Shoulder pain is a normal part of life. However, it can prevent you from carrying out your usual day-to-day activities and can make you feel worried and frustrated. The good news is that shoulder pain can be easily treated by you, at home.
This website provides information, advice and resources from our clinicians to help you do this. Shoulder pain could be caused by a number of conditions:
The rotator cuff is a group of muscles which help to control the movement of the ball and socket joint of the shoulder, with the tendon attaching the muscle to the humerus bone (upper arm bone). These tendons can either be intact or torn.
A number of other terms such as supraspinatus tendinopathy, tendinitis and bursitis are used by different people, but the diagnosis and treatment are essentially the same, and is referred to as rotator cuff tendinopathy. Overuse or unaccustomed activity, or sometimes trauma, such as a fall onto the hand or shoulder, can cause them to become painful
In the majority of cases, the tendon becomes painful without any serious damage and responds well to self-management, such as modifying your activity and progressive strengthening exercises. However, in some instances, the tissues can become inflamed (usually in younger people under the age of 40), show signs of degeneration or develop a tear.
A tear can be acute (sudden onset) following trauma, or can be chronic (long-lasting) due to tendon degeneration. Chronic tears are much more common in patients over the age of 60. A tear that does not extend the full way through a tendon is called a partial thickness tear.
Tears are very common, with up to 34% of the population having them. They do not always lead to pain and weakness and therefore do not always require surgery to repair them.
In smaller degenerative tendon tears, physiotherapy involving progressive strengthening exercise programmes has been shown to be very effective, as long as they are continued on a daily basis for at least 3 months and possibly up to 6 months.
The shoulder capsule is tissue that surrounds the shoulder joint and supplies the joint with nutrients and lubricating fluid. It also helps to stabilise the shoulder preventing it from coming out of the joint.
Frozen shoulder affects one in 20 people and is more common in women than men. Most cases of frozen shoulder happen between the ages of 40 and 60. The exact cause of frozen shoulder is unknown. For some reason your body has an over reactive response to a minor injury and tries to heal your shoulder capsule with scar tissue. This leads to pain and stiffness. People with diabetes or history of recent shoulder surgery or recent injury have an increased chance of developing this condition. Frozen shoulder is often confused with other shoulder problems but a true frozen shoulder is categorised into three distinct phases.
Activity modification does not mean you stop moving or using your shoulder altogether. Although it sounds straightforward, avoiding activities over your head or behind your back can help to reduce the irritation of your shoulder.
Your shoulder movement can be hugely affected by your posture. If you slouch, your ability to lift your arm above your head reduces by approximately 30 per cent. Sitting and standing in a good posture with your shoulders back will help your movement as well as prevent the tendons in your shoulder catching. Also try not to slouch and lean through our shoulders and elbows. This squashes all the structures in your shoulder against the ridge above the joint, causing pain and irritation.
Simple analgesia such as paracetamol can be used to dull the pain but does not cure the problem. Anti-inflammatories such as ibuprofen can also be effective. It is best to consult your GP if you have not taken these before. Seek further advice from your GP if your symptoms become unmanageable.
Icing your shoulder can be a very effective way of reducing your pain. Place a wet flannel and a pack of frozen peas on your shoulder for 20 minutes up to every hour. Check the skin under the ice every five minutes to avoid an ice burn. Once the pain begins to settle you can then start to ice your shoulder less frequently.
Injection therapy can be a very effective way of reducing your pain during this stage if anti-inflammatories or ice are having little effect. This can be done by either your specialist GP or by an enhanced role physiotherapist. Injections are not for everyone and may not be suitable for those with certain medical conditions.
Sleeping on your shoulder can be very painful during this stage. Try to sleep on your back or on the opposite shoulder with a pillow under the armpit of the affected shoulder.
Active assisted range of movement exercises Keeping your shoulder moving during this stage is very important but you should avoid pushing too far into very painful movement, as this can be counter productive. Active assisted stick exercises are a great way to keep your shoulder moving as well as trying to keep your muscles working.
At a point that is different for every frozen shoulder, you will feel your shoulder starting to move more. During this time it is important to regularly exercise your shoulder and use it as much as possible in day to day activities. When exercising at this stage it is important to start working into the resistance/tightness but this should never be painful. If you are unsure, seek advice from your GP or a physiotherapist.
The shoulder is one of the most commonly dislocated joints. Shoulder instability means that the shoulder can dislocate (be pulled out of joint) or sublux (moves more than it should do) during day-to-day activities. Both dislocation and subluxation can happen for a variety of reasons. How it happens has an impact on the type of treatment you will receive.
Patients who have had previous trauma or shoulder surgery are most likely to develop osteoarthritis in later life. Symptoms include swelling, stiffness, aching and sharp, stabbing pains.
If you are suffering from osteoarthritis of the shoulder then you should: