Shoulder Swelling

Shoulder swelling can significantly impact daily activities, from getting dressed to reaching overhead. The shoulder's complex structure—including bones, muscles, tendons, and bursae—means swelling can arise from various sources. Whether caused by acute injury, chronic overuse, or inflammatory conditions, shoulder swelling often signals underlying tissue damage or inflammation requiring attention. The location and pattern of swelling provide important clues: visible swelling may indicate bursitis or joint effusion, while deep swelling might suggest rotator cuff problems. Understanding the cause is crucial because treatment varies greatly—from simple rest and ice for minor injuries to surgery for severe tears. Early intervention often prevents chronic problems and helps maintain shoulder function.

⚠️ Seek Medical Attention For:

  • Severe pain with swelling
  • Inability to move shoulder
  • Visible deformity
  • Signs of infection (fever, redness, warmth)
  • Numbness or tingling in arm
  • Swelling after significant trauma
  • Rapid onset of swelling
  • Skin color changes
  • Weakness in arm or hand
  • Swelling not improving after 48 hours

Common Causes

Acute Injuries

  • Shoulder dislocation
  • Fractures (clavicle, humerus)
  • Rotator cuff tear
  • AC joint separation
  • Muscle strains
  • Contusions

Overuse Conditions

  • Rotator cuff tendinitis
  • Shoulder impingement
  • Bursitis
  • Biceps tendinitis
  • Repetitive strain
  • Swimmer's shoulder

Inflammatory Conditions

  • Rheumatoid arthritis
  • Osteoarthritis
  • Gout
  • Pseudogout
  • Polymyalgia rheumatica
  • Septic arthritis

Other Causes

  • Frozen shoulder
  • Calcific tendinitis
  • Lymphedema
  • Blood clots
  • Tumors (rare)
  • Referred swelling

Swelling Patterns and Locations

Front of Shoulder

  • Biceps tendon issues
  • AC joint problems
  • Anterior dislocation
  • Subscapularis injuries

Top of Shoulder

  • AC joint separation
  • Clavicle fracture
  • Trapezius strain
  • Subacromial bursitis

Side of Shoulder

  • Deltoid injuries
  • Lateral bursitis
  • Rotator cuff pathology

Generalized Swelling

  • Joint effusion
  • Inflammatory arthritis
  • Infection
  • Major trauma

Associated Symptoms

Shoulder swelling often occurs with:

  • Pain: Sharp, dull, or throbbing
  • Stiffness: Limited range of motion
  • Weakness: Difficulty lifting arm
  • Warmth: Increased skin temperature
  • Redness: Skin discoloration
  • Bruising: After injury
  • Clicking: Joint sounds
  • Instability: Feeling of looseness
  • Night pain: Disrupted sleep
  • Referred pain: To neck or arm

Medical Evaluation

Physical Examination

  • Visual inspection for deformity
  • Palpation for tenderness
  • Range of motion testing
  • Strength assessment
  • Special shoulder tests
  • Neurovascular examination

Imaging Studies

  • X-rays: Bone injuries, arthritis
  • MRI: Soft tissue detail
  • Ultrasound: Dynamic assessment
  • CT scan: Complex fractures
  • Arthrogram: Joint structures

Other Tests

  • Joint aspiration
  • Blood tests (infection, inflammation)
  • EMG/nerve studies
  • Bone scan

Treatment Options

Immediate Care

  • Rest and immobilization
  • Ice application (20 min)
  • Compression wrap
  • Elevation when possible
  • Sling support
  • Pain relief

Medications

  • NSAIDs (ibuprofen)
  • Acetaminophen
  • Corticosteroid injections
  • Topical anti-inflammatories
  • Muscle relaxants
  • Antibiotics if infected

Physical Therapy

  • Range of motion exercises
  • Strengthening program
  • Manual therapy
  • Modalities (ultrasound, TENS)
  • Posture correction
  • Activity modification

Advanced Treatment

  • Arthroscopic surgery
  • Open repair
  • Joint replacement
  • Platelet-rich plasma
  • Stem cell therapy
  • Nerve blocks

Self-Care and Management

During Acute Phase

  • Avoid overhead activities
  • Use ice for 48-72 hours
  • Support arm with pillow when sleeping
  • Gentle pendulum exercises
  • Maintain good posture
  • Stay hydrated

Recovery Phase

  • Gradual return to activities
  • Continue exercises as prescribed
  • Heat before activity
  • Ice after activity
  • Avoid sudden movements
  • Strengthen supporting muscles

Long-term Management

  • Regular stretching routine
  • Maintain shoulder strength
  • Ergonomic workspace
  • Proper lifting technique
  • Cross-training activities
  • Weight management

Prevention Strategies

  • Warm up properly: Before sports or exercise
  • Strengthen rotator cuff: Regular exercises
  • Maintain flexibility: Daily stretching
  • Use proper form: In sports and lifting
  • Gradual progression: Increase activity slowly
  • Rest adequately: Between intense activities
  • Ergonomic setup: At work and home
  • Address pain early: Don't ignore symptoms
  • Stay conditioned: Year-round fitness
  • Protective gear: In contact sports

Recovery Expectations

Minor Injuries

  • Strains/sprains: 2-6 weeks
  • Mild bursitis: 2-4 weeks
  • Tendinitis: 4-6 weeks

Moderate Conditions

  • Partial tears: 3-6 months
  • Frozen shoulder: 1-3 years
  • Impingement: 3-6 months

Severe Injuries

  • Complete tears: 6-12 months post-surgery
  • Fractures: 3-6 months
  • Joint replacement: 6-12 months

Related Symptoms

Shoulder Pain

Usually accompanies swelling.

Arm Weakness

Common with shoulder problems.

Neck Pain

May occur with shoulder issues.

Joint Stiffness

Often develops with swelling.