Paul Tompkins Physiotherapy

Orthopaedic & Sports Injury Specialist

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Conditions treated - Shoulder Pain

What is Shoulder Pain?

Shoulder pain is very common but it isn't usually caused by arthritis and will generally improve in a relatively short time and with simple treatments. In most cases you won’t even need to see your doctor. Sometimes shoulder pain may be part of a general condition such as rheumatoid arthritis, osteoarthritis or polymyalgia rheumatica (PMR). Rheumatoid arthritis quite often affects the shoulders. Osteoarthritis is less likely to affect the shoulders, but it can sometimes follow on from previous shoulder injuries.

The shoulder is a complex structure, and pain can be caused by problems with the muscles, tendons and other soft tissues or by arthritis in the joint itself. Sometimes shoulder pain is related to a problem in the neck.

Unless the pain is extremely bad or you have a definite injury there’s no need to see your doctor straight away. But if the pain isn’t improving after about 2 weeks then you should see your doctor or a physiotherapist in case you have a more complex problem.

You should see your doctor as soon as possible if:

  • you develop severe pain in both shoulders
  • you also have pain in your hips or thighs
  • you also feel feverish or unwell

These can be signs of a condition called polymyalgia rheumatica (PMR), which needs prompt treatment.

How can physiotherapy help?

It is important to regain normal everyday function as quickly as possible. This varies with the individual, some may need to return to sport at a high level, others may need to achieve independent living. To achieve any goal, the following issues must be addressed:

  • Reducing pain
  • Restoring full movement
  • Regaining strength and balance
  • Correction of any gait or posture concerns
  • Correct exercise programme for the individual

It is vital that the patient is assessed individually to understand their needs and provide the right rehabilitation programme. We will keep in communication with the surgeon to ensure optimal care.

What will happen when I see a physiotherapist?

The physiotherapist will assess how your shoulders are functioning, and will ask about how they are affecting your life. They will ask questions, watch your movements and feel the shoulder/s concerned.

Your consultation is likely to include:

  • exercises to do at home
  • posture and lifestyle advice, and activities to avoid
  • pain management techniques.

It may also include:

  • applying heat or cold to the affected area, and showing you how to do this at home
  • hydrotherapy.
  • electrotherapy.

Meanwhile, how can I help myself?

There are several ways that you can help yourself if you have shoulder pain.

Painkillers

Simple painkillers or anti-inflammatory tablets and creams that you can buy at the chemist can be helpful, but don’t use them for more than 2 weeks without seeking medical advice.

Ice

If your shoulder is inflamed (warmer to touch than the other side), an ice pack may be helpful. Leave the ice pack in place for 10 minutes or so, making sure you protect your skin from direct contact with the ice by wrapping it in a damp towel.

Rest and exercise

Aim for a balance between rest and activity to prevent your shoulder from stiffening. Try to avoid the movements that are most painful, especially those that hold your arm away from your body and above shoulder height. However, it’s important to remain generally active even if you have to limit how much you do.

When raising your arm, you can reduce the strain or pull on your shoulder by:

  • keeping your elbow bent and in front of your body
  • keeping your palm facing the ceiling when reaching up

When lowering your arm, bend your elbow, bringing your hand closer to your body.

Another good exercise is to use your good arm to help lift up your painful arm. Some people find that placing a cushion or rolled towel under the armpit and gently squeezing it can ease the pain.

You can download a selection of exercises that are designed to stretch, strengthen and stabilise the structures that support your back from the Arthritis Research Organisation web site.

Download a shoulder pain exercise booklet from the Arthritis Research Organisation web site(PDF).

Posture

Don’t sit leaning forwards with your arm held tightly by your side. This position can make shoulder pain worse, especially if some of the pain is coming from your neck. Keep a pillow or cushion behind your lower back when you’re sitting down, with your arm supported on a cushion on your lap.

If your shoulder is painful to lie on, the following positions may reduce the discomfort:

  • Lie on your good side with a pillow under your neck. Use a folded pillow to support your painful arm in front of your body. Another pillow behind your back can stop you rolling back onto your painful side.
  • If you prefer to sleep on your back, use one or two pillows under your painful arm to support it off the bed.
Reducing the strain

It’s usually best to carry out your normal activities, but try not to overdo it. You need to pace yourself to start with and try to do a bit more each day.

At home:

  • When vacuuming, keep your upper body upright with the cleaner close to your body, and use short sweeping movements.
  • Only iron essential items, and make sure the ironing board is at waist height.
  • Use a trolley or a backpack to carry shopping, or divide the weight between two bags and carry one in each hand. Alternatively, use bags with long straps and carry them with the straps crossed over your body from shoulder to hip.

At work:

  • Try to maintain a good posture when sitting or standing. Avoid holding your neck in fixed or twisted postures.
  • If you use a computer make sure the keyboard and monitor are directly in front of you, so you don’t have to turn your head or twist your body. Keep the mouse within easy reach so you don’t have to stretch.
  • When using the phone don’t trap the receiver between your head and your shoulder.
  • Avoid any manual work that hurts while you’re doing it.

It's important to seek advice if your job involves repetitive actions or awkward postures that might contribute to your shoulder pain.

Some companies have an occupational health department which might be able to help.

Complementary medicine

There are many different complementary and herbal remedies that are believed to help with pain relief, and some people do feel better when they use some complementary treatments. However, these treatments aren’t recommended for use on the NHS because there’s no conclusive evidence that they’re effective.

Note: If you are getting severe pain in one or more joints, or find some activities getting very difficult, go to your GP. He or she may prescribe medication to reduce the symptoms or refer you to a specialist or physiotherapist.

Disclaimer: The content on this page is provided for general information purposes only and is not meant to replace a physiotherapy or medical consultation.

Note: You do not need a GP referral to receive physiotherapy if you self fund your treatment. However if you intend to claim all or part of your treatment costs back a GP referral is usually required by your insurance company.