Left vs. Right Shoulder Pain

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Shoulder Pain

Published: 27 November 2015

Pain in one Shoulder - what are the differences between left and right shoulder Pain?

Both can be related to a number of different underlying causes. Shoulder pain presented on either the left or right side ONLY - is a common complaint in my physiotherapy practice. The most common type of person to present to me with right-sided shoulder pain is a right-handed, full-time office worker!

Believe it or not, approximately 70% of my right shoulder pain clients are right-handed office workers!

And the same holds true for my left shoulder pain clients.

As you are probably aware, office work these days involves long hours of sitting, in what I call a computer posture using a mouse, phone and keyboard with your right hand. This set of actions - if not performed correctly - can lead to right-sided and even chronic shoulder pain over time.

Commonly, most of us sit at our desks with your lower back slumped and middle back humped! Does this sound familiar to you? Your chin is then poked forwards to allow you to watch your computer screen.

Forgive me if I have you wrong, but the chances are if you have one-sided shoulder pain and have a busy office job, then you are likely to have some if not all of the above postural habits! Your right or left arm is then stretching forwards in a poor position to use the keyboard and mouse, placing excess pressure on your shoulder.

Overall, it is primarily the poor position of your spine that dictates the poor position of your shoulders, so posture correction of your spinal position is of great importance.

The pain that you have in your right or left shoulder may be coming from the strain on the shoulder joint itself in this position. It may also come from the strain on the ligaments, muscles, nerves and discs in your neck referring pain into your shoulder.

Let’s have a closer look at the structures involved in one-sided shoulder pain (as you can see, it is quite a long list and this is why I emphasise the importance of a correct diagnosis):

Diagnosing one sided shoulder pain

1. Shoulder joint damage: This is where your shoulder joint has been damaged by trauma, arthritis or poor posture. In this situation the damaged tissue needs to heal using mobilisation therapy and exercises.

   Positioning is also very important using posture correction and taping techniques where required. Your physiotherapist will help you identify which structure is at fault allowing treatment to be the most effective.

2. Shoulder tendon damage: Is where the tendons of the muscles around your shoulder become worn or torn in some way. The inflammation associated with this presentation causes your pain. Treatment needs to be directed to unloading the damaged tendon followed by exercises to ensure it is not over-strained again.

   Early intervention is important as if your tendon is left untreated for too long, long term damage to its structure may result, potentially causing you chronic shoulder pain over time.

3. Shoulder ligament damage: Is where a ligament around your shoulder gets over-strained or damaged in some way. Treatment is directed towards unloading the damaged ligament using taping techniques to help it heal. Following this, exercises to strengthen your shoulder complex will be required.

4. Dislocated shoulder: Is where the ball of your shoulder joint moves out of its socket. This is usually traumatically induced. Treatment is required to re-align your joint, followed by exercises to strengthen it so that is does not repetitively dislocate. Unfortunately I see repetitive dislocations frequently.

   If your shoulder is dislocating repetitively then please seek expert help as the more often it happens the weaker your shoulder joint becomes, and the chances of chronic shoulder problems becomes higher.

1. Neck pain: If a nerve in the left side of your neck is impinged it may refer pain to your left shoulder. Similarly with the right side. Treatment is directed towards the neck primarily followed by strength and posture exercises.

2. Emotional issues: In my opinion, one-sided shoulder pain is sometimes associated with recent emotional issues, with stress and tension in the upper back, shoulders and neck contributing to shoulder pain. This is a pattern that I see regularly in my practice. Treatment is required to treat the physical pain in your left shoulder, but also resolution of your emotional issue is encouraged. I advise craniosacral therapy or counselling, if self resolution is not possible.

3. Whiplash injuries: Commonly refer pain to your left shoulder. Seek physiotherapy treatment to help resolve your whiplash injury and your shoulder pain should resolve quickly.

4. Heart trouble: Can be the cause of your left-sided shoulder pain. Seek a good physiotherapy assessment. Your physiotherapist will thoroughly assess your shoulder - and if no mechanical signs of left shoulder pain are detectable they will send you for a heart review to your doctor. Alternatively, go to your doctor first!

Treating one sided shoulder pain

To treat your shoulder pain, a correct diagnosis is important. Identifying the cause is the key to the long term resolution of your left or right-sided shoulder pain.

Once you have identified the causes of shoulder your pain, treatment to that dysfunctional component will normally be done with mobilisation and positioning. Sometimes further medical intervention is required.

Long term treatment and management of one sided shoulder pain will be helped by correcting and maintaining a good spinal and shoulder posture, with a shoulder pain exercise program.

Read More:

I have a selection of articles on the different types of causes and treatments of shoulder pain. Click here to discover them

Discover more about the Anatomy of the Shoulder