Risk factors for developing shoulder pain
A number of factors increase your likelihood of developing shoulder pain, including age, gender, and genes. Even being overweight or smoking can play a role. Some of these factors fall within your control, while others are beyond it.
Genes: Certain shoulder problems seem to run in families. Rotator cuff injuries are more likely to occur not only in siblings, but also in cousins and other more distant relatives. The tendency to injury may be due at least in part to inherited anatomical differences in the shoulder joint. It’s also possible that family members tend to share shoulder-straining experiences—for example, if they play the same sports or have the same physically demanding occupation.
Arthritis also has a genetic component. Inherited characteristics in the shape of the acromion (a bony projection on the end of the shoulder blade) and the glenoid cavity (the socket in the shoulder joint) can increase the likelihood of shoulder degeneration and damage.
Age: Your likelihood of developing osteoarthritis increases as you age. Years of playing tennis and golf or engaging in other repetitive activities can cause minor injuries that add up over time, eventually leading to a loss of the cartilage that cushions your shoulder joints. Osteoarthritis and soft tissue conditions, such as rotator cuff injury, shoulder impingement syndrome, and frozen shoulder, are the most common causes of shoulder pain in older adults.
Gender: Women are at higher risk for shoulder pain than men. Their smaller size, coupled with generally weaker muscles, leads to greater shoulder instability. In addition, after a woman spends years playing sports or engaging in repetitive motions at work, her shoulder joints begin to loosen, putting her at increased risk for dislocation. Hormones might play a role in gender-related shoulder differences. Relaxin, the hormone released during pregnancy to ease delivery, does so by relaxing ligaments throughout the body. For these reasons, women are more likely to suffer injuries when they play sports. However, because men participate in sports more over all, they account for a greater proportion of sportsrelated shoulder injuries.
Obesity: Extra weight puts added pressure on the joints, and the heavier you are, the more weight your joints have to bear. The knees and hips carry most of this force, but shoulders can be affected, too. Obesity might also contribute to shoulder pain by triggering the release of inflammatory substances. Inflammation activates pain receptors in the area, contributing to shoulder pain.
Other medical conditions: People with certain medical disorders are more likely to develop shoulder pain. These disorders include diabetes, multiple sclerosis, fibromyalgia, and inflammatory forms of arthritis, such as such as rheumatoid arthritis and psoriatic arthritis.
In diabetes, chronic high blood sugar leads to connective tissue damage and inflammation in the shoulders, as well as in other parts of the body. Frozen shoulder and rotator cuff injuries are particularly common in people with diabetes. Although researchers don’t know exactly why, it may have to do with impaired blood flow. Another possible culprit is the formation of damaging substances known as advanced glycation end products. These substances—which form when blood sugar is high, and sugar molecules attach abnormally to protein or fat—can make tendons stiff and weak.
Multiple sclerosis causes nerve damage, which leads to pain, weakness, and reduced function throughout the body, including the shoulders. Fibromyalgia is marked by muscle pain and tenderness at various sites, including the neck and shoulders. And inflammatory forms of arthritis produce inflammation in the joints.
Smoking: Along with the many other ill effects of cigarette smoking— among them cancer, heart disease, and lung disease— some studies have linked this harmful habit to shoulder pain, tendon injury, and an increased risk for rotator cuff tears. Smoking promotes inflammation, and it robs the blood of the oxygen needed to heal injuries in the shoulders and elsewhere in the body.
People who smoke tend to have larger rotator cuff tears, and they don’t improve as much after rotator cuff surgery as nonsmokers, according to a 2018 study in BMJ Open Sport & Exercise Medicine. Another study found that smokers didn’t heal well after rotator cuff repair. Nicotine—the active component in tobacco smoke—reduces blood flow to the rotator cuff, an area of the body that already has a limited blood supply. A steady flow of oxygen- and nutrient-rich blood is essential for maintaining a healthy rotator cuff, as well for promoting healing after surgery.
