Why shoulder pain is not so easy to shrug off

Cameron Hatrick

Shoulder pain is something that a great many of us are likely to experience at some point in our lives, affecting our ability to work and play. Shoulder specialist Cameron Hatrick from Spring Orthopaedics explains more.

We use our arms constantly throughout the day making a painful shoulder difficult to ignore. Sudden arm movements or reaching above shoulder height usually make it worse and, if you roll onto your painful shoulder while asleep, the pain can often wake you up.

What causes it?

There are many causes of shoulder pain but some of the most common conditions are: frozen shoulder, where the joint is very stiff and painful; impingement syndrome, where inflamed tendons and bursae (the liquid-filled sacks that cushion joints) are compressed as you lift your arm up; and tears to one or more of the four shoulder tendons, collectively known as the rotator cuff.

How do shoulder problems usually occur?

Dramatic injuries like fractures or dislocations are usually caused by a one-off accident, but the most common shoulder problems are the result of repetitive minor injuries. Sports such as badminton, tennis and swimming front crawl, and activities that involve continuously reaching up with your arms, like decorating and plastering, are often the culprits. And given the amount we use our arms, simply living a long and active life can result in “wear and tear” on our shoulder joints.

What are the treatment options?

Treatment will vary dramatically for different problems so the most important step in treating your shoulder pain is to get the right diagnosis. Depending on the nature of your injury and level of pain, you may need an x-ray to determine what damage has occurred.

If your pain follows a relatively minor injury or comes on gradually, then you should see your GP or a local physiotherapist. They will give you advice about modifying your activities and show you exercises to address your problem. Occasionally they will give you a steroid injection which can reduce pain caused by inflammation.

When should I see a shoulder specialist?

If the pain persists despite rest, appropriate exercises and perhaps an injection, your doctor or physiotherapist will probably refer you to a specialist shoulder surgeon. The specialist will reassess your shoulder and may arrange an MRI or ultrasound scan of the joint.

Will this mean an operation?

Although surgery is occasionally recommended to treat shoulder pain, seeing the shoulder surgeon doesn’t mean you’ll automatically end up having an operation. Surgery is performed only if ‘conservative’ treatment has not worked and nowadays this is nearly always carried out via ‘keyhole’ surgery, often as a day case.

How can I protect my shoulder?

To reduce the risk of injury it is important to keep your shoulders mobile and the muscles toned with regular exercise. Always warm-up before exercising and build up gradually - don’t start with an Andy Murray serve the first time you dust off your tennis racquet this season!