflammatory medication that can be injected directly into the affected area. It’s often used as an early treatment option to quickly reduce pain and swelling caused by inflammation of tendons or ligaments.
PRP INJECTION (PLATELET-RICH PLASMA)
PRP uses your body’s own platelets to encourage natural healing. It’s typically recommended when inflammation is ongoing or when cortisone injections haven’t provided enough relief. PRP can help repair damaged tissue by stimulating healing at the cellular level, making it a useful option for chronic or stubborn shoulder conditions.
Surgical Treatments for Shoulder Pain
ARTHROSCOPY
Arthroscopy is a minimally invasive procedure used to examine and treat problems inside the shoulder joint. A small camera is inserted through a tiny incision, giving doctors a clear view of the affected area. This allows for precise treatment, such as removing inflamed tissue or repairing damaged tendons — all without the need for a large surgical cut.
SHOULDER JOINT REPLACEMENT
In rare cases, when other treatments have not provided relief, shoulder joint replacement may be suggested. This involves replacing the damaged parts of the shoulder with artificial components to restore function and reduce pain. It’s typically considered a last resort and only offered when a patient is a suitable candidate.
How to Prevent Shoulder Pain
The best way to prevent shoulder pain is to pay attention to your body and not ignore early signs of discomfort. If the pain doesn’t improve, it’s important to seek professional advice rather than push through it. Warming up properly before exercise or sports can help protect your shoulders. Maintaining a healthy lifestyle, with regular movement and a balanced diet, also supports joint and muscle health.
