The sensation of intense heat emanating from the shoulder area can arise from a variety of underlying causes. It represents a subjective experience that patients describe in different ways, ranging from a mild warmth to an acute, searing pain. This discomfort may be localized to a specific point within the shoulder or encompass a broader region, potentially radiating into the arm, neck, or upper back.
Understanding the etiology of this sensation is critical for accurate diagnosis and effective management. The shoulder’s complex anatomy, comprised of bones, muscles, tendons, ligaments, and nerves, makes it susceptible to a diverse range of conditions capable of triggering such symptoms. A comprehensive evaluation, including a thorough medical history and physical examination, is often necessary to pinpoint the source of the thermal sensation and implement the appropriate therapeutic interventions.
Potential etiologies include musculoskeletal issues such as rotator cuff tendinitis or bursitis, nerve-related problems like cervical radiculopathy or thoracic outlet syndrome, and inflammatory conditions like arthritis. Furthermore, referred pain from other areas of the body, such as the neck or heart, can also manifest as shoulder discomfort. The following sections will explore these potential causes in greater detail, providing insight into their respective mechanisms and characteristic presentations.
1. Rotator Cuff Injury
Rotator cuff injuries, encompassing tears, tendinitis, and impingement syndromes, are a significant contributor to the subjective experience of a burning sensation in the shoulder. Damage to the rotator cuff muscles and tendons, whether acute or chronic, can initiate an inflammatory cascade. This inflammatory process releases chemical mediators that stimulate nociceptors (pain receptors) in the affected tissues. The signals transmitted from these receptors can be interpreted by the central nervous system as a burning or searing type of pain.
The mechanical disruption caused by a rotator cuff tear can also contribute to the discomfort. A tear disrupts the normal biomechanics of the shoulder joint, leading to altered loading patterns and increased stress on the remaining intact tissues. This can result in secondary inflammation and pain. Furthermore, the inflammation and swelling can compress surrounding nerves, exacerbating the sensation and potentially causing radiating pain into the arm. For example, repetitive overhead activities, such as painting or throwing, can lead to chronic rotator cuff tendinitis, resulting in a persistent burning ache in the shoulder, especially during and after activity.
In summary, rotator cuff injuries induce a burning sensation through a combination of inflammatory processes, mechanical disruption, and potential nerve compression. Recognizing this connection is crucial for accurate diagnosis and the implementation of targeted interventions, such as physical therapy, anti-inflammatory medications, or, in severe cases, surgical repair, to address the underlying pathology and alleviate the patient’s symptoms.
2. Nerve Compression
Nerve compression, particularly within the cervical spine or thoracic outlet, constitutes a significant etiological factor in eliciting a burning sensation in the shoulder region. When a nerve is subjected to sustained pressure or impingement, its normal function is disrupted, resulting in aberrant neural signals. These distorted signals can be perceived as pain, tingling, numbness, or, notably, a burning discomfort. The specific quality and location of the sensation depend on the nerve affected and the degree of compression.
Cervical radiculopathy, characterized by nerve root compression in the neck, frequently presents with referred pain that radiates into the shoulder, arm, and hand. The compression can stem from disc herniation, spinal stenosis, or degenerative changes. Thoracic outlet syndrome (TOS) involves compression of nerves and blood vessels in the space between the clavicle and the first rib. Various forms of TOS exist, with neurogenic TOS being particularly relevant. Neurogenic TOS specifically affects the brachial plexus, a network of nerves that supplies the upper limb, leading to pain, numbness, and a burning sensation in the shoulder and arm. As an example, consider an individual with a desk job who maintains poor posture for extended periods. This prolonged forward head posture can contribute to cervical nerve compression, resulting in a radiating burning sensation in the shoulder and upper back. Similarly, athletes involved in repetitive overhead movements, such as swimmers or baseball players, are at increased risk of developing TOS, which can manifest as burning shoulder pain aggravated by activity.
