The most common causes of shoulder pain and how to treat them

Shoulder pain is one of the most common problems faced by patients of all ages. The shoulder joint, due to its complex anatomy and wide range of motion, is susceptible to injuries, degenerative changes, and inflammatory processes. Timely diagnosis and appropriate therapy are key to preserving joint function, reducing pain, and improving quality of life.

The shoulder joint is unique in its mobility – it allows us to raise our arms, rotate and perform precise movements. However, this very complexity and flexibility makes it susceptible to overuse, injury and inflammation. Understanding the type of pain and its causes is important in order to choose the optimal treatment for it.

Types of shoulder pain

Shoulder pain can come on suddenly or gradually, and can be localized or radiate to the neck, upper arm, or back. The most common types of pain include:

1. Acute pain – occurs suddenly, often after an injury or strenuous physical exertion. Examples include a fall, a blow to the shoulder, or sudden lifting of a heavy load. Acute pain is often sharp and accompanied by swelling or limitation of movement.
2. Chronic pain – lasts for months and is associated with degenerative changes, long-term overuse, or damage to tendons. Chronic pain is often dull, constant, and may worsen during activity or at night.
3. Night pain – typical of inflammatory and degenerative changes, makes it difficult to sleep and reduces quality of life. The pain is often worse in certain positions, such as lying on the affected shoulder.
4. Pain on movement – ​​occurs when lifting the arm, turning, or performing everyday activities such as getting dressed, driving, or carrying a bag. This type of pain often indicates damage to the tendons or joint capsule.
5. Referred pain – pain that is felt in the shoulder, but whose source is in another part of the body, most often the neck or spine. Identifying the true cause is key to effective therapy.

The most common causes of shoulder pain

Shoulder pain can be caused by a variety of conditions, and the most common causes include:

1. Inflammation of tendons and muscles (tendinitis, bursitis)
   Repetitive hand movements, sports such as tennis, swimming or weightlifting, and prolonged sitting at a computer can cause micro-injuries to tendons and joint bursae, leading to pain and limited movement.
2. Calcification in the shoulder (calcifying tendinitis)
   Occurs when calcium deposits are deposited in the tendons of the shoulder, most often in the rotator cuff tendon. It causes severe pain, especially at night and when moving the arm overhead. The pain can be sudden and intense, and in some cases there is a restriction of movement. It often requires a specialist examination and treatment (physiotherapy, injections or, less commonly, surgical removal of the deposits).
3. Restricted movement (frozen shoulder)
   A condition in which the shoulder joint capsule thickens and becomes stiff, causing pain with any movement. It often develops gradually, without a clear cause, and requires targeted therapies to restore mobility.
4. Degenerative changes and shoulder osteoarthritis
   Osteoarthritis, or shoulder osteoarthritis, is a degenerative joint condition that occurs due to the gradual wear and tear of the cartilage that protects the bones. Osteoarthritis is common in older people, but it can also occur in younger people who have had prolonged shoulder strain or previous injuries.
   Symptoms include:
   • Pain with movement or at rest,
   • Stiffness in the joint, especially in the morning or after prolonged rest,
   • Reduced range of motion,
   • A creaking or popping sound in the shoulder.
5. Rotator cuff injuries
   Injuries to the muscles and tendons that stabilize the shoulder are often caused by trauma or prolonged strain. Symptoms include pain when raising the arm and muscle weakness.
6. Dislocations and subluxations
   Partial or complete dislocation of a joint, most often after trauma. The pain is sharp, and the shoulder may appear deformed.
7. Referred pain
   Pain can come from the neck, spine, or chest, which requires careful diagnosis and targeted therapy.

Symptoms to watch out for

If any of the following symptoms occur, it is recommended to consult a specialist:

• Limited range of motion
• Sharp or throbbing pain when raising the arm
• Pain that interferes with daily activities or sleep
• Swelling, redness, or a feeling of warmth in the shoulder
• Feeling weak or unable to lift your arm

Timely diagnosis allows for the selection of optimal therapy and prevents chronic consequences.

Treatment of shoulder pain

The approach to treating shoulder pain depends on the cause and severity of the symptoms, and most often includes a combination of conservative and, if necessary, more advanced methods:

• Rest and activity modification – reducing movements that cause pain and strain on the shoulder.
• Physical therapy – targeted exercises to strengthen shoulder muscles and restore mobility.
• Painkillers and anti-inflammatory drugs – nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and inflammation.
• Injection therapies – the use of corticosteroids or modern methods such as PRP therapy to reduce inflammation and promote tissue healing.
• Orthopedic methods and modern technologies – in our Polyclinic we apply HBOT (hyperbaric oxygenation), ozone therapy, cryotherapy and red light therapy , which help regenerate tissue and reduce pain.
• Surgical treatment – ​​is considered only when conservative methods fail, e.g. in severe rotator cuff injuries, repeated dislocations, or persistent calcific tendinitis.

Methods of treating shoulder pain at EO2 Polyclinic

PRP therapy (Platelet-Rich Plasma)

It uses the patient’s own platelets to stimulate the regeneration of damaged tendons and muscles. It is effective for rotator cuff injuries, chronic tendinitis, and osteoarthritis, as it promotes natural healing and reduces inflammation.

Hyperbaric oxygen therapy (HBOT)

It increases the supply of oxygen to tissues under elevated pressure, accelerates regeneration and reduces inflammatory processes. It is suitable for chronic injuries, postoperative recovery and pain reduction in arthrosis or degenerative changes.

