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Shoulder Pain

Pain felt around the shoulder can sometimes be caused by neck problems. This is particularly true if the pain is felt on top of the shoulder in the large trapezius muscle that runs between the shoulder joint proper and the neck.

Pain arising from the shoulder joint itself is often felt in the upper arm rather than over the point of the shoulder. Common causes are frozen shoulder (also known as ‘adhesive capsulitis’), tendinitis and rotator cuff injuries.

Frozen Shoulder

This mainly affects older people and is rare under the age of 50. The symptoms usually begin suddenly and may follow a minor injury, such as a knock or a fall, although the injury may be so minor as to be forgotten.

We do not know what causes frozen shoulder but we do know that the capsule surrounding the joint becomes thickened and inflamed, causing pain. The inflamed capsule is ‘sticky’ and adhesions form between the capsule and the bones, restricting the movement of the joint.

Symptoms of Frozen Shoulder

  • Constant pain which can be very severe, even when the shoulder is held still.
  • Difficulty sleeping because of the pain – it may also be impossible to lie on the affected side.
  • Severe stiffness, which may make it difficult to reach up to a shelf or into a back pocket or, in some cases, to move the joint at all.

Frozen ShoulderAdhesive Capsulitis

Frozen Shoulder Treatment

When the shoulder is intensely painful, the most effective treatment is anti-inflammatory injection into the joint.

The other, equally important, aspect of treatment is physiotherapy. Physiotherapy includes teaching you exercises to bring back the range of movement and prevent the shoulder becoming stiff and stuck once the pain has gone.

If all the above treatments fail, you may want to consider Manipulation Under Anaesthesia whereby the surgeon will move your shoulder to the full range of motion while you are asleep. This procedure is much like physiotherapy but it is a more accelerated version.

Shoulder Tendinitis

Inflammation of the tendons or the sheaths containing them is a common cause of shoulder pain. A normal shoulder has an enormous range of movement – you can put your arms up above your head, bring them out to the sides and swing them up behind your back.

Unfortunately, it means that the tendons of the shoulder are easily damaged and subject to wear. They can fray and bleed a little, leading to inflammation. This causes pain which is always worse when the shoulder is moved and less severe at rest.

Shoulder Tendinitis Treatment:

Anti-inflammatory injection into the area around the inflamed tendon can be very effective. After a couple of days, you can start on physiotherapy to do some gentle exercise.

If the injection does not help with the pain, then you may want to consider Shockwave Therapy.

Avoid lifting heavy things while the shoulder is recovering.

Rotator Cuff Injuries

The rotator cuff muscles are vital for shoulder stability and they keep the shoulder moving in an optimal movement pattern the preventing injuries.

Rotator Cuff Tear

The rotator cuff is a group of four small muscles around the shoulder. common shoulder injuries include:

  • Rotator cuff tear – a tear of the small stabilising muscle surrounding the shoulder joint. This can cause pain, loss of movement and function at the shoulder.
  • Impingement syndrome – compression or irritation of the shoulder joint structures, usually aggravated when reaching the arm into an overhead position, or reaching the arm behind the back.
  • Instability –  occurs when the muscles and tendons around the joint have been stretched, and are no longer able to hold the joint in a :secure “ball and socket” position. The joint is an increased risk of dislocation.

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