In conclusion, nerve compression serves as a key mechanism in the generation of a burning sensation experienced in the shoulder. Its importance lies in understanding the potential origins of the compression, whether it be from cervical spine pathology or thoracic outlet impingement. Accurately identifying and addressing the underlying nerve compression is essential for effective pain management and restoration of normal function. Challenges in diagnosis may arise due to overlapping symptoms with other shoulder conditions, highlighting the need for thorough clinical evaluation and, when necessary, specialized diagnostic testing, such as nerve conduction studies or imaging modalities.
3. Inflammation
Inflammation represents a critical physiological response to injury, infection, or irritation within the shoulder. While essential for initiating the healing process, uncontrolled or chronic inflammation can be a primary driver of the subjective sensation of burning discomfort. The cascade of biochemical events associated with inflammation directly contributes to nociceptor activation and subsequent pain perception.
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Release of Inflammatory Mediators
Inflammation triggers the release of various chemical mediators, including cytokines (e.g., interleukin-1, tumor necrosis factor-alpha), prostaglandins, and bradykinin. These substances sensitize nociceptors, lowering their threshold for activation and amplifying pain signals. In the shoulder, conditions such as bursitis, tendinitis, or arthritis result in a sustained release of these inflammatory mediators, leading to a chronic burning sensation. For instance, in adhesive capsulitis (frozen shoulder), inflammation of the joint capsule causes pain and restricted movement.
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Vasodilation and Edema
Inflammation promotes vasodilation, increasing blood flow to the affected area. This vasodilation, along with increased vascular permeability, leads to edema (swelling). The increased fluid volume exerts pressure on nerve endings, further contributing to the sensation of burning pain. In cases of acute trauma to the shoulder, such as a rotator cuff tear, the resultant swelling and inflammation can compress nerves, generating a pronounced burning sensation.
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Nerve Irritation and Sensitization
Prolonged inflammation can directly irritate and sensitize peripheral nerves. This sensitization leads to a phenomenon known as neuropathic pain, characterized by an exaggerated response to stimuli. Even minor movements or pressure can trigger intense burning pain. For example, chronic inflammation in the shoulder joint, as seen in osteoarthritis, can cause sensitization of the suprascapular nerve, leading to persistent burning pain that is difficult to manage.
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Muscle Spasm and Guarding
Inflammation often induces muscle spasm and guarding, a protective mechanism intended to immobilize the injured area. However, prolonged muscle spasm can lead to ischemia (reduced blood flow) and the accumulation of metabolic waste products, such as lactic acid. This ischemia and metabolic build-up can further stimulate nociceptors and contribute to the burning sensation. For example, in cases of shoulder impingement syndrome, chronic inflammation can lead to persistent muscle spasm in the surrounding muscles, exacerbating the sensation of burning discomfort.
The multifaceted nature of inflammation, encompassing the release of inflammatory mediators, vasodilation, nerve irritation, and muscle spasm, highlights its significant role in generating the subjective experience of a burning sensation in the shoulder. Understanding the specific inflammatory processes involved in different shoulder pathologies is essential for implementing targeted treatment strategies aimed at reducing inflammation and alleviating the associated pain. Treatment may include anti-inflammatory medications, physical therapy to restore normal biomechanics and reduce muscle spasm, and, in some cases, corticosteroid injections to directly address the inflammation within the joint.
4. Referred Pain
Referred pain, characterized by the perception of pain in a location distinct from the actual source of the underlying pathology, significantly contributes to the subjective experience of a burning sensation in the shoulder. This phenomenon arises due to the convergence of sensory nerve fibers from different areas of the body onto common ascending pathways within the spinal cord and brain. Consequently, the brain may misinterpret the origin of the pain signal, attributing it to the shoulder even when the source lies elsewhere. This is particularly relevant when considering visceral organs, such as the heart, or structures in the cervical spine.
