When your shoulder hurts but your MRI showed nothing, the cause of the shoulder pain could be referred pain from your neck, Scapular Dyskinesis (movement timing), Microscopic Inflammation or Tendinopathy, Myofascial Trigger Points and even Subtle Dynamic Instability.
Subtle Dynamic Instability is functional laxity in which the ball and socket don't center properly during motion, which can irritate the surrounding soft tissue during active use rather than at rest.
Myofascial Trigger Points or tight knots in your upper back or shoulder blade muscles can also cause persistent, radiating aches, which don't register on imaging scans.
Microscopic Inflammation or Tendinopathy, which involves early chemical irritation, bursal inflammation or small fiber nerve sensitivity can generate real pain without showing up as a distinct tear or structural defect on an MRI.
Scapular Dyskinesis (Movement Timing), which involves poor coordination or muscle imbalance around your shoulder blade can also place abnormal mechanical stress on normal tendons during movement.
And referred pain from the neck, which can be a result of issues in your cervical spine, like a pinched nerve or disc irritation can also project deep pain into your shoulder joint, while your shoulder itself remains structurally healthy.
You can also often tell if your shoulder pain is muscular by the symptoms as shoulder pain that is muscular feels like a dull and achy soreness that gets worse when you move the muscle, but leaves the joint strength and range of motion mostly normal.
Signs of joint pain being muscular include surface tenderness, achy sensation, temporary relief occurs and it gets better at rest.
When your joint pain is muscular, the pain often fades when you stop moving and allow the muscle to rest.
And warm showers, gentle stretches, or light massage help the fibers feel better and the discomfort feels like a burning, throbbing or dull ache after heavy work, exercise or bad posture and you feel pain when you press directly on a tight knot or specific spot on the tissue.
The signs that your shoulder pain is not muscular include you have joint and tendon issues, nerve problems and severe tears.
Sudden weakness or an inability to lift your arm can mean that you have a rotator cuff tear.
Having pain that shoots down your arm or comes with numbness and tingling, often begins as a pinched nerve in your neck.
And having pain that stays constant even when you rest, or makes a clicking and grinding sound, often points to a joint or tendon problem.
Common conditions that also start with shoulder pain include rotator cuff tendinitis, frozen shoulder (adhesive capsulitis), Polymyalgia Rheumatica and Cervical Radiculopathy.
Rotator Cuff Tendinitis or Impingement, results from inflammation of the tendons or bursa in the shoulder that often starts as a mild, dull ache when lifting the arm or reaching overhead before turning into sharper pain.
Frozen Shoulder is a condition that often begins with a gradual, deep aching pain that restricts movement before severe joint stiffness sets in.
Polymyalgia Rheumatica is an inflammatory disorder, which commonly causes sudden, symmetric pain and morning stiffness in your shoulders and hips.
And Cervical Radiculopathy, involves a pinched nerve in your neck that frequently radiates pain, numbness or tingling directly into your shoulder.
The most painful shoulder condition is frozen shoulder also known as adhesive capsulitis.
Frozen Shoulder is when the capsule that surrounds the shoulder joint thickens, tightens and forms scar tissue.
The initial "freezing" stage of frozen shoulder brings constant, deep, and worsening aches which disrupts sleep and severely restricts movement.
Another most painful shoulder condition is calcific tendinitis.
Calcific Tendinitis is when calcium deposits build up inside your rotator cuff tendons.
And when these calcium deposits enter an inflammatory phase, they cause sudden, severe and blinding pain, which can make any movement of your arm nearly impossible.
Another most painful shoulder condition are fractures.
Acute traumatic injuries, like a broken collarbone or proximal humerus fracture, cause severe mechanical pain, although they also stem from structural breaks rather than chronic disease processes.
Severe Bursitis can also cause severe shoulder pain.
Severe Bursitis is a result of extreme inflammation of the fluid filled sac cushioning the joint.
Other conditions that can cause severe shoulder pain and shoulder pain in general include pinched nerve or cervical radiculopathy, brachial plexus injury, heart attack and gallbladder or digestive issues.
Referred pain from internal organs can cause severe discomfort that can be felt around your shoulder blade.
Sudden, severe pain, which is frequently in the left shoulder or arm can signal a cardiac emergency, especially if accompanied by chest pressure, shortness of breath or nausea.
Brachial Plexus Injury, results from damage or stretching to the network of nerves that run from the neck through your shoulder.
And Pinched Nerve or Cervical Radiculopathy, results from a compressed nerve root in the neck sending sharp, burning pain down into the shoulder.
And even a dislocated shoulder can cause shoulder pain.
When you have a dislocated shoulder, the top of the arm bone popping out of the shoulder socket, causing intense pain and a locked joint.