Shoulder Pain

Introduction to shoulder pain

Shoulder pain is a common problem with a number of different causes. It’s often a symptom of another problem.

There are a number of reasons why you might be experiencing shoulder pain, which include:

• poor posture
• frozen shoulder – a painful condition that reduces normal movement in the joint and can sometimes prevent movement in the shoulder altogether
• rotator cuff disorders – the rotator cuff is a group of muscles and tendons that surround the shoulder joint and help to keep it stable
• shoulder instability – where the shoulder is unstable and has an unusually large range of movement (hypermobility)
• acromioclavicular joint disorders – conditions that affect the acromioclavicular joint, which is the joint at the top of the shoulder
• osteoarthritis in the shoulder joints
• a broken (fractured) bone, such as a fracture of the humerus (upper arm bone) or broken collarbone

In some cases, pain in the shoulder isn’t caused by a problem in the shoulder joint, but by a problem in another area, such as the neck, that is felt in the shoulder and upper back.

Treating shoulder pain

There are things you can do yourself to treat shoulder pain, including using painkillers, or ice packs to reduce inflammation and relieve pain. Avoiding activities that may aggravate your symptoms will also help.

The type of treatment offered for your shoulder pain will depend on the underlying cause and your symptoms.

Options such as heat or ice packs and painkillers may help reduce pain and treat minor injuries at home.

You should see a doctor if your pain is the result of an injury, it’s particularly bad, or if there is no sign of the pain improving after a couple of weeks.

You may need to see our orthopaedic specialist if you have:

• a frozen shoulder that does not improve after six months
• a rotator cuff disorder that does not improve after three to six months
• an acromioclavicular joint disorder that does not improve after three months
• a rotator cuff tear
• shoulder instability and you are under 30 years old

The main treatment options for shoulder pain include:

• avoiding activities that make your symptoms worse
• using ice packs
• painkillers
• anti-inflammatories
• injections
• shockwave therapy
• physiotherapy
• surgery (in some cases)

As well as pain, you may also have reduced strength or movement in your shoulder. In this case, a combination of different treatments may be used.

When to see a doctor?

You should see a doctor if your pain is the result of an injury, it’s particularly bad, or there is no sign of improvement after a couple of weeks.

Shoulder pain can be a long-term problem: up to half of people still have symptoms after 18 months. A correct diagnosis will ensure you receive the right treatment.

Diagnosing shoulder pain

Your doctor may be able to diagnose the cause of your shoulder pain by discussing your symptoms with you and examining your shoulder. In some cases, tests may be needed.

As well as asking exactly where the pain is, your doctor will also need to know whether:

• you have had any recent injuries
• anything makes the pain feel better or worse
• the pain is worse at night
• the pain came on gradually or suddenly
• the pain is affecting your everyday life – for example, at work or when exercising
• you have any other symptoms

Physical examination

Your doctor will probably carry out a physical examination of your shoulder area. They will:

• compare your shoulders
• check for any redness, swelling or bruising
• check whether your joint is dislocated (whether the joint has come out of its correct position) – if it is, your shoulder will be in an unusual position
• feel your shoulder bones and joints to see whether this causes any pain

Investigations

X-ray

You may have a shoulder X-ray if the inside of your shoulder joint needs to be examined to rule out other damage. An X-ray uses radiation to detect problems with your bones.

Magnetic resonance imaging (MRI) scan

A magnetic resonance imaging (MRI) scan uses strong magnetic fields and radio waves to produce a detailed image of the inside of your body.

Shoulder Specialist

Dr Tan Chin Yik, Orthopaedic & Shoulder Specialist