Headache and Migraine

Common Causes of Shoulder Pain Without Injury

Shoulder pain can come from a traumatic injury while playing sports or as the result of an auto accident. However, many people can experience shoulder pain without trauma. This discomfort can be due to conditions like arthritis or bursitis, or it could be “referred” pain, which comes from an injury in another part of the body.

Shoulder pain without injury can cause discomfort, such as swelling and stiffness. It may also limit movement and make it difficult to perform everyday actions, such as carrying a grocery bag or picking up your child.

Here is an in-depth look at what can cause shoulder pain without injury and possible treatment options.

What Are The Reasons For Shoulder Pain Without Injury?

While shoulder pain without injury can sometimes come from damage to another part of the body (referred shoulder pain), it is usually caused by a specific condition. Here is what can cause shoulder pain without injury.


Arthritis is an inflammation of the joint. It can occur in any part of the body, including the shoulder joint. Shoulder pain without injury can be a symptom of osteoarthritis. This chronic condition involves the wearing out of the cartilage between the shoulder joint, causing the bones to grind together. Shoulder pain can also be a symptom of rheumatoid arthritis, an autoimmune disorder where the body attacks the joint lining.

Frozen Shoulder

Shoulder pain without injury can also be a symptom of a frozen shoulder. The medical term for this condition is adhesive capsulitis. A frozen shoulder occurs as a result of the thickening of the protective tissues that line the joint—the thickening results in pain, especially during any shoulder movements.

Rotator Cuff Tears

Rotator cuff tears can occur gradually due to overuse or repetitive motions. It can cause pain during movement and limit the motion of the shoulder joint.

Spine or Disc Issues

You can also experience referred shoulder pain without injury as a result of spinal or intervertebral disc issues. For instance, pain from a herniated disc in your neck or upper back can radiate into your shoulders and upper arm.

shoulder pain

When Should I Worry About Shoulder Pain?

In most instances, sudden shoulder pain without injury treatments can effectively relieve pain and restore the full range of motion. In some cases, however, the pain can be a sign of something more serious, such as cancer, heart problems, or systemic infections.

More severe problems are usually accompanied by additional symptoms. If you experience any of these additional problems, you should quickly seek medical care.

  • Fever along with shoulder pain
  • Complete inability to lift your shoulder
  • Heat and tenderness around the joint
  • Persistent shoulder joint swelling that doesn’t resolve with common home treatments
  • Persistent shoulder pain that doesn’t improve after treatment

Can Shoulder Pain be Related to Heart Problems?

Shoulder pain can also be related to heart problems, such as a heart attack or reduced blood flow to the heart. Individuals with symptoms that put them at increased risk for heart diseases, such as high blood pressure, also tend to experience musculoskeletal disorders, such as joint pain and rotator cuff problems. Also, sudden and sharp shoulder pain that is not connected to any injury may be an indication of a heart attack.


What Does Shoulder Bursitis Feel Like?

Shoulder pain without injury is commonly caused by bursitis. A bursa is a cushioning pad between bones and soft tissues such as tendons and ligaments in joints. While you have bursae all over your body, shoulder bursitis is the most common type of bursitis. It occurs when excess fluid builds up in a bursa. Individuals with shoulder bursitis may experience sharp pain, dull ache, or mild tenderness.

Shoulder bursitis can be diagnosed using an x-ray, MRI, or ultrasound. Treatment includes surgical and non-surgical methods and home remedies. Surgeries remove the affected tissue, while antibiotics, physical therapy, and anti-inflammatory injections can also help. Home treatments can include pain relievers, ice packs, and stretching.


Does Stress Cause Shoulder Pain?

While physical stress and repetitive aggravation of your shoulder joints and muscles will, without a doubt, cause shoulder pain, emotional stress can also lead to shoulder pains. Prolonged and increasing levels of stress, tension, and anxiety can cause inflammation throughout your body. This can cause both joint and muscle tightness.

The good news is that if your shoulder pain is caused by stress and anxiety, you can significantly relieve the discomfort by utilizing proven tools and techniques for handling stress. These treatments can include meditation, progressive muscle relaxation, breathing exercises, yoga, and exercise.

What Are Common Range of Motion Problems for the Shoulder?

In addition to a frozen shoulder and a rotator cuff tear, a wide range of other conditions can cause shoulder movement problems and make it difficult to move your arm above your shoulder.

Here are some other issues that can limit the range of motion in your shoulder.

