Shoulder pain

Shoulder pain can be debilitating and unsettling, especially if you're unsure how to manage it. Find out more about the causes of shoulder pain and what can be done to manage and treat it.

Shoulder pain has a number of common causes. These include:

• Trauma or injury: This refers to a direct blow to your shoulder, often caused by an injury during contact sport or a serious incident (such as a car crash). Shoulder trauma includes a fracture or broken collar bone.
• Arthritis (osteoarthritis or rheumatoid arthritis): Arthritis causes inflammation and swelling in your joints, often resulting in severe pain and reduced mobility. Both osteoarthritis and rheumatoid arthritis in your shoulder joint cause shoulder pain.
• Bursitis: Bursae are fluid-filled sacs that prevent wear and tear between your joints. Bursitis happens when your bursa is inflamed or irritated. If the bursa that sits between your rotator cuff and acromion is inflamed, it can result in shoulder impingement. This often leads to shoulder pain.
• Wear and tear: Johns Hopkins Medicine reports that wear and tear mostly refers to a tear in your rotator cuff, or the thinning of cartilage in the lining of one of your joints. Wear and tear can be a natural cause of shoulder impingement and osteoarthritis. These often lead to shoulder pain.
• Tendonitis: This happens when one of your tendons becomes inflamed and swollen. It can cause joint pain, stiffness and reduced mobility. If you experience tendonitis in your shoulder, you will likely experience shoulder pain as a result.

Fortunately, diagnosing shoulder pain can usually be achieved through a physical examination of your shoulder and an assessment of your medical history.

When you meet with your doctor, they will discuss your shoulder pain in depth. This will help them reach an accurate diagnosis.

Depending on your symptoms, other diagnostic tests might be used to rule out other causes of your shoulder pain. These tests include: a shoulder X-Ray, an ultrasound or an MRI.

Your doctor will explain these tests to you if they are needed.

If you attend physiotherapy appointments for your shoulder pain, your physiotherapist will produce a specialist shoulder pain exercise regime, tailored to your medical needs.

It is important to follow your exercise regime diligently to reap its benefits.

Examples of exercises for shoulder pain

The British Elbow & Shoulder Society has shared the below three shoulder pain exercises, which were recommended by leading shoulder physiotherapists. These should not be used as a replacement for seeking personalised advice from a specialist, however they give an idea of the types of shoulder exercises you may be recommended.

Wall slides

Stand facing a smooth wall, holding a cloth (or even wearing clean socks on your hands),and place the edges of your hands against the wall with your thumbs facing you. Step forward, gently pushing into the wall and sliding your hands upwards, as far as you can.

Eventually you will be able to do this without the support of the wall.

Push-ups against a wall

Put your hands flat against the wall, turned out slightly and set slightly wider than your shoulders. Lower your body towards the wall as if you were doing a push-up, then move yourself back to your starting position.

Shoulder rotation

Sit next to a table with your elbow resting just below shoulder height. You can use a rolled up towel to support it at this height. Make a gentle fist and rotate your forearm to point upwards, keeping your elbow bent.

There are several forms of shoulder pain, caused by different shoulder ailments. These include:

• Shoulder blade pain: While you might experience pain in or around your shoulder joint, other people might experience pain across their shoulder blade (scapula). This pain can vary from a dull ache to a sharp stabbing pain across your scapula.
• Shoulder impingement: According to the NHS shoulder impingement is a very common cause of shoulder pain. It happens when your tendon (a band of tissue) inside your shoulder rubs on nearby tissue and bone as you lift your arm. This often leads to swelling, pain and reduce mobility.
• Neck and shoulder pain: Shoulder pain might cause referred pain in your neck and vice versa.
• Pain in your right or left shoulder: Some people will develop pain in one shoulder, while others might experience pain in both shoulders at the same time. 

Sometimes, it can be challenging to determine the cause of your shoulder pain. According to Harvard Medical: “If you do experience shoulder pain, it's not always possible to figure out the cause. Sometimes problems in other parts of the body are actually the source of the pain, which then radiates to your shoulder”.

In order to determine the cause of your shoulder pain, you need an accurate diagnosis.

Shoulder pain at night can be debilitating and unsettling.

If you're busy during the day, you can sometimes be distracted from pain. When you’re in bed at night with limited distractions, your pain can feel worse and prevent you from falling asleep.

If you have severe shoulder pain at night, it might significantly impact your quality of life. However, there are methods for coping with shoulder pain at night.

As always, it is important to speak with your doctor for advice if you are struggling to cope with shoulder pain at night.

There are many effective forms of treatment for shoulder pain. These include:

• Pain relief: Painkillers might help manage your pain. Paracetamol or an anti-inflammatory medicine like ibuprofen often reduces pain, helping improve mobility in turn. Before taking medication, speak with your doctor.
• Heat therapy: The Arthritis Foundation recommends heat treatment for joint pain. According to the foundation, a heating pad will help relax your joints, improving your mobility and pain levels. Alternatively, placing a cold compress on your shoulder throughout the day could numb your shoulder pain, providing relief.
• Rest: Plenty of rest could help prevent aggravating your shoulder through overuse.
• Physiotherapy: The Arthritis Foundation also recommends physiotherapy to manage joint pain. Your physiotherapist will teach you shoulder pain exercises tailored to your medical needs. These will help strengthen your muscles, reduce your pain and improve your mobility. We have many specialist physiotherapists to help you manage your shoulder pain.
• Hydrocortisone (steroid) injection: The hydrocortisone (steroid) injection is injected into your painful joint. This reduces pain and swelling. It also makes movement easier. The hydrocortisone injection can improve joint pain for months at a time.
• Surgery: If your shoulder pain does not respond to the above treatment options, you might require surgery to help manage your shoulder pain. This surgery will depend on the nature of your shoulder pain. Your doctor will determine whether or not you require surgery. They will also identify which surgery will best treat your pain.

Shoulder pain can be frustrating to live with, but it’s important to know that good help is available. You are not alone.

An appointment with an experienced shoulder Consultant at one of our nearest hospitals could be helpful. They will assess and diagnose the cause of your shoulder pain and then discuss any suitable treatment options for your specific situation.

To schedule your visit, book a specialist appointment online today. We really look forward to helping get you out of pain and back to doing the things you love.