Shoulder pain – simplified!

Shoulder pain – simplified!

Are you suffering from new or ongoing shoulder pain?  Do you have shoulder pain that comes and goes depending on your activity level? This article is aimed at simplifying shoulder pain.

The shoulder joint AKA glenohumeral joint is a very mobile structure which could be likened to a golf ball (head of humerus) sitting on top of a tee (glenoid). Due to its mobility it allows us to move our arms in lots of different directions with the help of the strong muscles around the shoulder joint. Due to the fact that there is lots of mobility in the shoulder joint and because numerous structures can cause shoulder pain it can sometimes lead to difficulty in diagnosis. Below are four of the more common shoulder diagnosis that present to see a Chartered Physiotherapist.

Rotator cuff

The rotator cuff is a group of muscles or tendons that surround the shoulder joint ensuring the head of the humerus moves nicely in the glenoid. An injury to the rotator cuff can cause a dull ache deep in the shoulder which worsens when you try to sleep on that side. They are mostly seen in people who do a lot of repetitive overhead activity in their jobs or hobbies i.e. painters, tennis. On occasion rotator cuff injuries can occur due to a single trauma to the shoulder.  The risk of a rotator cuff injury increases with age. Individuals suffering from this injury usually complain of pain and sometimes weakness with overhead activity and don’t usually have symptoms with activities below shoulder height. These injuries usually do really well with an appropriately graded strengthening program. If they don’t improve with exercise therapy an opinion from a specialist maybe required.

Shoulder stiffness

Shoulder stiffness can occur secondary to trauma or it may occur spontaneously as a “Frozen Shoulder” also known as “Adhesive Capsulitis” is when there is a thickening or swelling of the normally flexible tissue that surrounds the shoulder joint.  The reasons why someone may get a frozen shoulder is still not fully understood. However, there are several risk factors to developing a frozen shoulder which include immobilisation of the shoulder following surgery or injury, diabetes, heart disease, lung disease, stroke, Parkinson’s disease.

The main symptoms of a frozen shoulder are pain and stiffness with dressing, driving, reaching/lifting overhead, scratching your back. In the more severe cases sleep can be affected.

Frozen shoulder is known as a self-limiting condition which means it will get better by itself however treatment provided at the appropriate times can ease symptoms.  Frozen shoulder symptoms can present from mild to severe cases. It has three stages of varying duration depending on the individual – Freezing, Frozen and Thawing. The three stages have different symptoms and therefore different treatment options.


Acromioclavicular joint

Also known as the AC joint is the joint at the top of the shoulder consisting of the end of the clavicle (collarbone) and the scapula (shoulder blade). The AC joint is important in allowing overhead and across the body movement of the arm. Injury to the AC joint usually occurs after a fall onto the point of the shoulder. Individuals who injure their AC joint usually report pain localised over the joint with compression of the joint reproducing their symptoms in particular lying on that shoulder to sleep.

Referred pain

The joints of the neck and middle part of the back can refer pain, pins and needles and numbness to the shoulder and arm even in the absence of pain in that area. In addition, the muscles around the neck and scapula can contribute to shoulder pain. It is important when you see a Doctor or a Chartered Physiotherapist that they quickly check for referred pain to rule out this diagnosis.

Top tips for managing Shoulder Pain

  • As with any condition/injury it is always important to get a definite diagnosis.
  • In the early stages pain relief maybe required therefore a discussion with your GP or pharmacist is appropriate. A Chartered Physiotherapist maybe able to provide other options for pain relief including soft tissue techniques, joint mobilisations or acupuncture
  • Use the shoulder within the limits of your discomfort. This allows you to maintain the shoulders range of movement
  • When sleeping try to lie on the unaffected side and place a pillow under the affected arm to maintain a comfortable position