  • Wearing a sling or other device that limits shoulder movement for a prolonged period
  • Having a thyroid condition
  • Having a cardiovascular disease or a heart attack
  • Having diabetes
  • Suffering a stroke
  • Experiencing different forms of arthritis

If you experience sudden shoulder pain without injury and symptoms include a racing heart or other cardiovascular emergency signs, you should seek medical treatment immediately.

You Can Get Treatment for Your Sudden Shoulder Pain Without Injury at Carolinas Pain Center

There are a variety of reasons you may experience shoulder pain without injury. Luckily, most common issues are treatable once you define the problem. At Carolinas Pain Center, we can assess shoulder pain, find the root causes, and offer shoulder pain treatment options.

You do not have to deal with the discomfort and limited motion caused by shoulder pain without injury. If you are experiencing chronic issues that do not resolve with common home treatments like over-the-counter pain relievers and ice packs, you should make an appointment with Carolinas Pain Center to get answers and treatment options for your shoulder issues.

What Not to Do with a Migraine

  • Headache and Migraine Pain

Migraines can strike at the worst times and can be debilitating. Once they start, extreme sufferers can expect to be out of commission for hours, even days. For those prone to migraine headaches, it is important to know what not to do in the throes of a migraine and between migraines. These are the dos and don’ts for chronic migraines.

How Do You Know If You Have a Migraine?

Most migraine sufferers report an intense, throbbing pain that worsens with movements, lights, sounds, smells, and other triggers. For some people, there are symptoms that arise before the actual headache. There are four stages of a migraine.

Phase 1: The Prodome

The prodome isn’t experienced by everyone. It’s kind of a “premonitory” or “pre-headache” stage. During the prodome, one can find it hard to concentrate, speak, read, or sleep. They can feel irritable, anxious, or even depressed without explanation. Nausea and muscle stiffness can also occur. People may feel sensitive to lights, sounds, and smells.

Phase 2: The Aura

Not everyone is aware of or feels an aura, period. It happens quickly — between five minutes and an hour. The aura stage may overlap with the actual headache for some migraine sufferers. During the aura phase of a migraine, people may experience visual disturbances or even temporarily lose sight. There is numbness, tingling, or weakness in one side of the head or body. Speech may even be affected.

Phase 3: The Headache

A migraine headache typically brings a strong, throbbing pain in the head (that may move from one side of the head to the other), neck pain, stiffness, nausea, vomiting, and/or nasal congestion. Symptoms of anxiety and depression are also common. Migraine sufferers can expect this phase to last from four hours to three days.

Phase 4: The Postdrome

This last stage is akin to a hangover that may linger for one to two days. It can be difficult to concentrate or comprehend things, and many people feel fatigued and somewhat depressed — although some even experience a sort of euphoria when the pain is over.

Migraine coming on


What Can Worsen a Migraine?

Not everyone experiences a migraine the same way, and what triggers or exacerbates one person’s pain may have no effect on someone else. However, there are a few things that tend to worsen migraines.



Unhealthy Habits

It’s essential to eat and sleep properly in any event, but for people who get migraines, these habits may have tangible effects on migraine frequency, duration, and level of pain. Consuming lots of alcohol, caffeine, and even foods like sweets, artificial sweeteners, and heavily salted foods (such as cured meats) can also have a negative effect on someone’s migraines. Oversleeping or not sleeping enough, dehydration, and low glucose levels can also exacerbate migraine symptoms — as can stress.

Over-Medication for Pain

Just because a medicine is available over the counter doesn’t mean it should be taken regularly. In fact, taking things like ibuprofen, acetaminophen, or aspirin for more than a couple of days in a row may result in medication overuse headaches (MOH) — sometimes referred to as “rebound headaches.” People who take opioid medications for long periods of time can also experience a heightened pain response called opioid-induced hyperalgesia.

Certain Medications

More clinical studies are needed to confirm the correlation between migraines and these medications, but for some people, migraines are triggered or made worsened by:

  • SSRI (Selective Serotonin Reuptake Inhibitor) Antidepressants
  • Nasal Decongestants and Steroids — for chronic allergies
  • Oral Contraceptives or Hormone Replacement Therapy
  • PPIs (Proton Pump Inhibitors) — for acid reflux, such as Nexium

Someone who is on one or more of these medications and finds that their migraines have gotten more intense should speak to their doctor.

What Should You Not Do with Migraines?

It’s important for migraine sufferers to identify their particular triggers, and this list may be a good start.