Ozone therapy

It stimulates circulation and detoxification, promotes tendon and muscle regeneration, and reduces inflammation and joint stiffness. It is useful for chronic pain and degenerative changes.

Cryotherapy

It has anti-inflammatory and analgesic effects, reducing swelling and pain. It is effective in acute injuries, exacerbations of chronic conditions, and post-traumatic pain.

Red light therapy

Red light phototherapy penetrates tissue, stimulates cell regeneration and improves circulation. It is ideal for chronic injuries, inflammation and arthrosis.

Prevention and maintenance of a healthy shoulder

To keep your shoulder healthy and pain-free:

• Avoid repetitive strain and sudden movements
• Strengthen your rotator cuff muscles and surrounding muscles regularly.
• Maintain good posture, especially while working at a computer.
• Respond promptly to pain or discomfort
• Combine professional therapies and home exercises

Conclusion

Shoulder pain can significantly affect quality of life, but timely diagnosis and the use of appropriate therapies can prevent long-term problems. At the Polyclinic, we combine PRP therapy, HBOT, ozone therapy, cryotherapy and red light therapy , tailored to each patient, to ensure maximum treatment effectiveness.

Specialist examinations are performed by Dr. Milan Milošević , a specialist in orthopedics and traumatology of the musculoskeletal system, a multiple award-winning expert — named ‘Best Orthopedic Doctor’ for 10 years in a row (2015–2024).

Note: This content is for informational purposes only and does not constitute medical advice or replace consultation with a professional healthcare professional.e odabir optimalne terapije i sprječava kronične posljedice.

Liječenje boli u ramenu

Pristup liječenju boli u ramenu ovisi o uzroku i težini simptoma, a najčešće uključuje kombinaciju konzervativnih i, po potrebi, naprednijih metoda:

• Odmaranje i prilagodba aktivnosti – smanjenje pokreta koji izazivaju bol i opterećuju rame.
• Fizikalna terapija – ciljane vježbe za jačanje mišića ramena i vraćanje pokretljivosti.
• Lijekovi protiv bolova i upale – nesteroidni protuupalni lijekovi (NSAID) mogu ublažiti bol i upalu.
• Injekcijske terapije – primjena kortikosteroida ili suvremenih metoda poput PRP terapije za smanjenje upale i poticanje cijeljenja tkiva.
• Ortopedske metode i suvremene tehnologije – u našoj Poliklinici primjenjujemo HBOT (hiperbaričnu oksigenaciju), ozonoterapiju, krioterapiju i terapiju crvenim svjetlom, koje pomažu regeneraciji tkiva i smanjenju boli.
• Kirurško liječenje – razmatra se samo kada konzervativne metode ne daju rezultate, npr. kod teških ozljeda rotatorne manžete, ponavljanih dislokacija ili upornog kalcificirajućeg tendinitisa.

Metode tretiranja boli u ramenu u EO2 Poliklinici

PRP terapija (Platelet-Rich Plasma)

Koristi vlastite trombocite pacijenta za poticanje regeneracije oštećenih tetiva i mišića. Učinkovita je kod ozljeda rotatorne manžete, kroničnog tendinitisa i artroze, jer potiče prirodno zacjeljivanje i smanjenje upale.

Hiperbarična oksigenoterapija (HBOT)

Povećava opskrbu tkiva kisikom pod povišenim tlakom, ubrzava regeneraciju i smanjuje upalne procese. Pogodna je za kronične ozljede, postoperativni oporavak i smanjenje boli kod artroze ili degenerativnih promjena.

Ozonoterapija

Stimulira cirkulaciju i detoksikaciju, potiče regeneraciju tetiva i mišića, te smanjuje upalu i ukočenost zgloba. Korisna je kod kroničnih bolova i degenerativnih promjena.

Krioterapija

Djeluje protuupalno i analgetski, smanjuje oticanje i bol. Učinkovita je kod akutnih ozljeda, pogoršanja kroničnih stanja i posttraumatskih bolova.

Terapija crvenom svjetlošću

Fototerapija crvenim svjetlom prodire u tkivo, potiče regeneraciju stanica i poboljšava cirkulaciju. Idealna je za kronične ozljede, upale i artrozu.

Prevencija i održavanje zdravog ramena

Kako bi rame ostalo zdravo i bez bolova:

• Izbjegavajte ponavljajuće preopterećenje i nagle pokrete
• Redovito jačajte mišiće rotatorne manžete i okolne mišiće
• Održavajte dobru posturu tijela, posebno tijekom rada za računalom
• Pravovremeno reagirajte na bol ili nelagodu
• Kombinirajte profesionalne terapije i kućne vježbe

Zaključak

Bol u ramenu može značajno utjecati na kvalitetu života, ali pravovremena dijagnoza i primjena odgovarajućih terapija mogu spriječiti dugotrajne probleme. U Poliklinici kombiniramo PRP terapiju, HBOT, ozonoterapiju, krioterapiju i terapiju crvenom svjetlošću, prilagođenu svakom pacijentu, kako bismo osigurali maksimalnu učinkovitost tretmana.

Specijalističke preglede obavlja prim. dr. med. Milan Milošević, specijalist ortopedije i traumatologije koštano-zglobnog sustava, višestruko nagrađivani stručnjak — proglašen ‘Najdoktor ortoped’ 10 godina zaredom (2015.–2024.)

Napomena: Ovaj sadržaj služi isključivo informativnoj svrsi i ne predstavlja medicinski savjet niti zamjenjuje konzultaciju sa stručnim zdravstvenim djelatnikom.