The convergence-projection theory provides a neuroanatomical explanation for referred pain. According to this theory, visceral afferent neurons (those carrying sensory information from internal organs) and somatic afferent neurons (those carrying sensory information from the skin, muscles, and joints) converge onto the same second-order neurons in the spinal cord. The brain, having limited capacity to distinguish between these convergent inputs, incorrectly projects the sensation to the somatic region most frequently associated with input from those particular spinal cord segments. For instance, myocardial ischemia, a condition characterized by reduced blood flow to the heart, can manifest as a burning or aching pain in the left shoulder and arm. This occurs because the sensory fibers from the heart and the left shoulder/arm converge on similar spinal cord levels. The brain, accustomed to receiving somatic input from the shoulder, misinterprets the visceral signal as originating from that region. Another example involves diaphragmatic irritation, which may occur secondary to pneumonia or intra-abdominal infection, can refer pain to the shoulder tip due to shared innervation via the phrenic nerve (C3-C5). Compression of nerve roots in the cervical spine can likewise lead to referred pain patterns that manifest as a burning sensation in the shoulder.
The clinical significance of understanding referred pain in the context of shoulder complaints cannot be overstated. It is crucial to consider and rule out non-musculoskeletal causes before initiating treatment solely focused on the shoulder itself. A thorough medical history, including assessment of potential cardiac, pulmonary, or gastrointestinal issues, and a comprehensive physical examination are essential to differentiate referred pain from primary shoulder pathology. Failure to recognize referred pain patterns can lead to misdiagnosis, inappropriate treatment, and delayed management of potentially serious underlying conditions. Therefore, a comprehensive diagnostic approach is paramount in evaluating the complaint of a burning sensation in the shoulder, ensuring that both local and distant sources of pain are adequately considered.
5. Muscle Strain
Muscle strain, or a tear in muscle fibers, is a common occurrence in the shoulder region and a potential contributor to the sensation of intense heat often described. While a muscle strain can manifest as a sharp, localized pain, the inflammatory response that follows can generate a burning sensation, particularly if the injury is significant or involves nearby nerves. This connection between muscle strain and the subjective experience of a burning sensation necessitates a careful evaluation to differentiate it from other potential shoulder pathologies.
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Inflammation and Nociceptor Activation
A muscle strain initiates an inflammatory cascade, releasing chemicals like prostaglandins and cytokines. These substances sensitize nociceptors, the body’s pain receptors, making them more responsive to stimuli. This heightened sensitivity can result in the perception of a burning pain, even with minimal movement or pressure. The severity of the burning sensation often correlates with the degree of muscle fiber damage and the intensity of the inflammatory response. For example, a minor strain in the deltoid muscle may cause a mild burning sensation during specific arm movements, while a more severe strain involving a larger muscle group can produce a constant, intense burning pain that limits shoulder function.
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Muscle Spasm and Ischemia
Following a strain, muscles often enter a state of spasm, a protective mechanism intended to limit movement and prevent further injury. However, prolonged muscle spasm can lead to ischemia, or reduced blood flow, to the affected area. Ischemia results in the build-up of metabolic waste products, such as lactic acid, which can further irritate nerve endings and contribute to the burning sensation. Additionally, the sustained contraction of the muscle itself can compress surrounding tissues, including nerves, further exacerbating the discomfort. For instance, a strain in the trapezius muscle, commonly caused by poor posture or repetitive movements, can lead to chronic muscle spasms, resulting in a burning sensation that radiates into the neck and upper back.
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Nerve Irritation
Depending on the location and severity of the muscle strain, surrounding nerves may be directly irritated or compressed. This irritation can lead to radicular symptoms, including pain, numbness, tingling, and, importantly, a burning sensation. The suprascapular nerve, for example, is vulnerable to compression or irritation in the vicinity of the supraspinatus and infraspinatus muscles, two rotator cuff muscles commonly involved in strains. Irritation of this nerve can produce a burning pain that radiates down the arm. Similarly, strain in the upper trapezius can irritate the spinal accessory nerve.
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Referred Pain from Trigger Points
Muscle strains can lead to the formation of trigger points, localized areas of hyperirritability within the muscle tissue. These trigger points can refer pain to other areas of the body, often following predictable patterns. While trigger point pain is frequently described as a deep ache, it can also manifest as a burning sensation, particularly when the trigger point is located near a nerve or when the referred pain pathway involves sensitized nerve fibers. For instance, trigger points in the infraspinatus muscle can refer pain to the front of the shoulder, which may be experienced as a burning discomfort.