  • Do not mess with your sleep schedule. Aim to get 7-9 hours of sleep every night.
  • Do not skip meals, and do not eat lots of junk food. A sudden drop in blood sugar can trigger a migraine. Regular indulgence in high sodium, MSG, artificial ingredients, heavily processed foods, and high quantities of sugar may make you more prone to migraines.
  • Do not let yourself get dehydrated. Dehydration is a common trigger for headaches and can exacerbate a migraine.
  • Do not take pain medication for more than 3 or 4 days in a row. Developing the body’s resistance and expectation of medication can bring on a headache and affect the efficacy and effectiveness of the medicine.
  • Do not try to “motor through” a migraine. Ignoring the pain will not make it go away — in fact, it may make the pain worse and the duration of the migraine longer. 

What not to do with a migraine

What Should I Do While Having a Migraine?

At the first sign of the onset of a migraine, you should:

  • Take a time-out. Stress only makes things worse, and migraines usually come with sensitivity to stimuli. Find somewhere quiet, dark, and peaceful to rest. 
  • Drink some water. Staying hydrated — and getting hydrated if you have become dehydrated — goes a long way to fending off migraines. If you think you need to replenish your electrolytes, get a sports drink, preferably a low-sugar option.
  • Apply something cold or hot to your head. Some people feel some relief with an ice pack, while others find that heat works better for them. Use whatever works in your experience, whether it’s a bag of frozen peas, a steamy shower, or a heating pad for your head, neck, and shoulders.
  • Take your pain medicine as recommended or prescribed by your doctor. This should be done at the first instance, not when your migraine has progressed — and it will — to the point of no return. The earlier you work to stave off the migraine, the higher likelihood of success and the more effective the treatment will be. 


A comprehensive migraine treatment regimen may be highly personalized. The more you are aware of your triggers and what remedies work for you, the better off you are. Find out more about headache pain or make an appointment with us at Carolinas Pain Center. Get your migraine pain under control.

When to Worry About a Headache: Dangerous Headaches

  • when to worry about a headache

Do you know when to worry about a headache?

Headaches are not usually a cause for concern. The average headache comes with a manageable level of pain and is typically triggered by something like work stress, poor posture, flashing lights, strong smells, and loud sounds. Unfortunately, headaches can also be a symptom of a more serious medical condition like a tumor, stroke, aneurysm, or meningitis.

So, how can you distinguish dangerous headaches from harmless ones? If you don’t know when to worry about a headache, we encourage you to read through our detailed guide below. This information should help you decide whether or not to seek medical assistance for your head pain. 

When Is a Headache Dangerous?

To determine whether or not a headache is dangerous, it’s essential to understand the different types of headaches. Headache pain can be dull, sharp, throbbing, brief, or long-lasting. The pain can occur anywhere in the face or head, depending on the type of headache you’re experiencing. If you’re not familiar, the most common types of headaches include:

  • Cluster
  • Tension
  • Sinus
  • Neck
  • Migraine
  • TMJ

You can distinguish these headaches by where they tend to cause pain. Cluster headaches, for example, cause pain around the eyes, whereas tension headaches usually occur in the forehead area. Cluster headaches and tension headaches are good examples of head pain that doesn’t usually require urgent care. 

Any headache can technically be dangerous, provided it’s a symptom of a serious medical condition like a tumor, stroke, or aneurysm. The best example of this would be what’s called a thunderclap headache. This headache strikes seemingly out of nowhere and causes severe pain. They’re typically a sign of bleeding in and around the brain, so sufferers should seek medical attention immediately.

when to worry about a headache



Warning Signs of Dangerous Headaches: When to Worry About a Headache

Head pain can be dangerous without striking suddenly and severely like a thunderclap headache. Sometimes a dangerous headache will create a dull and tolerable ache rather than an electric-shock type of pain. That’s why pain severity should be just one of many metrics used to determine whether or not your headache requires medical attention. 



If you identify with any of the points listed below, you should seek medical help as soon as possible. These are a few of the key warning signs of dangerous headaches. 

  • Your headache has persisted for longer than 72 hours without a period of at least 4 hours pain-free.
  • Over-the-counter pain medications and at-home remedies are continuously ineffective.
  • The pain is the worst you’ve ever experienced from a headache. 
  • Your headache returns to the same spot over and over again.
  • You also have symptoms like vision loss, uncontrollable vomiting, fever, and slurred speech.

Headaches can be harmless, but you should take them very seriously if you begin to experience any of the issues described above. Getting yourself help from a medical professional in a timely manner could save your life. 

If you have any other questions about how headaches can be dangerous, how to manage head pain, or anything else, we encourage you to read through our informative FAQ below. 

FAQs Regarding When to Worry About a Headache

How long is too long for a headache?

Headaches usually go away within 4 hours, but it’s not uncommon for the head pain to persist for longer. If your headache persists for longer than 72 hours, however, you should seek immediate medical attention. This is one of a few signs that your head pain may be the result of a serious medical issue. 

