Shoulder

Shoulder Pain: A Complete Diagnostic Guide for Patients

By Dr. Sumit Dubewar · Orthopedic Surgeon, Secunderabad · 5 min read

Shoulder pain has many causes — and treating the wrong cause can make things significantly worse. This guide helps you understand the most likely cause of your shoulder pain based on your symptoms.

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Dr. Sumit Dubewar

MBBS · DNB · DABRM (USA) · FIJR · FIASM · MNAMS
Orthopedic & Regenerative Joint Preservation Specialist, Secunderabad
📞 +91 9370498182 · ONE Healthcare Clinic, Tirumalagiri

Using Symptom Location to Guide Diagnosis

Front of Shoulder Pain

Most likely: Biceps tendinopathy, AC joint problems, or anterior labral tear. The long head of the biceps runs through the front of the shoulder and is a common pain generator, particularly with overhead lifting.

Top of Shoulder Pain

Most likely: AC (acromioclavicular) joint arthritis or injury. Pain directly at the top of the shoulder, especially with cross-body movements.

Outer Side / Upper Arm Pain

Most likely: Rotator cuff tendinitis or tear, shoulder impingement syndrome. Classic pattern is pain with the arm between 60-120 degrees of elevation — the painful arc.

Deep Inside the Shoulder

Most likely: Glenohumeral arthritis, labral tear, or posterior impingement. Deep groin-type pain inside the joint during all movements, particularly rotation.

Diagnostic Tests Used

X-Ray

First-line investigation. Shows bony problems — arthritis, fractures, calcifications, AC joint changes.

Ultrasound

Excellent for evaluating soft tissue — rotator cuff tears, biceps tendon, bursitis. Quick and cost-effective.

MRI

Gold standard for labral tears, rotator cuff assessment, and cartilage evaluation. Best for complex or unclear cases.

A Common Mistake

Many patients get an MRI scan first without a proper clinical examination. The MRI report then drives treatment — which can be misleading, as MRI frequently shows abnormalities that are not causing symptoms. Always have a proper clinical examination first.

🎬 Shoulder Pain Guide — Dr. Sumit Dubewar

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