In conclusion, muscle strain can induce a burning sensation in the shoulder through a complex interplay of inflammation, muscle spasm, nerve irritation, and the development of trigger points. Recognizing the potential for muscle strains to present with this particular symptom is crucial for accurate diagnosis and the implementation of appropriate treatment strategies, which may include rest, ice, compression, elevation (RICE), pain medication, physical therapy, and trigger point release techniques.
6. Joint dysfunction
Joint dysfunction within the shoulder complex can contribute significantly to the subjective sensation described as a burning discomfort. Malalignment or restricted movement in any of the shoulder’s constituent jointsthe glenohumeral, acromioclavicular, sternoclavicular, and scapulothoraciccan disrupt normal biomechanics and lead to a cascade of compensatory changes, potentially resulting in a thermal sensation.
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Altered Biomechanics and Muscle Imbalance
Joint dysfunction alters the coordinated movement patterns of the shoulder, forcing certain muscles to overwork while others become weakened. This imbalance can lead to muscle fatigue, spasm, and the development of trigger points, all of which contribute to the perception of a burning sensation. For example, restricted scapular movement due to sternoclavicular joint stiffness can cause the upper trapezius to become overworked, leading to a burning ache in the upper shoulder and neck region.
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Inflammation and Capsular Irritation
Abnormal joint mechanics can place undue stress on the joint capsule and surrounding ligaments, resulting in inflammation. This inflammation can directly irritate nerve endings within the joint capsule, generating a burning sensation. Additionally, inflammatory mediators released during this process can sensitize nociceptors, further amplifying the perceived discomfort. Adhesive capsulitis (frozen shoulder), characterized by inflammation and contracture of the glenohumeral joint capsule, frequently presents with a burning pain that worsens with movement.
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Nerve Compression and Impingement
Joint dysfunction can contribute to nerve compression syndromes, such as suprascapular nerve entrapment. Misalignment of the scapula or clavicle can narrow the spaces through which the suprascapular nerve passes, leading to compression and irritation. The resulting symptoms may include a burning pain in the posterior shoulder, weakness in external rotation, and atrophy of the infraspinatus muscle. Impingement syndromes, where tendons are compressed within the shoulder joint, may also lead to a burning sensation due to the inflammatory response and mechanical irritation of the surrounding tissues.
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Referred Pain from Cervical Spine Dysfunction
Cervical spine dysfunction can indirectly contribute to shoulder pain, including the sensation of heat. Restricted movement or misalignments in the cervical vertebrae can cause nerve root irritation, leading to referred pain patterns that manifest in the shoulder region. This referred pain can be perceived as a burning ache, particularly if the affected nerve root supplies sensory innervation to the shoulder and upper arm. For instance, cervical radiculopathy involving the C5 or C6 nerve roots may present with burning pain in the deltoid region.
The presence of joint dysfunction within the shoulder complex can thus initiate or exacerbate the sensation of a thermal discomfort through various mechanisms, including altered biomechanics, inflammation, nerve compression, and referred pain. Identifying and addressing the underlying joint dysfunction is crucial for restoring normal shoulder mechanics, reducing inflammation, and alleviating the associated symptoms. Treatment approaches may include manual therapy techniques, such as joint mobilization and muscle energy techniques, as well as exercises to restore proper muscle balance and movement patterns. A comprehensive assessment of the entire kinetic chain, including the cervical spine and thoracic region, is essential to identify all contributing factors and develop an effective management plan.
7. Vascular issues
Vascular compromise, although less common than musculoskeletal or neurological etiologies, can contribute to the subjective experience of intense heat in the shoulder region. Disrupted blood flow to the shoulder tissues, whether due to arterial insufficiency or venous congestion, can trigger metabolic imbalances and nerve irritation, potentially leading to the sensation.
