Symptom
Many people notice clicking, popping or grinding in their shoulder. In most cases these noises are not harmful and do not necessarily mean that something is damaged. However, when clicking is associated with pain, weakness, instability or loss of function, it is worth having your shoulder assessed. The shoulder is one of the most complex joints in the body, with several moving structures working together, so clicking or grinding can arise from a number of different causes.
Sometimes the shoulder simply produces painless clicks as tendons or muscles move over bony prominences. If there is no pain and no loss of function, this is often a normal finding and does not require any treatment.
Occasionally the noise comes from the shoulder blade moving over the rib cage rather than from the shoulder joint itself. This is known as scapulothoracic crepitus, or 'snapping scapula', and is usually managed without surgery.
Painful clicking may occur for a number of reasons. A SLAP tear, an injury to the cartilage at the top of the shoulder socket, or an unstable long head of the biceps tendon can produce painful clicking or catching, particularly during overhead activities or throwing sports.
Patients who have previously suffered a shoulder injury or undergone surgery may occasionally develop loose bodies within the joint. These small fragments of cartilage or bone can become trapped during movement, causing painful catching, locking or sudden episodes where the shoulder feels as though it momentarily sticks.
A grinding sensation, sometimes described as crepitus, is more commonly associated with arthritis, where the smooth cartilage lining the joint has worn away. In these situations the grinding is often accompanied by stiffness, reduced movement and pain.
Clicking can also arise from the acromioclavicular (AC) joint, particularly after a previous shoulder separation. Some patients notice the joint moving or clicking when lifting the arm or carrying heavy objects. Although this can occasionally be unsettling, many AC joint injuries settle without surgery and can often be managed successfully with physiotherapy and activity modification.
The most important step is identifying which structure is actually responsible for your symptoms. This starts with a careful history and examination. Depending on the findings, simple X-rays, ultrasound or MRI may be useful, although imaging is not always necessary.
Treatment depends entirely on the underlying cause. Many patients improve with reassurance, physiotherapy and simple activity modification. Others may benefit from injections, and a smaller number of patients with structural problems such as unstable cartilage, loose bodies or significant tendon injuries may benefit from keyhole surgery.
A careful assessment, examination and simple X-rays can often provide a huge amount of information. Many patients do not initially need extensive scans. The aim is not simply to reduce pain, but to help restore comfortable movement, sleep and confidence in using the shoulder again.
The noise itself is rarely the problem. The important question is whether the clicking is associated with pain, weakness, instability or loss of function. By understanding the cause, we can decide together whether reassurance, rehabilitation or further treatment is the most appropriate next step.
Why we treat
clicking and grinding matters because of what it takes away. Your sleep, your work, and the parts of the week you look forward to.
A full golf swing
Jobs around the house
Lengths without pain
Tears of the labrum where the biceps anchors into the socket.
Read about slap lesionsPain at the front of the shoulder from the long head of biceps.
Read about proximal biceps tears and tendonitisPain right on the top of the shoulder, over the collarbone joint.
Read about ac joint pain and arthritisWear of the ball-and-socket joint causing pain and stiffness.
Read about shoulder (glenohumeral) arthritisPainful pinching of the cuff and bursa under the acromion.
Read about impingement and bursitisA shoulder that slips, gives way or has dislocated.
Read about shoulder instability and labral tearsIf this sounds like what you are experiencing, we will find the earliest suitable appointment for you at Woodlands Hospital in Darlington.
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