Shoulder

Shoulder pain can be caused by a number of different reasons but for the vast majority of people it is not caused by anything serious. The most common shoulder problems are subacromial pain; frozen shoulder and osteoarthritis.

Subacromial pain normally occurs as a result of a problem with the soft tissue structures (e.g. tendons or bursae). Although this can be due to a specific cause, it is more commonly triggered following a change in your normal daily routine or exercise programme. You may find that your shoulder is painful when you try and lift your arm above your head, or when carrying heavier items.

Frozen shoulders often occur without any specific injury and the exact reason for this is not very well understood although they are more common in people who have diabetes. You may notice that your shoulder is initially very painful and it gradually becomes more stiff. Over time you will gradually start to lose the movement in it. Most of the time the prognosis is good and symptoms will improve, although it can sometimes take up to a few years for your symptoms to completely settle.

Osteoarthritis in the shoulder usually affects the ball and socket joint or the joint between your shoulder blade and collar bone. A lot of the time osteoarthritis doesn’t cause any symptoms but it can sometimes flare up, causing the joint to become swollen and painful. The condition involves the gradual loss of cartilage between the bones. Contrary to popular belief, osteoarthritis is not caused by ageing and it does not necessarily deteriorate over time.

With most shoulder problems it is useful to and manage the amount of lifting or overhead activities you are doing, this is called load management. Try and use your arm as much as possible, as long as it feels comfortable to do and it doesn’t cause any flare up of your symptoms over the next 24-48 hours.

Exercise is an incredibly important part of managing your shoulder problem. Although it may appear daunting, general exercise (e.g. walking, running) can help to reduce pain and improve your overall health. Try and do exercise that you enjoy, that way you are more likely to do it regularly. It is also worth trying some specific shoulder exercises, some examples can be found in our shoulder leaflet. Alternatively you could try and get some advice and exercise from a physiotherapist.

Medication that helps to control your pain can enable you to keep active. Discuss with your GP or pharmacist to find out what you can take to help.

It is also important to address other lifestyle factors such as stress, anxiety, low mood and a lack of sleep. Smoking can also slow the recovery process. Addressing these factors can all help to reduce your symptoms.

Most of the time X-Rays or scans are not required. An assessment by your GP or physiotherapist should be sufficient in helping to identify the problem. Occasionally further investigations are required by your GP or physiotherapist will be able to advise you if this is the case.

If you notice any of the following associated with your shoulder pain, please make an urgent appointment to see your GP:

• Sudden loss of shoulder movement following a fall
• A red, swollen and painful shoulder or arm
• Generally feeling unwell (e.g. flu like symptoms)
• Pins and needles or numbness down your arm
• Sudden unexplained weight loss
• A previous history of cancer
• Pain that is severe and doesn’t change, either with activity or at rest