Learning About Internal Derangement of the Shoulder

Internal derangement of the shoulder is a broad term for a shoulder problem inside the joint that causes pain or makes it hard to move your shoulder normally.

There are three main causes of internal derangement of the shoulder.

• Injury. For example, falling on your shoulder, sustaining a hard shoulder impact, or grabbing onto something to keep from falling can cause it.
• Repeated overhead motion. Regularly playing sportslike tennis or volleyball can be a cause. So can swinging a hammer often.
• Aging. Wear and tear over time and arthritis can also cause it.

If you have a sudden (acute) injury, some symptoms may include:

• A severe pain or a “popping” feeling in your shoulder.
• Bruising or swelling around your shoulder.
• Weakness in the arm.

If you have a chronic or overuse injury, some symptoms may include:

• A “clicking” or “catching” feeling in your shoulder.
• Pain that is worse at night or when doing any overhead activity.
• Continued weakness in the arm.

Your doctor will ask you questions about your symptoms and do a physical exam. This exam involves checking your range of motion and strength, as well as looking for other things that may have caused your pain. Other tests may include X-rays, an MRI, or an ultrasound.

Your treatment will be based on your age, the demands on your body, and the cause of the issue.

Common treatments include:

• Avoiding activities that cause shoulder pain.
• Taking over-the-counter medicines to reduce pain and swelling.
• Doing physical therapy to improve movement, strength, and endurance.

If these treatments don't help, or if repeated overhead motion is a big part of your life, your doctor may recommend surgery.