What causes pain on tip of shoulder?

There could be many causes for pain on the tip of the shoulder. It could be subacromial bursitis, peri-arthritis shoulder, biceps tendinitis, and many more which we are going to discuss.

However, they all differ in nature of pain, shoulder movement restriction mechanism, their causes are different, they all have a different history.

In this article, I am going to break down all the possible causes of tip shoulder pain with the sign and symptoms to help find yours. So, let us get started.

6 causes of pain on tip of shoulder

Tip of shoulder pain may or may not be associated with painful restriction of shoulder joint motion. But, most often they co-exist and the good thing is most of them can be managed with simple home exercises. We are going to learn the six most common causes for tip of the shoulder pain. Let us start with subacromial bursitis.

1) Subacromial bursitis

If you have throbbing pain on the tips of the shoulder that increases with shoulder movement in any direction, then chances are it is due to subacromial bursitis. Swelling and redness around the shoulder with pain at the tip of the shoulder is a sign of a painful condition known as subacromial bursitis.

It is seen more often in individuals who participate in repetitive overhead activities such as athletes, factory workers, and manual labourers. Older individuals are more prone to experiencing subacromial bursitis likely due to years of wear leading to an increase in subacromial impingement.

If the problem is detected early, it can be easily managed with physiotherapy and exercise. Read my “Subacromial bursitis: Causes, Treatment & Exercises” for more information.

2) Adhesive capsulitis

Adhesive capsulitis is also known by other names such as frozen shoulder, peri-arthritis shoulder. Adhesive capsulitis is a very painful shoulder condition where the shoulder becomes stiff. You will have difficulty and pain raising your shoulder, combing hairs, doing undoing your clothes, reaching back pocket.

One of the most important sign is nocturnal shoulder pain, i.e disturbed sleep due to night shoulder pain. Although it is commonly seen in females and diabetics, it can affect anyone. The common cause of frozen shoulder is:

1. Pain– Because of pain, the shoulder remains in the immobilized position which gives rise to adhesion formation in the capsule of the shoulder joint.
2. Immobilisation– In some cases, the condition is initiated by a period of immobilization; eg- prolonged use of shoulder sling after Colle’s fracture.
3. Posture– Wrong posture like kyphotic, head forward, rounded shoulder.
4. Occur more in females particularly postmenopausal women.
5. Diabetics are found to be more prone to it.

Physiotherapy and regular exercises are very important for the treatment of the frozen shoulder. I have already covered these topics in my previous post which you may visit for information.

• 5 frozen shoulder exercises for quick relief.
• 4 Easy Shoulder Wand Exercises for Painful, Stiff Shoulder

3) Biceps tendinitis

Biceps tendinopathy is a relatively common ailment that typically presents as pain, tenderness, and weakness in the tendon of the long head of the biceps brachii. The exact point is the anterior (front) part of the shoulder joint line.

Often, the pain may be diffuse or vague, especially when another condition, such as rotator cuff disease, subacromial impingement, or shoulder instability, is present. Sensations of instability, popping, and grinding should be noted and qualified to location and arm position.

4) Rotator cuff tendinitis/tear

When a patient partially tears their rotator cuff (RC), it is common that they present with reduced shoulder function with shoulder weakness, pain, and stiffness). They may also have pain at rest, night pain, or a painful arc.

Sing of impingement may include painful overhead reaching, an inflamed subdeltoid bursa, or positive special tests meant to provoke symptoms. Patients can also present with pain radiating to the lateral mid‐arm or tip of the shoulder, pain while lying on the shoulder or sleeping with the arms overhead, and pain that occurs when reaching above the head. 

Learn more about rotator cuff tear exercises here: 12 Easy Rotator Cuff tear Exercises for Shoulder Pain Relief

5) Impingement syndrome

Shoulder impingement is a clinical syndrome in which soft tissues become painfully entrapped in the area of the shoulder joint. Patients present with pain on elevating the arm or when lying on the affected side.

The affected patients are generally over age 40 and suffer from persistent pain without any known preceding trauma. The cause may be excessive stress on the shoulder joint or an apparently trivial injury. Patients report pain on elevating the arm between 70 ° and 120 ° (the “painful arc”), on forced movement above the head, and when lying on the affected side.

6) Acromioclavicular joint osteoarthritis

This is the common cause of the tip of shoulder pain in elderly people. Osteoarthritis of the acromioclavicular joint is a common source of shoulder pain that is often neglected by clinicians.

Injuries are a common precipitating cause, occurring through direct impact on the joint or a fall on an outstretched arm. Arthritis is the main cause of pain, and it develops as a consequence of constant stress on the joint, often in people who perform repeated overhead lifting activities. Physical therapy, unfortunately, has little to offer, as therapeutic exercise and range of motion play only a minor role.

Sunit. S. Ekka

Dr Sunit Sanjay Ekka is a physiotherapist in practice for the last 15 years. He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. The patient is his best teacher and whatever he gets to learn he loves to share it on his Youtube channel and blog.