Shoulder pain
The shoulder is one of the most complex anatomy parts, mostly because it is so mobile and required to be stable enough to support the elbow and hand. It is a well-lubricated ball and socket joint and formed by the humerus (the upper arm bone) which fits into the glenoid (socket) on the scapula (shoulder blade). Each of the surfaces are covered by cartilage – a form of cushioning to protect the joint.
When our arm moves in different directions, the shoulder blade which is attached to the rib cage moves with it – either up and down or from side-to-side. The clavicle (collar bone) attaches at the front of the shoulder joint which connects to the ribs.
The tendons of the rotator cuff muscles stabilises and holds the arm within the shoulder joint without comprising it’s flexibility. Other soft tissue, including the bursae (fluid filled sacs) helps to reduce friction in the shoulder. However, it can sometimes become inflamed causing pain. There are many nerves and vessels travelling down the arm and innervate muscles and skin. In fact, the nerves send the pain signals to the brain to let us know there is an injury.
How is shoulder pain diagnosed?
A physiotherapist may ask you a number of questions to assist in their diagnosis. These include:
- Where exactly is the pain located?
- Is the pain in one or both shoulders?
- Are there any pins and needles or numbness down the arm?
- Is there any neck pain?
- What does the pain feel like? Is it a dull or shape ache?
- How intense is the pain?
- Is the pain constant or intermittent?
- If you have shoulder and neck pain, does it come on together or separately?
- What makes the pain worse and what makes it better?
- How is it affecting your daily life?
These questions together with a physical examination aids your physiotherapist in diagnosing the shoulder pain and determining a treatment plan. If the pain does not subside within a few weeks, your physiotherapist may refer you to a specialist consultant or to your GP for further imaging (such as an X-ray or MRI scan) to assist their diagnosis and treatment strategy.
Possible causes of shoulder pain:
- Osteoarthritis
- Muscle imbalance
- Shoulder impingement
- Frozen shoulder
- Shoulder instability or dislocation
- Rotator cuff tears
- Referred pain from the neck
- Shoulder fracture
- Rheumatoid arthritis
- Hypermobility
- Thoracic outlet syndrome
- Heart attack
- Cancer
How to treat shoulder pain
Suggestions for treatment include:
- Heat Therapy
- Ice Therapy
- Physiotherapy
- Pain medication
- Acupuncture
- Rest and activity modification
How we can help your shoulder pain
We will do whatever we can to get you on the fastest route to recovery. Some of the treatment methods we use include:
- Mobilisations
- Strengthening exercises
- Myofascial trigger point release
- Pilates
- Cross-friction massage
- Stretching and range of movement exercises
- Acupuncture
- Functional exercises
- Postural exercises
- Core stability exercises
- Taping