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Arterial Insufficiency and Ischemic Pain
Reduced arterial blood supply to the shoulder muscles, tendons, and nerves can result in ischemia, a state of oxygen deprivation. Ischemic pain is often described as a deep, aching, or burning sensation. While acute arterial occlusion would likely present with more severe and widespread symptoms, chronic or partial arterial insufficiency can manifest as a more subtle, localized burning pain, especially during activity. Conditions such as atherosclerosis or vasculitis, though less frequently affecting the shoulder arteries directly, can predispose individuals to reduced blood flow and subsequent pain. For example, subclavian steal syndrome, where blood flow is diverted from the vertebral artery to the subclavian artery due to a proximal subclavian artery stenosis, can cause shoulder pain and arm fatigue, which can be experienced as a burning sensation, particularly during exertion.
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Venous Congestion and Edema
Obstruction of venous outflow from the shoulder can lead to congestion and edema, increasing pressure on surrounding tissues, including nerves. This compression can result in a burning or aching pain. Thrombosis of the subclavian or axillary veins, though relatively uncommon, can cause significant swelling and discomfort in the shoulder and arm. In thoracic outlet syndrome, venous compression can also contribute to a sensation of burning in the shoulder due to impaired drainage and resulting edema.
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Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome (CRPS)
Although the exact pathophysiology is not fully understood, CRPS, sometimes triggered by trauma or surgery, can involve vascular dysfunction. CRPS is characterized by chronic pain, swelling, changes in skin temperature and color, and altered sweating. The pain is often described as burning, throbbing, or shooting. Vascular changes, such as vasoconstriction or vasodilation, are thought to contribute to the pain and sensory abnormalities associated with CRPS. In the shoulder, CRPS may develop following a fracture, surgery, or even a minor injury, leading to a persistent burning sensation and significant functional impairment.
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Thoracic Outlet Syndrome (TOS)
Vascular TOS, involving compression of the subclavian artery or vein, can directly impact blood flow to and from the shoulder and arm. Arterial compression may lead to ischemic pain, described as aching or burning. Venous compression can lead to swelling, throbbing pain, and a feeling of heaviness in the arm. Both arterial and venous TOS can manifest as shoulder discomfort. The arterial form less common can cause shoulder pain and arm fatigue, which can be experienced as a burning sensation, particularly during exertion.
In summary, while less prevalent than other etiologies, vascular issues can contribute to the complaint of a burning sensation in the shoulder. Recognizing the potential for vascular compromise is essential for accurate diagnosis and appropriate management, as prompt intervention may be necessary to prevent irreversible tissue damage or long-term complications. A thorough vascular examination, including assessment of pulses, skin temperature, and capillary refill, as well as appropriate imaging studies, may be warranted in cases where vascular involvement is suspected.
Frequently Asked Questions
This section addresses common inquiries related to the sensation of intense heat localized to the shoulder region. The following questions and answers aim to provide clarity and guidance regarding potential causes, diagnostic approaches, and management strategies.
Question 1: What conditions typically manifest as thermal discomfort in the shoulder?
Rotator cuff injuries, nerve compression syndromes, inflammatory processes, and referred pain patterns are frequent contributors to a burning sensation within the shoulder. Muscular strains and joint dysfunction can also elicit this sensation.
Question 2: How does rotator cuff pathology induce this sensation?
Rotator cuff injuries incite inflammation, which stimulates nociceptors. The disrupted shoulder biomechanics can lead to secondary inflammation, potentially compressing surrounding nerves, thereby intensifying the discomfort.
Question 3: How does nerve compression contribute to this sensation?
Nerve compression, particularly within the cervical spine or thoracic outlet, disrupts normal nerve function. Aberrant neural signals are generated, which can be perceived as pain, tingling, numbness, or a burning discomfort in the shoulder.
Question 4: What role does inflammation play in generating this type of pain?
Inflammation triggers the release of chemical mediators that sensitize nociceptors. The resulting vasodilation and edema can exert pressure on nerve endings, contributing to the experience of a burning discomfort.
Question 5: Can issues elsewhere in the body cause a shoulder thermal sensation?
Referred pain from visceral organs, such as the heart, or structures in the cervical spine can manifest as pain in the shoulder. Sensory nerve fibers converge onto common ascending pathways, leading to misinterpretation of the pain’s origin.
