The shoulder is the most flexible joint in the body. However, it is an unstable joint because it's restricted in its range of motion allowed. The shoulder can easily be injured because the ball of the upper arm is larger than the shoulder socket that holds it. The shoulder must be held together by its muscles, tendons, and ligaments to remain stable. Some shoulder problems result from the damage of these soft tissues caused by injury, overuse of the shoulder, or underuse of the shoulder. In other cases, shoulder pain arises from a degenerative process in which tissues break down and no longer function well.

Shoulder pain may be localised or may spread to areas around the shoulder or down the arm. If you are experiencing shoulder pain for an extended period of time, your doctor will likely do an X-rays, MRI, and arthrogram to diagnose the cause of shoulder pain.

Possible causes of shoulder pain include:

  • Rheumatoid arthritis
  • Osteoarthritis
  • Inflammation from a natural reaction to an infection or injury
  • Tension in the muscles between the neck and shoulder
  • Damage in the muscles and tendons around the shoulder
  • Inflammation in the bursa – a fluid-filled cushion which normally helps the muscles and tendons slide smoothly over the shoulder bones
  • Damage to the bones and cartilage as a result of arthritis


At our clinic, we use Intra-articular, peri-articular, intrabursal injection of Hylan GF20, steroid or prolotherapy agents depending on the cause of the shoulder pain.