Shoulder Pain & Orthopedic Shoulder Care in Northern Virginia

Shoulder pain can make it difficult to reach overhead, lift an object, exercise, get dressed, drive, or sleep comfortably. Because the shoulder depends on several joints, muscles, tendons, ligaments, and other structures working together, pain can have many different causes.

At Arthritis & Sports Orthopaedics, our shoulder specialists diagnose and treat conditions ranging from overuse injuries and rotator cuff problems to shoulder instability and arthritis. Treatment may include physical therapy, medication, injections, minimally invasive procedures, arthroscopic surgery, or shoulder replacement depending on the cause and severity of your symptoms.

What Can Cause Shoulder Pain?

The shoulder allows more movement than almost any other joint in the body. That flexibility helps us reach, lift, throw, push, pull, and perform countless everyday activities, but it also makes the shoulder vulnerable to injury and overuse.

Shoulder pain may develop gradually or begin suddenly after an injury. Identifying which structure is causing the symptoms is important because different shoulder conditions often produce similar pain.

Rotator Cuff Tendonitis & Tears

The rotator cuff is a group of muscles and tendons that help stabilize the shoulder and allow you to lift and rotate your arm.

Rotator cuff problems may develop from repetitive activity, age-related tendon changes, or a sudden injury. Symptoms may include pain when raising or lowering the arm, weakness, difficulty reaching overhead, and pain when lying on the affected shoulder.

Not every rotator cuff injury requires surgery. Treatment depends on the type of tear, the severity of symptoms, your strength and function, your activity level, and other individual factors.

Shoulder Impingement & Bursitis

The tendons and bursae around the shoulder can become irritated when the tissues are repeatedly compressed during arm movement.

Pain is often noticeable when reaching overhead or lifting the arm away from the body. Some patients also experience tenderness along the outside of the shoulder or pain that becomes worse at night.

Physical therapy, activity modification, medication, and selected injections may be used depending on the diagnosis.

Shoulder Arthritis

Shoulder arthritis develops when the cartilage that helps the joint move smoothly becomes damaged over time.

Symptoms can include a deep ache in the shoulder, stiffness, reduced range of motion, grinding or clicking, and difficulty with everyday activities such as reaching into a cabinet or putting on a jacket.

Many patients begin with nonsurgical treatment. When arthritis becomes advanced and pain or loss of function continues despite appropriate conservative care, shoulder replacement may be considered.

Learn more about arthritis treatment.

Frozen Shoulder

Frozen shoulder, also called adhesive capsulitis, causes progressive pain and stiffness as the tissues surrounding the shoulder joint become tight.

People with frozen shoulder often have difficulty reaching overhead, behind their back, or away from their body. A key feature is loss of motion even when someone else tries to move the shoulder.

Frozen shoulder often improves over time, but treatment may help reduce pain, restore motion, and maintain function during recovery.

Labral Tears, Instability & Dislocations

The labrum is a ring of strong tissue around the shoulder socket that helps provide stability.

A labral injury can occur after a shoulder dislocation, fall, sports injury, repetitive overhead activity, or other trauma. Symptoms may include pain, catching, popping, weakness, or a feeling that the shoulder could slip out of place.

Shoulder instability can range from a single traumatic dislocation to repeated episodes in which the joint feels loose or dislocates again.

Treatment depends on the patient's age, activity level, type of injury, degree of instability, and whether the problem continues after nonsurgical care.

Biceps Tendon Injuries

The long head of the biceps tendon attaches near the shoulder and can become irritated, partially torn, or damaged along with other structures such as the rotator cuff or labrum.

Pain is often felt toward the front of the shoulder and may become worse with lifting, reaching, throwing, or other repetitive arm activity.

AC Joint Injuries, Fractures & Sports Injuries

Pain at the top of the shoulder may involve the acromioclavicular, or AC, joint where the collarbone meets the shoulder blade.

AC joint injuries, sometimes called shoulder separations, frequently result from a fall or direct blow to the shoulder. Athletes may also develop fractures, dislocations, tendon injuries, labral tears, and other shoulder problems from contact sports, throwing, lifting, or repetitive overhead activity.

Learn more about our sports medicine program.

Where Is Shoulder Pain Usually Felt?

The location of shoulder pain can provide useful clues about which structures may be involved, but the location alone cannot confirm a diagnosis.

Pain on the Front of the Shoulder

Pain toward the front of the shoulder may occur with biceps tendon problems, certain rotator cuff conditions, or injuries involving structures inside the shoulder joint.

Pain on the Side of the Shoulder

Pain along the outside of the upper arm is commonly associated with rotator cuff and bursa problems. It may become more noticeable when lifting the arm, reaching overhead, or lying on the affected side.

Deep Pain Inside the Shoulder

Pain that feels deep within the joint may occur with arthritis, labral injuries, instability, or other problems involving the shoulder joint itself.

