Shoulder pain is an extremely common problem and there are many different causes. It can be very distressing as the pain may be severe and can occur without any apparent cause. However, it can often be treated with appropriate pain relief and rarely needs an operation.
Shoulder anatomy
Your shoulder is a ball and socket joint. It is made up of three bones called the collar bone (clavicle), shoulder blade (scapula) and the long bone of your arm (humerus). Your shoulder joint allows you to move your hand in lots of different directions and to carry heavy loads. It has a number of muscles that work together providing mobility and stability. There are four particular muscles in the shoulder called your rotator cuff. These muscles work to keep your shoulder held into its socket.
What is the cause of shoulder pain?
There are a number of different reasons why you might experience shoulder pain including:
Bursitis
Rotator cuff tear or tendinopathy
Frozen shoulder
Shoulder instability or dislocation
Arthritis
What tests do you need?
In most cases you will not need any further tests. A full clinical examination carried out by a doctor or physiotherapist is much more accurate at diagnosing your shoulder problem. The majority of imaging scans will be negative and will not quicken your recovery.
When should you go to A&E?
You should seek emergency attention if:
You have had a significant injury and you suspect you may have a fracture or have dislocated your shoulder
You have left arm pain radiating into your jaw or chest pain, particularly if you have a history of high blood pressure or angina
You have a history of cancer and new bony pain
Your shoulder pain is associated with severe abdominal pain
When should you see your GP?
You should seek GP attention if your shoulder pain is continually affecting your sleep and your daily activities. Your GP can refer you on for physiotherapy.
How can you treat your acute shoulder pain?
Self-help measures are the initial treatment for most shoulder pain.
Use simple pain relief like regular paracetamol or ibuprofen as it is really important to control your pain to allow you to move more easily—if your pain is persisting, see your GP about prescribing stronger painkillers
Try hot packs over the muscles in your neck and shoulder area to reduce muscle spasm
Reduce activities that aggravate your shoulder pain and allow your shoulder to rest—avoid heavy lifting and repetitive tasks, and address any issues at work that may be irritating your shoulder
Try gentle range of movement exercises within your pain free range to maintain movement in the shoulder joint—gentle exercise increases blood flow to the tissues and promotes healing
Avoid sleeping on your painful shoulder
Have a positive and realistic outlook as your shoulder will get better but may take some time, with good and bad days—pace yourself and do not overdo it by setting unrealistic goals on the way to recovery at home and work
Shoulder exercises
It is important to maintain as much range of movement in your shoulder as possible to prevent it from becoming stiff, and to promote tissue healing. The exercises below should be performed gently, within pain limits, increasing the movement as pain allows.
While standing let your painful arm swing down by your side. Gently swing your arm in circles, side to side and then forwards and backwards.
Stand facing a wall. ‘Walk’ your fingers up the wall as high as possible. Reverse down in the same way.
Stand and grip one end of the stick with the arm to be exercised. Lift the stick up forwards or sideways by assisting with the other arm.
Further information
Further information an general advice is available on the following websites:
