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Shoulder Pain

The shoulder is one of the most complex yet flexible joints in the body. It’s built to allow movements in several directions; forward, backward, upward, around in a circle and outward; and it supports most of our basic motions: lifting, throwing, pulling, pushing, etc.

We depend on our shoulders every day and this makes it vulnerable to fatigue and injury. Shoulder problems are very common and may become more frequent with age. Shoulder pain can be abrupt or gradual, and may range from very mild to excruciating.

Common shoulder conditions

Some of the specific conditions that cause shoulder pain include:

  • Frozen shoulder (Adhesive capsulitis)
  • Rheumatoid arthritis
  • Referred neck pain
  • Heart attack
  • Biceps tendonitis
  • Subacromial bursitis (joint inflammation)
  • Shoulder impingement or painful arc syndrome
  • Separated shoulder
  • Dislocated shoulder
  • Sprains
  • Tendon rupture
  • Osteoarthritis
  • Polymyalgia rheumatica
  • Calcific tendonitis and calcific periarthritis
  • Lung conditions
  • Rotator cuff tear
  • Broken collarbone
  • Broken arm
  • Brachial plexus injury
  • Avascular necrosis

Causes of shoulder pain

Most shoulder problems affect a small area and are usually short-lived. However, in some cases the problem could be a part of a wider, long-term illness such as polymyalgia rheumatica (muscle pain and stiffness in shoulders) or osteoarthritis.

Causes of shoulder pain include:

  • Inflammation in the bursa – a fluid-filled sac which allows the tendons and muscles smoothly slide across the shoulder bones
  • Tension in the muscles between the neck and shoulder – this is usually caused by bad posture i.e. the way you sit or stand when you’re at work or using a computer
  • Damage to the muscles and tendons around the shoulder
  • Inflammation – causing swelling and pain in the shoulder – as a natural reaction to an injury or infection
  • Neck problems which can cause a tingling sensation in the arm or hand and pain to erupt in the shoulder or upper arm. This is known as radiated pain or referred pain.

Other causes of shoulder pain are:

  • Infection
  • Tumours
  • Nerve-related problems

When should you see a doctor?

Most shoulder pain problems can be treated without visiting the hospital. Exceptional cases include a sudden, continuous pain or a serious injury. You should however immediately see your doctor if:

  • Pains and discomfort still persist 2 weeks after treatment
  • You feel feverish or unwell
  • You also have pain in your thighs
  • You develop severe pain in both shoulders
  • Your hand or arm is weak or numb
  • The shoulder starts swelling suddenly
  • The pain is excruciating
  • You can’t move the shoulder at all
  • Your shoulder joint looks deformed.

Most doctors will carry out a physical examination as well as medical tests in order to properly diagnose your condition.

Treatment

Depending on the severity, cause and duration of the pain, doctors recommend different treatment options for patients. They include:

Medication

Doctors prescribe non-steroidal anti-inflammatory pain-relieving drugs (NSAIDs) such as Ibuprofen, Advil or Naproxen and anti-biotics (to be taken only as directed) to reduce pain and inflammation.

Occupational therapy

This is therapy that teaches a patient how to live independently with some lifestyle changes. Changing your lifestyle (avoiding overexertion, resting, altering normal activities) and learning to adapt to these changes is another way of treating or preventing the pains before they escalate.

Physiotherapy

Physical therapy for shoulder pain involves using physical and therapeutic techniques such as stretching and strengthening exercises, massage and manipulation to restore strength and vigour to the shoulders and body.

Some exercises to relieve shoulder pain include:

  • Shoulder stretches
  • Door press
  • Shoulder circle
  • Steroid injections

Where necessary, your doctor may also prescribe anti-inflammatory corticosteroid injections. They are usually given along with local anaesthetic to reduce pain and inflammation. It is dangerous to take more than 2 or 3 shots into the shoulder as it may do more harm than good.

Surgery

Some more serious shoulder problems like rotator cuff tears or recurring dislocation may require surgery to treat. In these cases, surgery will be recommended early on and can involve traditional open procedures for shoulder replacement or larger reconstructions or arthroscopy to repair torn tissues or remove scar tissue.

Shoulder Pain FAQ’s

Is shoulder pain a sign of cancer?
Shoulder pain can be linked to lung cancer, however for an accurate diagnosis, see your doctor immediately.
What if there’s nothing wrong with my shoulder?
It is possible to also experience shoulder pain even when your shoulder is fine. Sometimes a pinched or trapped nerve can send pain signals to the shoulder.
What is the recovery process after shoulder replacement surgery?
Factors such as history, medical condition, type of procedure performed and age determine the recovery speed, process and return to normal activity. However, it usually takes about 6 to 8 weeks after the procedure, to resume normal activities.
Talk to your doctor about return to activity following shoulder replacement.

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