The shoulder joint is a complex one because it is a very mobile joint, yet it is also expected to be a stable one. Shoulder pain is very common and is most often felt in the upper arm rather than in the joint itself.
The shoulder joint is held together by muscles and ligaments rather than by the shape of the bones. It is usually these soft tissues that are the source of pain. Often the damage is done to the shoulder over a long period of time rather than from just one incident.
Shoulder injuries can get progressively worse without treatment. Part of the reason is that pain in the shoulder, regardless of the source, alters the natural movement patterns and balance of muscles that exists there. This is often hard to notice and requires a physiotherapist to help to correct.
Common sources of shoulder pain are:
the rotator cuff - group of tendons and muscles that surround the shoulder joint. It supports the various components of the shoulder and ensures the joint remains stable.
ligaments – these are tough elastic bands that prevent excess joint movement.
capsule - a soft tissue bag that engulfs the joint and contains joint fluid within.
the neck – be especially aware of symptoms that extend below the elbow and if you get tingling or numbness sensation in the arm which may indicate that your problem is actually coming from the neck!
Treatment may include the following depending on the injury:
Rest from the movement or activity that brings on your pain.
An anti-inflammatory tablet. This may be prescribed by your doctor, or you can buy several different types over the counter at the chemist. Nurofen (ibuprofen) is probably the most common.
Physiotherapy which may include massage, joint and soft tissue mobilisations, postural education, biomechanical correction, core stability exercises, specific exercise for functional and/or sporting recovery.
Coritsone injection, by your doctor or a shoulder specialist, into or around the shoulder joint.
Surgery, for the majority of shoulder injuries, is seen as a last resort.
Useful tips for shoulder pain:
Try to keep the shoulder moving. You may find some relief by leaning forwards onto the good arm on a table and allowing the painful arm to hang like a pendulum over the edge. Swing the arm both back and forward and also side to side. This also helps to prevent the shoulder from becoming stiff.
If it is difficult to move the arm because of pain or weakness, you may be able to move it if you bend your elbow. This takes some strain off your shoulder.
Pain when lying down is often a problem with shoulder injuries. It is generally not a good idea to lie on the shoulder. The most comfortable position is often lying on the pain free side and cuddling a pillow with the sore arm. If lying on your back, a pillow or rolled towel under the arm may help. Taking some pain relief just prior to going to bed may also help.
If the arm is painful even at rest, when you are walking take the strain off the joint by putting your hand in your pocket or in the loop of your belt.
Try and keep your posture upright. If you sit in a slouched position it can hinder shoulder movement and also can put more pressure on your neck.