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How Shoulder Pain Is Diagnosed

A shoulder may look like a simple joint. After all, it’s just a ball and socket. But your shoulder requires a number of muscles, ligaments, and tendons to keep the joint in place and permit its (significant) full range of motion.

If your shoulder hurts, the root cause could be an injury to those many soft tissues or even to the bone. That’s why our expert rheumatologists at the Rheumatology Center of New Jersey recommend a thorough evaluation and diagnosis before starting any type of treatment for shoulder pain.

Where does it hurt?

Unlike muscle pain, which can be fairly easy to pinpoint, the exact area of your shoulder pain may be more difficult to identify. Your shoulder joint contains many different types of tissues and nerves that overlap one another. 

Shoulder pain could be caused by tears or inflammation in one or more of your:

Your shoulder pain might also arise from a simple fracture or hairline fracture to one of the bones in your joint. 

When you come in for a diagnosis, we evaluate your range of motion as well as the strength of your shoulder to help identify the structure or structures that are involved in your pain.

Why and how does it hurt?

We also ask you specific questions about when the pain first started. If you suffered an acute injury, such as throwing out your shoulder during a baseball game or falling on your arm, you might have a good idea of when the injury occurred.

But if you have chronic pain, you might not remember exactly when it started. The pain could have built gradually over the years. Slow onset of pain might be associated with arthritis or other conditions caused or worsened by wear-and-tear or aging.

The type of pain sensation also helps with the diagnosis. Does your shoulder burn or tingle? Does it only hurt when you move it? Or does it ache, no matter what you do.

A look inside your shoulder

To obtain an accurate diagnosis for your shoulder pain, we use imaging techniques to take a look at your rotator cuff as well as the bones and other soft tissues in your shoulder joint. We may recommend:


An X-ray is the best and most accurate way to determine if damage to your bones is causing your shoulder pain. X-rays can clearly show even the thinnest of hairline fractures. 

An X-ray also illuminates the presence of painful bony protrusions called bone spurs. You may develop bone spurs if you have arthritis. Your body produces the extra bone as your cartilage wears away, to keep the bones of your joint from rubbing together. But the bone spur might press against a nerve or otherwise irritate your soft tissues.


Ultrasound bounces sound waves through your shoulder. The resulting images provide us with a clear idea of which soft tissues are torn, ruptured, or simply inflamed. 

A diagnosis informs treatment

Once we have an accurate diagnosis for your shoulder pain and have identified all of the structures involved in your pain and lack of mobility, we create a custom-designed targeted treatment plan. Depending on your needs, we may recommend:

Don’t play hit and miss with your shoulder pain. Find out what’s at the root of your pain by getting a thorough examination and accurate diagnosis today. Call one of our offices in Somerville, Flemington, or Monroe, New Jersey. You may also request an appointment using our online tool.

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