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If you experience any of the following in relation to your shoulder pain, you should go to A&E:
These signs tend to indicate a break in a bone, ruptured tendon or dislocation, which will need more immediate treatment.
The shoulder is one of the more complex joints in the body, so when someone is experiencing pain in their shoulder there are several potential sources of the problem. Overall, the joint contains two ‘sub-joints’: the glenohumeral joint (the ball and socket joint where your arm joins on to your shoulder blade) and the acromioclavicular joint (commonly abbreviated to AC joint or ACJ) where the clavicle joins the shoulder blade. These are shown to the right:
The AC joint is more commonly the source of shoulder problems, rather than the ball and socket joint itself, although both are prone to dislocation and arthritis.
In addition to these joint elements, the shoulder also comprises a series of muscles, collectively known as the ‘rotator cuff’. This is made up of four separate muscles that help to stabilise the top of the humerus (upper arm bone) in the socket joint on the shoulder blade. As there are so many elements in this joint, there is not much extra space around it, so sometimes the tendons of these rotator cuff muscles can get squashed (medically termed ‘impingement’) or get small tears, which can also cause pain.
‘Frozen shoulder’ is another source of shoulder pain, and is caused by inflammation and stiffness in the connective tissue capsule that surrounds the joint. This is also known as ‘adhesive capsulitis’ and can cause restricted movement as well as pain.
The final common source of shoulder pain is the bursae of the shoulder joint. A bursa is a small sac of joint fluid that sits around the joint. These are found in joints all over the body. There are several present in the shoulder joint, and can sometimes become irritated and inflamed (particularly in such a cramped space) causing a ‘bursitis’ and resultant shoulder pain.
Although there are several potential causes of shoulder pain, the treatment and management is generally similar and the following strategies can be helpful in most circumstances:
The most important thing to remember is to keep moving your shoulder! Although movement may be painful, most things will be made worse by not using the joint. This can make any later physiotherapy even more difficult
For all of these exercises, start slowly and build up the time and repetitions as you feel stronger. If you feel any strong or sharp pain, stop the exercise
If the pain doesn’t get better after 2 weeks, it is advised to go and see a GP. They may prescribe some stronger pain medication or injections, advise further exercises or refer to a physiotherapist or specialist for further tests or treatment.