Shoulder Pain

We have all suffered from sore, achy shoulders at some point, but shoulder pain and stiffness can be terribly debilitating. It can make everyday activities difficult and torturous: putting on a coat, lifting your arms above your head and even reaching things from shelves whilst shopping. It can limit us from playing many sports – golf, tennis, cricket to name a few. Even running may cause pain. The shoulder is a ball and socket joint, but one with a fairly shallow socket. This allows for the tremendous range of movement seen in a healthy shoulder. However, with greater mobility comes less stability, and greater risk of injury. The shoulder complex relies on muscles and tendons for much of its stability, making its structure unique and rather prone to injury.

SOME COMMON CAUSES OF SHOULDER PAIN AND STIFFNESS

• Arthritis – Degenerative changes to the joint due to aging, repetitive stress, or traumatic injury.
• Tendonopathy – Injury, inflammation or degenerative change to shoulder tendons, often in the rotator cuff and most commonly supraspinatus.
• Frozen Shoulder (adhesive capsulitis) – A condition where the capsule around the shoulder joint thickens and stiffens, leading to pain and restricted movement.
• Capsular injury. – The capsule of the shoulder joint can become stretched and weakened by partial or full dislocation of the shoulder joint. The glenoid labrum, a cartilage cup which helps to reinforce the ball and socket joint of the shoulder and prevent dislocation, can also become torn. These are common sporting injuries. Rugby players often get labral injuries and the stresses placed upon the shoulder during a tennis serve can lead to shoulder instability.
• Acromioclavicular joint injury – The ligaments which support the ACJ can become sprained leading to instability and pain. This can follow trauma, and lead to subluxation or dislocation or can be a slow postural weakening of the ligaments.
• Shoulder tension – Many people suffer muscular pain because of tension in the muscles of shoulders and neck. There are many causes of this. It can be to do with the stresses of work, staring at a computer screen all day or maybe a plasterer working on a ceiling, or a parent carrying children. It can be related to poor posture or muscle imbalance. Myofascial trigger points are often present in these muscles. These are contractures (knots) in the muscles which can refer to pain elsewhere.

HOW WE TREAT SHOULDER PAIN.

Effective treatment stems from understanding the cause of the problem. The first step will be to understand the nature of your shoulder pain and how it affects your life. Examination and testing of your structure and biomechanics will help us to understand not only the tissues causing symptoms and local diagnosis but also any underlying causes.

Once a diagnosis has been reached and we have agreed a treatment plan, a range of techniques may be used. Soft tissue massage to tight muscles, passive and active mobilisation techniques to increase joint movements, acupuncture needling or laser may be applied to trigger points, Shockwave therapy to chronic tendon problems, or spinal joints may be manipulated to improve spinal mobility. Exercises will be prescribed to increase mobility or strengthen muscles.

Advice on how to prevent further episodes of shoulder pain and preventative treatments are available. If immediate treatment is not appropriate, other options will be discussed and further referrals made with your consent.