Shoulder Pain That Travels Down the Arm

Some shoulder conditions cause pain that spreads into the upper arm. Pain, numbness, or tingling that extends farther down the arm or into the hand may also come from the neck or nerves rather than the shoulder itself. An examination can help determine where the symptoms originate.

When Should You See an Orthopedic Shoulder Specialist?

Consider scheduling an orthopedic evaluation when shoulder pain continues, repeatedly returns, or begins interfering with sleep, work, exercise, or everyday activities.

An evaluation may be especially helpful if you have increasing weakness, loss of motion, difficulty raising your arm, repeated clicking or catching, a feeling that the shoulder is unstable, or symptoms that have not improved with basic home care.

Seek prompt medical attention after an injury if the shoulder appears deformed, you cannot move the arm, or you develop severe pain or sudden swelling.

Shoulder pain can occasionally come from a medical problem outside the shoulder. Seek emergency medical care for shoulder pain accompanied by chest pressure or tightness, shortness of breath, sweating, dizziness, or other symptoms that could indicate a heart problem.

How Is Shoulder Pain Diagnosed?

Because several shoulder conditions can produce similar symptoms, an accurate diagnosis is important before choosing treatment.

Your orthopedic provider will ask about when the pain started, where you feel it, whether an injury occurred, which movements make it worse, and how the symptoms affect your daily activities.

Physical Examination

During the examination, your provider may evaluate shoulder motion, strength, tenderness, stability, and movements that reproduce your symptoms.

The examination may also include your neck and surrounding areas when there is a possibility that symptoms are coming from another source.

X-Rays, Ultrasound & MRI

X-rays are commonly used as an initial imaging test and can help identify arthritis, fractures, joint alignment problems, and other changes involving the bones.

If a rotator cuff injury is suspected, ultrasound or MRI may provide additional information about the tendons and surrounding soft tissues.

MRI or MR arthrography may be recommended when a labral tear or shoulder instability is suspected.

Not every patient with shoulder pain needs advanced imaging. Your provider will determine which studies are appropriate based on your symptoms, examination, and suspected diagnosis.

What Are the Nonsurgical Treatments for Shoulder Pain?

Many shoulder conditions can initially be treated without surgery.

The appropriate treatment depends on what is causing the pain, how long symptoms have been present, your activity level, and the amount of weakness or loss of function you are experiencing.

Activity Modification & Medication

Temporarily avoiding activities that repeatedly aggravate the shoulder may allow irritated tissues to recover.

Your provider may also discuss appropriate over-the-counter or prescription medication based on your diagnosis, medical history, and individual needs.

Physical Therapy

Physical therapy is commonly used for many shoulder conditions and can help improve mobility, strength, stability, and movement mechanics.

Treatment may include exercises designed to improve shoulder and shoulder-blade strength, restore range of motion, and gradually help you return to work, recreation, or sports.

Physical therapy also plays an important role in rehabilitation after many shoulder surgeries.

Learn more about physical therapy at Arthritis & Sports.

Shoulder Injections

Corticosteroid injections may be considered for selected shoulder conditions when reducing inflammation and pain could help improve function or allow a patient to participate more effectively in rehabilitation.

The usefulness of an injection depends on the diagnosis and the individual patient. An injection that may be appropriate for one shoulder condition may not be recommended for another.

Treatment for Chronic Tendon Pain

When certain chronic tendon problems do not improve after an appropriate course of nonsurgical treatment, other minimally invasive options may sometimes be considered.

Tenex is an ultrasound-guided procedure designed to remove damaged tendon tissue through a small incision and may be an option for carefully selected patients with chronic tendon pain.

Learn more about the Tenex procedure.

When Is Shoulder Surgery Considered?

Shoulder surgery may be considered when an injury is unlikely to heal adequately without an operation or when pain, weakness, instability, or loss of function continues despite appropriate nonsurgical treatment.

The procedure recommended depends on the specific condition.

Shoulder Arthroscopy

Shoulder arthroscopy is a minimally invasive technique that allows an orthopedic surgeon to examine and treat structures inside the shoulder through small incisions.

Depending on the diagnosis, arthroscopy may be used to treat certain rotator cuff injuries, labral tears, instability, biceps tendon problems, and other conditions.

Rotator Cuff Repair

Surgical repair may be recommended for certain rotator cuff tears based on factors such as the size and type of tear, weakness, functional limitations, age, activity level, and whether the injury occurred suddenly or developed over time.

Rotator cuff repair is commonly performed arthroscopically or with minimally invasive techniques.

Labral Repair & Shoulder Stabilization

Patients with recurrent shoulder instability or certain labral tears may benefit from surgery designed to repair the damaged tissue and restore stability to the shoulder.

