Most problems in the shoulder involve the ligaments, tendons, and bones.

Athletes are especially susceptible to shoulder problems.  A shoulder problem can develop slowly in athletes through repetitive, intensive training.  However, individuals involved in daily activities that require excessive overhead arm motion are likely to experience shoulder pain at one point or another.

There are three main categories of shoulder pathology which cause pain:

TENDON PROBLEMS
Tendon problems usually involve the rotator cuff and biceps tendon.  Pathology that affects the rotator cuff tendon include partial and/or complete rotator cuff tears and rotator cuff tendinitis with impingement syndrome and bursitis.  Biceps tendinitis and biceps tendon tears can also cause shoulder pain.

INSTABILITY
Shoulder instability is caused when the shoulder joint (glenohumeral) moves or is forced out of its normal position.  Pathology that affects shoulder instability include shoulder dislocation, shoulder joint tears, labral tear, and shoulder separation.  A separated shoulder is caused by an injury to the acromioclavicular (AC) joint.  The AC joint is the joint on top of the shoulder where the collarbone and shoulder blade connect.

ARTHRITIS
The most common symptom of arthritis of the shoulder is pain, which progressively worsens and is aggravated by activity.  Limited motion and/or a clicking sound when the shoulder is moved may be another symptom.

TREATMENT OPTIONS
Treatment for tendon issues may include conservative treatment involving nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy.  Surgical treatment may be undertaken if conservative treatment fails.  This includes surgeries such as arthroscopic rotator cuff repairs.

Treatment for shoulder instability may involve conservative measures including physical therapy and activity modification.  If conservative treatment fails, arthroscopic stabilization (arthroscopic Bankart repair or arthroscopic labral repair) is an option.

Arthritis of the shoulder may be treated conservatively with NSAIDs, steroid injections, and physical therapy. Surgical treatment includes shoulder joint replacement.