The ball and socket joint of the shoulder anatomically sacrifices a degree of stability to offer a great range of motion. This relative instability occasionally causes damage, especially from over-use or repetitive action injuries. Osteopathic joint manipulation and muscular rehabilitation can help with shoulder joint pain – just contact us to ask one of our osteopaths for advice.

Causes of Shoulder Pain

There are a number of reasons why you might be experiencing shoulder pain, which are described by nhs.uk and include:

• Osteoarthritis – degenerative wear and tear in the shoulder joints.
• Poor posture- causing the shoulder to be held in a position causing stress to supporting muscles. This often causes a combination of neck and shoulder pain.
• Inflamed joint (frozen shoulder)- this is a painful condition that reduces normal movement in the joint and can sometimes prevent movement in the shoulder altogether.
• Rotator cuff damage – the rotator cuff is a group of supporting muscles that control the shoulder joint and maintain its stability.
• Shoulder instability (hypermobility)  – where the shoulder may become unstable due to an unusually large range of movement.
• Acromioclavicular joint disorders – damage to the acromioclavicular (AC) joint, where the collar bone and shoulder blade meet.
• A broken (fractured) bone, such as the collarbone (clavicle) or upper arm bone (humerus).
• Shoulder blade pain – this often originates from an underlying rib, so accurate diagnosis is vital.
• Referred pain from elsewhere- sometimes heart, liver and gall bladder problems can refer symptoms to the shoulders, so a detailed case history is important to establish if the cause is mechanical or medical.

Treating shoulder pain

Depending on the cause of your shoulder pain, which should be discussed with your osteopath, you may benefit from one or a combination of the following treatments:

• manual therapy- e.g. osteopathy
• injections of corticosteroids
• avoiding activities that make your symptoms worse such as throwing
• using a wrapped ice pack for 5-10 minutes each hour
• painkillers & anti-inflammatories, e.g. over-the-counter paracetamol or ibuprofen or prescribed diclofenac or naproxen
• exercises to strengthen your shoulder
• manipulation under anaesthetic
• surgery (in some cases) although one review of a number of studies found long-term physiotherapy was as effective as surgery for impingement syndrome (any type of damage to the tendons in the rotator cuff).

When to seek help

You should see one of our osteopaths or your GP if your pain is the result of a traumatic injury, it’s particularly painful, or there is no sign of improvement after a few days.

Some 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 and speed up this recovery period.

Common Shoulder Pain conditions

Frozen shoulder (adhesive capsulitis) occurs when there is thickening, swelling and tightening of the joint capsule, which surrounds the shoulder joint. This makes movement stiff and painful.

Frozen shoulder pain and symptoms can vary greatly but tend to advance slowly. They are usually felt in three stages, spread over an average of 18 months.

Most cases of frozen shoulder occur in people aged over 40. The condition is more common in women than in men, but as to the reason why- we are still unsure.

Tendonitis is inflammation (swelling) of a tendon.

Bursitis is inflammation of a bursa. A bursa is a small, fluid-filled sac usually found over the joints and between tendons and bones.

Tendonitis and bursitis often occur together. When the tendons or bursa are trapped between the bones it is often known as “impingement syndrome”.

If the tendon is repeatedly scraped against the shoulder bones, it can gradually weaken and will sometimes tear Tendon tears are most common in people aged over 40. Tears that affect younger people are usually caused by an accident. In older people, tears are often caused by impingement syndrome.

It is estimated that around half of people over the age of 60 may have partial or complete rotator cuff tears. This is because your tendons become weaker as you get older.

Shoulder instability usually occurs in people aged under 35 and can be either:

• traumatic – the shoulder is forced out of place by a sudden impact
• atraumatic – the shoulder gradually moves out of place over time

Acromioclavicular joint disorders include:

• tearing or stretching the ligaments in your acromioclavicular joint – usually traumatic or from repetitive use
• partially or completely dislocating your acromioclavicular joint
• Osteoarthritic change to the joint through wear and tear.

Acromioclavicular joint disorders are more common in men and those between the ages of 20 and 50.

Whatever the cause of you shoulder problem, our experienced team will aim to find you an appointment quickly and offer a professional service to diagnose and treat your shoulder discomfort. You can use our online booking service to make an appointment, or call our clinic reception if you would prefer to speak to someone in person.