Question 6: What steps should be taken when experiencing a persistent thermal sensation in the shoulder?
A thorough medical evaluation is warranted. This assessment should include a detailed medical history, a comprehensive physical examination, and potentially diagnostic imaging or nerve conduction studies to determine the underlying cause and guide appropriate management.
Understanding the diverse origins of a thermal shoulder sensation facilitates informed decision-making regarding diagnostic and therapeutic interventions. Prompt and accurate diagnosis is paramount for effective management and optimal outcomes.
The following section will explore specific diagnostic and treatment modalities commonly employed in addressing the phenomenon.
Managing Shoulder Discomfort
Addressing a burning sensation in the shoulder necessitates a multifaceted approach, focusing on accurate diagnosis and targeted interventions. The following guidelines offer practical strategies for managing this discomfort and improving shoulder function.
Tip 1: Seek Professional Medical Evaluation: Persistent or severe shoulder pain warrants assessment by a qualified healthcare professional. Self-diagnosis and treatment can delay appropriate care and potentially worsen the underlying condition. A physician can conduct a thorough examination, order necessary diagnostic tests (e.g., MRI, nerve conduction studies), and formulate a tailored treatment plan.
Tip 2: Adhere to Prescribed Medication Regimens: If medication is prescribed, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants, strict adherence to the dosage and schedule is essential. Consult the prescribing physician or pharmacist regarding potential side effects and drug interactions.
Tip 3: Engage in Targeted Physical Therapy: Physical therapy plays a critical role in restoring shoulder function, reducing pain, and preventing recurrence. A physical therapist can design an individualized exercise program to improve range of motion, strength, and stability. Proper technique and progression are crucial to avoid further injury.
Tip 4: Modify Activities to Avoid Aggravating Factors: Identify activities that exacerbate shoulder discomfort and modify or avoid them. This may involve adjusting work ergonomics, altering sports techniques, or limiting repetitive overhead movements. Activity modification can reduce stress on the shoulder joint and promote healing.
Tip 5: Apply Cryotherapy or Thermotherapy: Cold or heat therapy can provide symptomatic relief. Ice packs can reduce inflammation and pain in acute injuries, while heat can relax muscles and improve circulation in chronic conditions. Apply ice or heat for 15-20 minutes at a time, several times per day.
Tip 6: Maintain Proper Posture: Good posture is essential for optimal shoulder biomechanics. Avoid slouching or hunching forward, as this can place undue stress on the shoulder joint and surrounding muscles. Maintain a neutral spine position and ensure adequate support when sitting or standing.
Tip 7: Promote Adequate Rest and Recovery: Allow sufficient time for the shoulder tissues to heal and recover. Avoid overexertion and ensure adequate sleep. Rest enables the body to repair damaged tissues and reduce inflammation.
Implementing these management strategies can significantly alleviate the discomfort and enhance shoulder function. Remember, consistent adherence to prescribed treatments and lifestyle modifications is paramount for achieving long-term relief.
The following conclusion will summarize the primary points discussed throughout this exploration of shoulder discomfort.
Conclusion
The inquiry into the etiology of a burning sensation localized to the shoulder reveals a multifaceted landscape of potential causative factors. This exploration has encompassed a spectrum of conditions, ranging from musculoskeletal origins, such as rotator cuff injuries and muscle strains, to neurological considerations, including nerve compression syndromes and referred pain patterns. The influence of inflammatory processes and joint dysfunction has also been thoroughly examined, alongside the less frequent, yet significant, contribution of vascular compromise. A nuanced understanding of these potential sources is paramount for accurate diagnosis and effective management.
Given the complexity inherent in differentiating the various potential etiologies, a comprehensive medical evaluation is strongly advised for individuals experiencing persistent or severe shoulder discomfort. Such an evaluation should include a detailed medical history, thorough physical examination, and, when indicated, advanced diagnostic imaging or neurophysiological testing. Prompt and accurate identification of the underlying cause is crucial for implementing targeted interventions, mitigating long-term complications, and optimizing patient outcomes.
