Shoulder pain is one of the most common reasons for people to visit their GP. There are a number of things that can cause pain in and around your shoulder and upper arm. Let’s look at some of them:
Frozen Shoulder AKA adhesive capsulitis
This is a very easy one to spot. Generally you are over 50 and you cannot move you arm up above your head and, with your elbow bent at 90 degrees like you are holding a tray, cannot move your forearm out to the side as if passing the tray. When we say you can’t, it means it just won’t go regardless of your pain.
Nobody yet knows why it happens but we know it sometimes unfortunately can occur after a broken shoulder/arm. The research shows that it will be very painful, it will then get even stiffer but after that it will resolve all by itself, it just takes a while, sometimes up to 2 years! Other options include trying a procedure called a hydrodilatation or a ‘manipulation under anaesthetic’ or an arthroscopic capsular release all of which would be performed by a surgeon.
Most of the rest!
The majority of other shoulder pains can generally be included under the banner term of “sub acromial impingement syndrome” or rotator cuff tendinopathy. This ultimately refers to tendons (how the muscle attached onto the bone) or bursa (a thin fluid filled sac) becoming pain sensitive.
What does this mean in English?! Well tendons and the bursa will take a lot of getting squashed and stretched and exercised but sometimes you can overdo it. This then makes the tendon or bursa more irritable or sensitive so you get pain sometimes with things that were not painful before – lying on your shoulder, reaching above shoulder height, or reaching behind your back are typical examples.
In the past management used to include cortisone injections and sometimes surgery! People were told that a bone was wearing the tendon away and needed to be operated on, research has changed this practice and shown generally this isn’t true. The good news is that modern research has also shown that good physiotherapy is very effective for reducing or eliminating pain and quickly improving function with targeted rehabilitation. Equal to surgery but without all the risks.
Things to look out for
A complete tendon tear (rupture) normally means you find it very difficult to, or can’t, lift the arm in the air by itself, but it can be lifted up with help from the other arm, regardless of pain.
If you experience pins and needles or numbness it is unlikely to be a shoulder problem and more likely to be an irritated nerve in the neck or arm. It made sound silly but as this is often overlooked, if you move your neck and your arm hurts it is a neck problem not a shoulder problem! (even if your pain is in or around your shoulder)
If your arm or hand becomes swollen or changes colour for no reason, please consult your GP as soon as possible as this can be a circulatory problem.
Shoulder problems can seem complicated but are actually very simple to diagnose and rehab with tailored exercise to address the cause of the problem not just treat the symptoms.
If you want to talk to an expert to find out more about how to reduce YOUR shoulder pain feel free to get in touch with any questions you might have.
Just remember you CAN do something about it.
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