Shoulder Pain

The shoulder is one of the most complex joints in the body, which is why it can achieve such complex movement patterns and can be incredibly strong. However, this amazing range of movement sometimes comes with its problems and irregularities.

You may have a shoulder injury or shoulder pain that has gradually developed over time or that has come on quite suddenly. There may have been a traumatic incident such as a fall on the shoulder or a change in exercise levels that could have triggered it.

Our specialist physiotherapists have a wealth of knowledge dealing with shoulder injuries, ranging from impingement syndrome, rotator cuff injuries, peripheral nerve injuries, complex shoulder dislocations/instability and together we have rehabilitated thousands of shoulders recovering from surgical procedures.

The BBC in 2018 reported that the NHS in England had withdrawn as ‘non-essential’ certain operations, including the removal of bone spurs in the shoulder. Whilst we believe that this is an excellent operation and we have rehabilitated many shoulders from bone spurs, the advice is that it can be treated effectively by Physiotherapy and exercise. We have also seen this in many patients and have treated many shoulder pain and bone spur patients over the years very effectively.

Further reading here in the BMJ.

  • Top of Shoulder Pain

    The most common cause of pain on the top of your shoulder (over the bony prominence) is the Acromio-clavicular Joint (ACJ). This can be sprained from a fall, injured from a lift, be degenerative and/or be muscular in origin.

    Bone and Joint Journal in 2018 described Acromio clavicular joint injuries (ACJ) as occuring ‘five times more frequently in men than in women, with the highest incidence in the 20- to 30-year-old age group. Patients usually complain of pain and tenderness over the shoulder, particularly over the AC joint.’

  • Shoulder Joint Pain

    There are a number of different joint issues. please click on each for more detail. The rotator cuff accounts for 85% of shoulder pain cases.

    The British Journal of General Practice in 2014 stated that ‘shoulder pain is the third most common musculoskeletal presentation in primary care after back and knee pain. Annually 1% of adults are likely to consult with new shoulder pain.’

  • Shoulder Blade or Scapula Pain

    Pain over the shoulder blade, under the shoulder blade or between the spine and the shoulder blade is one of the most complex areas to treat in the body. There are a number of areas that refer pain to this site.

    The function of the scapula or shoulder blade in shoulder function ‘was often neglected in designing a rehabilitation protocol for the shoulder.’ IJSPT 2013 

    However, it is understood that weakness of the scapular stabilizers and resultant altered biomechanics could result in abnormal stresses to the anterior capsular structures of the shoulder, increased possibility of rotator cuff compression and decreased shoulder complex neuromuscular performance. IJSPT 2013 

    The neck joints are commonly associated with the referral of pain to the inside border of the scapular nearer the spine as well as affecting how the shoulder blade works. Further information in JOSPT 2014.

    The mid-back, known as the thoracic spine, can also be responsible for symptoms in this area. The symptoms in the shoulder blade can be burning, tingling, numbness and aching. Get this checked out!

    Then there is the local musculature around the shoulder blade that can be strained or in spasm. This can cause any number of symptoms around the shoulder blade. Posture, stiffness, lifestyle and occupation play a massive role in the flexibility and strength around the shoulder blade/spine and as Chartered Physiotherapist we will look closely at each of these factors.

  • Fractured shoulder

    There are many types of fractures that can occur in and around the shoulder, but they can generally be sorted into three sections. The shoulder blade (scapular), the upper arm bone (humerus) and the collar bone (clavicle). All three can cause loss of movement in the shoulder, swelling, pain and tenderness. When you fracture a bone it generally bleeds, therefore swelling is generally associated with this injury. If you suspect you have fractured a bone in your shoulder then you should go straight to an Accident and Emergency department or seek urgent medical attention. If your physiotherapist suspects a fracture during your assessment, then they will write a letter to your GP or A & E requesting further investigation in the form of x-rays or scans.

    If you would like to book an appointment with one of our team then please contact our reception staff on 01604 601641 to book your appointment or book on line via the link at the top of the page.