Shoulder Pain in Vienna
The shoulder makes itself felt when getting dressed, when lifting overhead or at night when lying on your side. The causes vary widely — from an irritated tendon to a calcium deposit to an injury after a fall. At my practice at the Orthozentrum Döbling I establish where the symptoms come from.
In short
Shoulder pain is a key symptom, not a diagnosis. Most often it stems from the rotator cuff tendons, a calcium deposit in the tendon, an inflamed joint capsule, instability after a dislocation or cartilage wear. When and during which activity the pain occurs narrows down the cause: night pain and pain above head height point to the tendons, increasing loss of movement to the capsule, a fall to an injury. Which structure is responsible becomes clear in the consultation, the clinical examination and with ultrasound. The findings determine the way forward: I usually treat irritation and wear conservatively; with a recent rotator cuff tear, a shoulder that has become unstable after a dislocation or a clearly displaced fracture, on the other hand, I discuss an operation at an early stage.
Possible causes of shoulder pain
The shoulder has little bony guidance; tendons, capsule and muscles hold it together. Accordingly, many structures come into question as the source of pain. What takes the assessment further is the question of when the pain occurs and what preceded it.
Pain at night and when lying on the shoulder
Anyone who can no longer lie on the affected side usually has a problem with the tendons beneath the acromion (the roof of the shoulder) or with the bursa. This is typical of a rotator cuff tear and of calcific tendinitis (tendinitis calcarea), in which a calcium deposit interferes with the tendon.
Pain when lifting above head height
If the arm hurts within a certain arc of movement and when working overhead, this points to inflammation of the bursa beneath the acromion (subacromial bursitis), formerly called impingement, or to a partial tear of the tendon. The examination shows which structure is causing the symptoms.
The shoulder becomes stiffer from week to week
If the shoulder loses movement in all directions without a preceding accident, I think of a frozen shoulder (adhesive capsulitis) — an inflammation of the joint capsule with shrinkage. Load-dependent pain with a grinding sensation fits better with shoulder osteoarthritis (omarthrosis).
Symptoms after a fall or an impact
If the shoulder was dislocated or a feeling of instability remains, the issue is shoulder dislocation and instability with damage to the labrum and capsule. A dislocation of the acromioclavicular joint (AC joint) and fractures also first show up as shoulder pain.
Pain after sporting load
Sudden pain with an audible snap during bench pressing or heavy lifting points to a tendon tear — a pectoralis tendon rupture of the chest muscle or a biceps tendon tear. I assess persistent overhead symptoms in sport within sports orthopaedics.
How I make the diagnosis
It starts with a detailed consultation: since when, during which activities, what happened beforehand. Then I examine clinically — active and passive mobility, the strength of the individual tendons, tender points, stability. Ultrasound is available in my practice; with it I assess tendons, bursa and calcium deposits in motion. Where needed, I arrange an X-ray or MRI; both take place outside the building. The page on the shoulder specialist in Vienna gives an overview of shoulder diagnoses.
When prompt assessment matters
Some symptoms should not be left to wait: a visible deformity after a fall, a sudden loss of strength when lifting, a dent in the upper arm, numbness in the arm, and pain with redness, swelling and fever. A shoulder that dislocates repeatedly should also be examined promptly. For acute cases I offer appointments outside regular consulting hours.
Treatment: the findings decide
Treatment is guided by the cause, not by the pain alone. I usually treat irritation of the tendons and bursa conservatively: targeted offloading and physiotherapy, which takes place in the same building at the Orthozentrum Döbling, and, in my practice, shockwave therapy in focused and radial form, magnetic field therapy, ultrasound-guided injection and PRP therapy. The situation is different with a recent tendon tear, a shoulder that has become unstable after a dislocation or a displaced fracture: here I discuss an operation early, because waiting tends to make the findings worse. In every case, the aim is to ease the pain and restore mobility.
When an operation is necessary
If the symptoms persist despite conservative treatment, or if the findings show damage that will not heal on its own, I discuss the surgical route with you. Much can be addressed arthroscopically: repair of the rotator cuff, removal of a calcium deposit, stabilisation with fixation of the labrum and capsule. I use open surgery where the injury requires it, for example with a torn pectoralis tendon. I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare. My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. Whether an operation makes sense depends on the findings; we make the decision together once all the results are available.
Frequently asked
Common questions about shoulder pain
An examination makes sense if the pain persists, occurs at night, if mobility decreases or if strength fades when lifting. You should have your shoulder assessed promptly in the case of a visible deformity after a fall, a sudden loss of strength, numbness in the arm, or redness, swelling and fever.
When you lie down, the muscles no longer take load off the joint, the head of the humerus moves closer to the acromion and the pressure on the tendons and bursa increases. That is why tendon disorders such as a rotator cuff tear, calcific tendinitis or bursitis typically make themselves felt at night. The inflamed joint capsule of a frozen shoulder also disturbs sleep.
First I ask how the symptoms began, what triggered them and which movements hurt. Then I examine the shoulder clinically: active and passive mobility, the strength of the individual tendons, tender points and stability. After that I assess the tendons, bursa and any calcium deposits with ultrasound. Finally, I discuss what the findings mean.
No. You do not need a referral for an appointment, and you do not have to organise an MRI yourself. Please bring everything you already have to your first consultation: your e-card, previous reports, doctors' letters and X-ray, CT or MRI images. I decide whether additional imaging makes sense after the examination and ultrasound.
That depends on the cause. For symptoms affecting the tendons and bursa I use shockwave therapy, ultrasound-guided injection, magnetic field therapy and PRP therapy. Where stiffness and loss of strength are the problem, physiotherapy takes centre stage. The aim of treatment is to ease the pain and restore mobility.
That depends on the cause. I usually treat irritation and wear conservatively. With a larger or recent tendon tear, recurrent instability after a dislocation or a displaced fracture, on the other hand, I discuss an operation at an early stage. The findings, your age, your occupation and your demands in sport also play a part in the decision.
My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. For operations, direct settlement with supplementary private insurance is possible.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.