Which type of headache is considered a medical emergency?

Your headache may be a medical emergency if it lasts longer than 72 hours, is the worst headache you’ve ever experienced, or comes with symptoms like uncontrollable vomiting or vision loss. Thunderclap headaches should also be treated as medical emergencies, along with headaches that are accompanied by a fever, slurred speech, or numbness. 

Is it OK to go to sleep with a headache?

Sleeping with a headache is not dangerous in itself. That said, you should take steps to ease your head pain before going to bed, as an untreated headache may worsen overnight. You also shouldn’t use sleep as a replacement for seeking medical attention if your symptoms are severe and resistant to at-home treatment.

It’s also worth noting that not getting enough sleep and getting too much sleep can trigger migraines. If you’re someone that suffers from regular headaches or migraines, maintaining a consistent sleep schedule of 7 or 8 hours a night might help you keep them at bay. 

What do I do if my headache won’t go away?

If your headache persists for longer than 72 hours, you should see a doctor as soon as possible. The same is true for headaches that come and go but continuously occur in the same spot. 

What does it mean if your headache won’t go away?

Headaches that don’t go away may indicate a more serious medical condition, such as a tumor, aneurysm, meningitis, and more. You may also suffer from chronic migraines, which have a variety of causes. If there isn’t an underlying condition to treat, you may need to see a pain specialist that can assist with headache pain management. 

When should I go to the hospital for a headache?

You should seek medical attention immediately if you experience extreme pain, pain of any severity that persists for longer than 72 hours, or side effects like fever, dizziness, vomiting, and slurred speech. 

What happens to the brain when you have a headache?

When you have a headache, the muscles or blood vessels around your head and neck may tighten or swell. These changes can put pressure on or stimulate the surrounding nerves, which then send pain signals to the brain. 

There’s also a theory concerning migraines that involves brain cells triggering chemicals like serotonin, which can narrow your blood cells. Your blood vessels may also contract and cause throbbing pain when your estrogen levels rise and fall. As you can see, there are still a lot of unknowns surrounding headaches and how they occur. 

see a doctor to know when to worry about a headache

How to Get Rid of Headaches Fast

Thankfully, not all headaches require a trip to the emergency room. You can treat most minor headaches from the comfort of your own home. Some of the most common remedies for easing head pain symptoms include:

  • Applying a cold pack or heating pad
  • Drinking plenty of water 
  • Easing any pressure on your scalp or head
  • Relaxing and destressing
  • Dimming the lights in your home
  • Taking over-the-counter pain medication


If these remedies aren’t effective or you’d like a more permanent solution for chronic headaches, the pain specialists at Carolinas Pain Center can help you. We can provide insight on when to worry about a headache and offer a wide range of treatments to eliminate your head pain or to help you manage it better. This includes trigger point injections, massage therapy, acupuncture, botox, biofeedback, prolotherapy, and more. 

We may also prescribe preventative or abortive medications, such as anti-depressants, anti-seizures, triptans, and anti-inflammatories. The treatment and medication you receive will vary based on the cause and severity of your headaches, which we take into account when preparing a personal treatment plan for you.

Don’t Tolerate Painful Headaches

Why suffer through chronic headaches when you could find relief at the Carolinas Pain Center? Our dedicated team of pain specialists has the skill and equipment necessary to assess your condition and offer a diverse selection of treatments. We take an individualized and multidisciplinary approach to our care by developing a personalized treatment plan just for you. Our methods have relieved the pain and improved the quality of life of countless patients throughout North Carolina. 

If you experience regular headaches and would like us to create a treatment plan for you, we encourage you to get in touch with our team. To contact us, please call 704-500-2332 or make an appointment using our online form. 

What To Do When You Feel a Migraine Coming On

  • Migraine pain

Migraines are headaches with more intense and potentially debilitating symptoms, as they can last anywhere from hours to days. People who suffer from regular migraines may feel a sense of hopelessness. Thankfully, there are several preventative measures you can take if you feel a migraine coming on! 

This article will discuss multiple ways of managing migraine pain and addressing the issue immediately — before it worsens. This information is essential for anyone that struggles with migraines, as we offer both short-term and long-term migraine treatment options. So why suffer through migraine symptoms when you can take action?

What Does a Migraine Feel Like?

Symptoms of migraines include severe throbbing pain or a pulsing sensation. This pain usually begins on one side of the head, around the eyes, or in the forehead. Migraines worsen with time, and the pain can escalate with movement, bright light, loud noises, and other external factors.

