Causes of shoulder pain

Rotator Cuff Pathology (70% of all shoulder pain)

Rotator Cuff Tendinitis

Inflammation of the tendons of the supraspinatus, infraspinatus, teres minor, and subscapularis muscles. Develops with repetitive overhead arm movements (painters, tennis players, swimmers). Pain with arm abduction, especially in the 60-120° range («painful arc»). Nighttime pain is a typical sign.

→ Rotator Cuff Treatment using MIBRAR® Method

Partial and Complete Rotator Cuff Tear

Acute (from falling on outstretched arm, sudden jerk) or chronic (degenerative — after age 50). Partial tear: pain and weakness with abduction. Complete tear: inability to raise arm, «falling arm sign». MRI data shows 30% of people over 60 have asymptomatic tears.

Impingement Syndrome (Subacromial)

Compression of rotator cuff tendons and subacromial bursa between humeral head and acromion during arm elevation. Causes: acromion shape (hooked), osteophytes, ligament thickening. Pain when raising arm above horizontal.

→ Impingement Syndrome Treatment

Capsule and Ligament Pathology

Adhesive Capsulitis (Frozen Shoulder)

Fibrotic thickening and fusion of joint capsule. Three phases: «freezing» (3-9 months — increasing pain), «frozen» (4-12 months — minimal pain but severe motion restriction), «thawing» (6-24 months — gradual recovery). More common in women 40-60 years old; diabetes increases risk 5-fold.

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Shoulder Joint Instability

After shoulder dislocation or congenital hyperelasticity. Sensation of shoulder «popping out», apprehension with certain movements. Labral injury (labrum) — Bankart lesion.

→ Shoulder Instability Treatment

Other Causes

Calcific Tendinitis

Calcium crystal deposition in rotator cuff tendons (most often supraspinatus). Severe pain during resorption phase — patient cannot move arm. X-ray shows white calcific deposits.

→ Calcific Tendinitis Treatment

Shoulder Osteoarthritis (Omarthrosis)

Degeneration of glenoid and humeral head cartilage. Crepitus, motion restriction, pain. Less common than knee or hip osteoarthritis, but significantly reduces quality of life.

→ Shoulder Osteoarthritis Treatment

Shoulder Bursitis

Inflammation of subacromial or subdeltoid bursa. Pain with abduction, tenderness to palpation. Often accompanies rotator cuff tendinitis and impingement.

→ Shoulder Bursitis Treatment

Acromioclavicular Joint Osteoarthritis

Pain at top of shoulder, with cross-body adduction (arm across chest to opposite shoulder). Common MRI finding after age 50.

Referred Pain (Cervical Spine)

C5-C6, C6-C7 disc herniations can present as shoulder pain without clear joint pathology. Important: shoulder pain + finger numbness → cervical spine MRI mandatory.

Diagnosis of Shoulder Pain

MRI of the Shoulder Joint

Visualizes the rotator cuff, labrum, cartilage, joint capsule, bone marrow. For suspected SLAP injury or Bankart lesion, MR arthrography (with intra-articular contrast) is recommended.

Ultrasound of the Shoulder Joint

Dynamic examination — allows assessment of tendons during movement. Detects rotator cuff tears, bursitis, effusion. Sensitivity for full-thickness tears — 95%, for partial tears — 70%.

X-ray

In 2 projections + axial. For evaluation: acromion shape (Bigliani I-III), calcific deposits, osteoarthritis, humeral head position (high-riding — with massive cuff tear).

Clinical Tests

Neer and Hawkins tests (impingement), Jobe test (supraspinatus), lift-off test (subscapularis), Speed test (biceps), apprehension test (instability). Combination of tests provides accuracy up to 85%.

Shoulder MIBRAR® Method Treatment

MIBRAR® restores damaged rotator cuff tendons, joint capsule, and cartilage without arthroscopy or open surgery.

Rotator Cuff

CGF and mesenchymal stem cells are injected under ultrasound guidance directly into the tendon injury site. For partial tears — tendon structure restoration within 3-6 months. For tendinopathy — inflammation reduction and tissue strengthening.

Joint Capsule

For adhesive capsulitis — CGF injection into the capsule with hydrodilatation. Growth factors break down fibrous adhesions and restore capsule elasticity. Acceleration of the "thawing" phase by 2-3 times.

Cartilage and Subacromial Space

For osteoarthritis — cartilage regeneration. For impingement — reduction of subacromial bursa inflammation and regeneration of damaged tendons, elimination of compression cause.

91% For rotator cuff pathology
88% For frozen shoulder
30-45 min Procedure duration
0 sutures No incisions

Don't wait for the tear to become complete

Untreated partial rotator cuff tears progress to full tears. Send your MRI for evaluation.

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Conditions of the Shoulder Joint

Rotator Cuff

Tendon injury. Pain with abduction, night pain, weakness.

Frozen Shoulder

Adhesive capsulitis. Progressive limitation of all movements.

Shoulder Impingement Syndrome

Tendon compression under acromion. Pain with arm elevation.

Calcific Tendinitis

Calcium deposition in tendons. Severe pain during resorption.

Shoulder Osteoarthritis

Cartilage degeneration. Crepitus, limited motion, pain.

Shoulder Instability

Recurrent dislocation, Bankart lesion. Sensation of "popping out".

Questions about Shoulder Pain

Why does the shoulder hurt when raising the arm?

Most common causes: shoulder impingement syndrome (tendon compression under acromion), tendinitis or partial rotator cuff tear, calcific tendinitis. Pain occurs in the 60-120° abduction range — "painful arc".

What is Frozen Shoulder and how is it treated?

Adhesive capsulitis is a fibrotic adhesion of the joint capsule. Three phases: freezing, frozen, and thawing. The cycle lasts 12-36 months. MIBRAR® accelerates the thawing phase 2-3 times faster: CGF reduces inflammation, Lipogems® restores the capsule.

Can a rotator cuff tear be repaired without surgery?

With partial tears and tendinopathy — yes. MIBRAR® delivers CGF and stem cells to the damaged tendon area. For complete tears > 3 cm, arthroscopic reconstruction is recommended combined with MIBRAR® biological stimulation.

What imaging is needed for shoulder pain?

MRI of the shoulder joint is the gold standard. It visualizes the rotator cuff, cartilage, labrum, and joint capsule. Ultrasound is used for dynamic assessment of tendons. X-ray is used to detect calcifications and osteoarthritis.

Why does shoulder pain worsen at night?

Night pain is a characteristic sign of rotator cuff pathology. When lying down, pressure on the inflamed tendon increases. Night pain is also typical for calcific tendinitis and adhesive capsulitis.