Physiotherapy Guidance on Managing Shoulder Pain

What is Physiotherapy and how can it help your shoulder pain?

Physiotherapy uses proven techniques to help restore movement and function to anyone affected by an injury, disability, or a health condition. Our physiotherapists will use their in-depth knowledge of how the body works, combined with hands-on clinical expertise, to assess, diagnose, and treat your symptoms. They can even advise you on how to prevent many injuries and health conditions.

Why have I got shoulder pain?

There are a number of reasons a person may experience shoulder pain and it’s onset maybe sudden, due to trauma or wear and tear.  The shoulder is a complex, mobile joint. There are many structures which can be responsible for pain symptoms.  The neck and upper back can also refer symptoms to the shoulder.  If you are experiencing severe shoulder pain or your symptoms are not improving, you should consult your GP or seek advice from a physiotherapist.

Detailed below are some of the more common causes of shoulder pain:

  • Poor posture – Prolonged repetitive activities can lead to poor posture.  The shoulder (Glenohumeral Joint) is a ball and socket joint that relies on synchronisation of the musculature around the joint.  Altered posture can lead to increased muscle activity in some muscles and weakness in others, this in turn, will lead to altered mechanics during movement of the shoulder resulting in painful arcs of movement.
  • Frozen shoulder– Frozen shoulder is also known as adhesive capsulitis or shoulder contracture.  A frozen shoulder will most commonly cause symptoms of pain and stiffness.  Range of movement can become very limited and it is often associated with pain at night.
  • Osteoarthritis– Although less common in the upper limb, Osteoarthritis in the Glenohumeral joint and Acromiclavicular joint (joint in the top of the shoulder) can cause pain and in particular, reduced mobility of the shoulder joint.  Previous fractures, heavy manual labour and repetitive weight bearing activities are the most common cause of this.
  • Rotator cuff disorders– The main stabilisers of the shoulder joint, the Rotator cuff are a group of muscles and attaching tendons, that work together to control movement of the shoulder joint, particularly movements above shoulder height and arcs of movement away from the body.  Rotator cuff tears and weakness in this group of muscles are more common in people over 40 who do repetitive activities.
  • Shoulder instability– This occurs when the ‘ball’ part of the joint, does not move correctly in the ‘socket’ part of the joint.  This can lead to a feeling of ‘slipping’ or ‘clicking’ in the joint and even a sense that the joint may dislocate.  Symptoms may also include, numbness, weakness and tingling in the arm.


How can you help yourself?

  • Painkillers – Over the counter medications such as Paracetamol and Ibuprofen can be very effective in relieving a painful shoulder.  Speak with your pharmacist or GP before taking these medications if you have not taken them before or you are on other medication.
  • Hot and Cold packs – Some people find heat very effective in relieving symptoms, a hot bath or hot water bottle placed over the site of pain for at least 20 minutes can help to reduce muscle spasm and tension.  Alternatively, Ice treatment can also be effective at relieving acute swelling.  Avoid applying Ice packs or frozen vegetables directly on the skin, place a damp towel around the pack or on the skin and check the skin regularly to avoid Ice burns.
  • Sleeping position and posture – Changing your sleeping position can help.  Try not to sleep on your affected side and try a pillow under your arm to rest your shoulder in a comfortable position.  Changing your seating position at work, home or in your car can also help to relieve symptoms.   Avoid any position that aggravates your symptoms, in particular overhead activities.
  • Physiotherapy – Physiotherapists can diagnose and treat most causes of shoulder pain with manual therapy, massage, muscle strengthening and reconditioning programmes.
  • Corticosteroid injections – Sometimes it is necessary to reduce inflammation around the joint in order for the tissues in the shoulder to heal more effectively.  Your physician will guide you on this if it is deemed necessary.
  • Surgery – In some cases, surgery is indicated to relieve ongoing symptoms.

What exercises can help restore movement and reduce pain?

Trying some or all of the following exercises, they can help to reduce stiffness and alleviate pain.  If any of the exercises exacerbate your symptoms, stop and seek advice from a physiotherapist.

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