You’re probably wondering, what causes migraine pain? Unfortunately, there’s no definitive answer. Migraines are very complex and still not fully understood. Knowing how to treat and manage migraine symptoms is typically more productive than determining an exact cause.


Migraine Symptoms

It’s important to note that migraines may feel different depending on what stage of the migraine you’re experiencing. Therefore, to effectively address your migraine pain, it helps immensely to understand the various phases and their identifiable symptoms.

Please note, not all migraines will follow all four phases.


The prodrome phase takes place one or two days before the actual migraine attack. You may experience seemingly unrelated symptoms, such as constipation, neck stiffness, mood changes, increased urination, and frequent yawning. Knowing these signs can give you a day or two’s warning of an oncoming migraine attack.  


Some people experience a migraine aura right before or during migraines. Auras are reversible visual symptoms that include vision loss, trouble with speaking, and optical phenomena like seeing bright spots. These symptoms build up over several minutes and are usually a more prominent indicator of an oncoming migraine than the prodrome symptoms. 


The symptoms of the actual migraine attack, which may last anywhere from 4 to 72 hours, vary. However, the most common migraine symptoms include throbbing or pulsing pain on one or both sides of the head, nausea, vomiting, and sensitivity to light, sound, and less frequently, smell and touch. 


After the attack has ended, you may feel tired, confused, or euphoric. The former is more common than the latter. You may still experience a few of the symptoms in a way that’s much less intense, with sudden head movement potentially bringing the pain back for a brief time. 


Migraine coming on

Managing Migraine Pain

The key to managing migraine pain is to try and stop it before it starts. Using the information provided above, you may be able to determine when you’re experiencing the aura phase preceding the migraine attack. During this time, the best thing for migraine relief is to take an over-the-counter medication like Advil. Medication is the fastest way to get rid of a migraine when you feel it coming on. You can also take medication during a migraine attack, though it typically won’t be as effective. 

There are also natural ways of reducing the frequency of your migraines and the severity of your symptoms. The first is stress management, such as a long bath after a busy day or anything else that helps you unwind. Regarding diet, you should avoid skipping meals and be consistent with the times of day that you’re eating. 


It would be best to maintain a healthy sleep schedule, which means getting enough sleep without oversleeping. If you’re in the midst of a migraine, you may be wondering if it’s unsafe to fall asleep. It is safe to sleep with a migraine, but it’s wise to try and treat your symptoms before falling asleep. Otherwise, they may be worse when you wake up. 


Migraine Treatments

If you experience chronic migraines that don’t improve much with over-the-counter medications, you may need to see a specialist. They can offer information regarding other treatment options, including acupuncture, massage therapy, botox, trigger point injections, biofeedback, cognitive behavioral therapy, and more. 


What Not To Do

You should avoid doing certain things when managing your migraines, as you could accidentally trigger a migraine or worsen your symptoms. For example, drinking lots of alcohol and caffeine can bring on migraines. The same is true for foods with strong smells.

Also, don’t take pain medication for more than 3 or 4 days. While over-the-counter medications can ease migraine symptoms, taking them too frequently can result in a type of rebound headache. If you feel the need to take these medications for more than a few days in a row, that’s a strong indicator that you need to speak with your doctor. 


Carolinas Pain Center Is Here To Help

There are ways of treating migraines on your own through over-the-counter medication and natural remedies. However, there are times where professional intervention becomes necessary, mainly if your migraines are overly frequent, severe, or resistant to medication. 

Our specialists at the Carolinas Pain Center can create an individualized personal treatment plan to help you manage your migraines and improve your quality of life. With our multidisciplinary approach, our services have changed people’s lives all across Charlotte and Huntersville, North Carolina.

If you have any questions or want to book an appointment, please don’t hesitate to call 704-500-2332, email info@carolinaspaincenter.com, or fill out our contact form. You can also find other educational resources on our website. 

Types of Headaches and Treatment Options

  • Migraine

What Type of Headaches Are You Experiencing?

The causes for migraines and headaches is not well known. Research suggests that the pain is due to inflammation, the trigeminal nerve, blood vessels surrounding the brain, and Serotonin levels. This article will give you more information about headaches and treatment options.

Head and Facial Pain

  • Facial Pain
Few things can be more excruciating than chronic head and facial pain. Simple daily tasks become unbearable chores. It can be impossible to focus on even the simplest mental task, and sleep becomes something dreaded rather than something restful. A thorough consultation can provide accurate diagnosis as to the cause, and a comprehensive multidisciplinary approach to pain management can get you on your way to managing the pain and returning to a normal life.