The appropriate procedure depends on the type of injury, the amount of damage, and the patient's activity goals.

Total Shoulder Replacement

Total shoulder replacement may be considered when advanced arthritis or other severe joint damage causes persistent pain, stiffness, and loss of function that no longer responds adequately to nonsurgical treatment.

During an anatomic total shoulder replacement, damaged joint surfaces are replaced with artificial components designed to reproduce the shoulder's normal ball-and-socket relationship.

Learn more about shoulder replacement surgery.

Reverse Shoulder Replacement

Reverse shoulder replacement changes the normal orientation of the shoulder's ball-and-socket components.

This design may be recommended for certain patients when the rotator cuff cannot adequately support a traditional shoulder replacement or when other complex shoulder problems are present.

Matthew H. Griffith, MD, has extensive training and experience in both total and reverse shoulder replacement.

Which Arthritis & Sports Shoulder Specialist Should I See?

Our shoulder specialists evaluate both acute and chronic shoulder conditions and offer treatment ranging from nonsurgical care to advanced arthroscopic and reconstructive surgery.

Matthew H. Griffith, MD — Shoulder Surgery & Sports Medicine

Matthew H. Griffith, MD, is a board-certified orthopaedic surgeon who completed fellowship training in sports medicine and shoulder surgery at Massachusetts General Hospital and Harvard University.

His expertise includes rotator cuff injuries, shoulder instability, sports injuries, shoulder arthroscopy, total shoulder replacement, and reverse shoulder replacement.

Dr. Griffith sees patients at our Sterling office.

Meet Dr. Matthew Griffith.

David S. Goodwin, MD — Sports Medicine & Shoulder Arthroscopy

David S. Goodwin, MD, is a board-certified orthopaedic surgeon specializing in sports medicine, arthroscopy, and joint-preservation techniques.

He treats youth and adult patients with athletic and other shoulder injuries using both nonsurgical and surgical approaches.

Dr. Goodwin sees patients at our South Riding office.

Meet Dr. David Goodwin.

Shoulder Care in Sterling & South Riding, Virginia

Arthritis & Sports provides orthopedic shoulder care at our locations in Sterling and South Riding, Virginia.

Our team serves patients throughout Loudoun County and Northern Virginia, including Ashburn, Leesburg, Reston, Herndon, Chantilly, Aldie, and surrounding communities.

Patients have access to orthopedic evaluation, diagnostic services, nonsurgical treatment, surgery, and on-site physical therapy through one coordinated practice.

Visit our Sterling location.

Visit our South Riding location.

Frequently Asked Questions About Shoulder Pain

How do I know if shoulder pain is from my rotator cuff?

Rotator cuff problems commonly cause pain when raising or lowering the arm, weakness with lifting or rotation, and discomfort along the outside of the shoulder or upper arm. However, arthritis, bursitis, frozen shoulder, biceps problems, and other conditions can cause similar symptoms. An examination can help determine which structure is responsible.

Why does my shoulder hurt at night?

Several shoulder conditions can become more noticeable at night, including rotator cuff problems, bursitis, arthritis, and frozen shoulder. Sleeping directly on the affected shoulder may increase pressure on irritated tissues, but nighttime pain alone cannot identify the cause. Learn more about common causes of shoulder pain at night.

Can a rotator cuff tear heal without surgery?

Not every rotator cuff tear requires surgery. Many patients can improve with physical therapy, activity modification, medication, and other nonsurgical care. Whether surgery is appropriate depends on the type and size of the tear, weakness, symptoms, activity goals, age, and whether the tear resulted from an acute injury.

What does frozen shoulder feel like?

Frozen shoulder typically causes both pain and significant stiffness. Patients may gradually lose the ability to raise their arm, reach behind their back, or perform other normal shoulder movements. Unlike some painful shoulder conditions, the shoulder may remain limited even when another person tries to move the arm.

When is shoulder replacement considered?

Shoulder replacement may be considered when advanced arthritis or other severe joint damage causes ongoing pain and loss of function that have not improved enough with appropriate nonsurgical care. The type of replacement recommended depends on the condition of the joint, rotator cuff, bone, and surrounding structures.

Should I see an orthopedic doctor for persistent shoulder pain?

An orthopedic evaluation is appropriate when shoulder pain continues, repeatedly returns, causes weakness or stiffness, interrupts sleep, limits your normal activities, or does not improve with basic conservative care. Identifying the source of the symptoms can help determine which treatment options are most appropriate.

Schedule an Appointment for Shoulder Pain

You do not have to determine the cause of your shoulder pain on your own.

Our orthopedic shoulder specialists can evaluate your symptoms, identify the source of your pain, and recommend a treatment plan based on your condition, activity level, and goals.

Request an appointment with Arthritis & Sports Orthopaedics in Sterling or South Riding today.