Diagnosing shoulder pain

Your GP may be able to diagnose the cause of your shoulder pain by discussing your symptoms with you and examining your shoulder. In some cases, tests may be needed.

As well as asking exactly where the pain is, your GP will also need to know whether:

• you have had any recent injuries
• anything makes the pain feel better or worse
• the pain is worse at night
• the pain came on gradually or suddenly
• the pain is affecting your everyday life  for example, at work or when exercising  
• you have any other symptoms

Physical examination

Your GP will probably carry out a physical examination of your shoulder area. They will:

• compare your shoulders 
• check for any redness, swelling or bruising 
• check whether your joint is dislocated (whether the joint has come out of its correct position)  if it is, your shoulder will be in an unusual position
• feel your shoulder bones and joints to see whether this causes any pain

Arm movements

Your GP may also ask you to do some specific arm movements  for example, placing your hands on the back of your neck and pointing your elbows out to the side. The type of movements that cause pain will help your GP to determine the underlying cause.

Investigations 

If you need any imaging tests to examine your shoulder in more detail, your GP may refer you for hospital tests. You may also need some blood tests. These are explained below.

X-ray

You may have a shoulder X-ray if the inside of your shoulder joint needs to be examined to rule out other damage. An X-ray uses radiation to detect problems with your bones.

Magnetic resonance imaging (MRI) scan

A magnetic resonance imaging (MRI) scan uses strong magnetic fields and radio waves to produce a detailed images of the body especially useful for soft tissues like tendons and ligaments.

Read about  magnetic resonance imaging (MRI) scans for more information about the procedure.

Ultrasound scan

An ultrasound scan uses high frequency sound waves to create an image of part of the inside of the body and can be used to diagnose problems with joints, ligaments and tendons.

Read about  ultrasound scans  for more information about the procedure.

Blood tests

A sample of your blood may be tested to rule out conditions that can cause shoulder pain or similar symptoms, such as:

• polymyalgia rheumatica   a condition that inflames the tissues of the joints, causing symptoms of muscle pain and stiffness
• a cancerous tumour
• diabetes   a condition caused by too much glucose in the blood, which makes you more likely to develop  frozen shoulder

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