Troubleshooting shoulder pain
Shoulder pain can really pull you down. The use of the arm is vital in our day-to-day activities, so when we are limited it hits us hard. About 1% of adults aged over 45 present with a new episode of shoulder pain, and we all get aches and strains throughout our lives.
Before we go into the causes, a brief anatomy lesson will make it easier to put things into perspective.
The Glenohumeral joint (the shoulder) has 3 bones involved in the function of the upper arm: the humerus, clavicle (collar bone) & Scapula (shoulder blade) articulate as a group, and are held in place with ligaments and muscles to support and move the joints. Within the joint itself is cartilage which aids the fluidity of motion, and stability of the joint.
The rotator cuff are the celebrities of the muscle world – these 4 muscles provide strength and stability during the motion of the shoulder. They all originate from the shoulder blade and go on to merge and wrap around the head of the humerus.
Other important structures in and around the shoulder are the nerves, which stem from the neck and travel around the shoulder, terminating in the arm and hand.
Any one of these structures can become problematic, and the causes can stem from one or several factors:
- Degeneration – a normal process of wear-and-tear, the same as wrinkles and greying hair. It is inevitable, but varies from person to person, depending on what that person’s lifestyle and life-choices have been, such as manual work, poor diet, or being sedentary. This is often known as osteoarthritis.
- Overuse – ranging from irritation, to tears of the rotator cuff, these injuries are common. Be it from painting the house, to playing tennis for a few too many matches, these activities can cause issues if your current health and fitness aren’t sufficient, or if you have any biomechanical imbalances/weaknesses.
- General Injury – from falling over and jarring the shoulder, to having the arm pulled when you slipped on a step while holding the banister. This can range from a minor strain, to more extreme injuries such as dislocation.
- Posture – sustained static positions or repetitive motions can cause issues within the joint due to the lack of variation.
- No reason at all – this may sound odd, but sometimes you can develop problems without knowing the cause of the issue in the first place. These are still being researched, but those who are diabetic and or over 45 years of age have shown to be more prevalent in these groups. Examples of this include frozen shoulder.
- The Neck? In some circumstances, a neck issue can refer to the shoulder through the nerves, but can also affect how the muscles function around the shoulder.
Sometimes, the pain can resolve by itself. A large proportion of problems can self-resolve over 4 to 6 months, while sometimes though they can linger, with conditions such as Frozen Shoulder taking up to 2 or 3 years to resolve. This is where having an assessment can be of benefit.
If in the event of severe injury, it is best to attend Accident & Emergency for the initial assessment. If they are satisfied that you have not sustained a serious injury, then follow the advice below.
What can you do to help?
The most important thing is not to panic. We advise use of ice for up to 15mins, every 2-3 hours over the first 2 days, if your pain has just come on.
Many people aren’t keen on taking tablets for their pain. It is of our opinion that if you can create a situation to reduce your pain and help you feel better. This may mean taking basic analgesia to help with pain and inflammation in the short term. If you aren’t sure, a quick call to your GP surgery or pharmacist for advice over the phone is best.
We are designed to move, and complete rest has been proven to be detrimental long term, so keeping the shoulder gently moving is important. We would then advise making an appointment to see a Chartered Physiotherapist as soon as possible. We are always happy to discuss symptoms and provide appropriate advice to patients to ensure they are following correct methods to feel better.
As Physiotherapists, we can introduce you to a graded exercise programme to help to rehabilitate your shoulder. Getting started on appropriate exercises, as prescribed by a Physiotherapist, helps to ensure you don’t develop imbalances, whilst also working to try and prevent future problems.
For examples on different exercises to help your shoulder, see this handy video featuring some of our Physiotherapy team.