Shoulder pain
Shoulder pain can be very debilitating. There are many reasons for shoulder pain other than the obvious ones, which are broken bones and dislocations. A few of the more common conditions which people might have heard about are: frozen shoulder, rotator cuff strains/tears, impingement syndrome and arthritis of the shoulder. All of these are treated by us on a regular basis. Our team use the case history and examination to effectively find the cause of the pain and provide the necessary treatment.
Rotator Cuff
The rotator cuff is a group of 4 muscles and tendons, made up of the supraspinatus, infraspinatus, teres minor and subscapularis. These muscles are an integral part of all shoulder movements. The shoulder joint is a ball and socket joint. It’s a big ball and a small socket. The best way to think about this is a football ball on top of a teacup saucer. The rotator cuff muscles engulf the top of the humerus. When we lift our arm the shoulder muscles activate, and the rotator cuff muscles initiate the movement. But to stop the humerus (football) rolling off the glenoid (saucer) the rotator cuff muscles also cause the head of the humerus to slide, helping to keep it in position.
The rotator cuff muscles are very active, and they can be injured in many ways. Some of these can be traumatic, like falling on an outstretched arm. Others can be from overuse, such as repeatedly throwing a ball for the dog, or sliding food along the check-out till at the supermarket. Another common cause of rotator cuff injuries is from awkward movements, such as reaching into the back seat of a car to get something. Unfortunately, as we grow older the rotator cuff can also begin to suffer from wear and tear, which is another cause of pain in the shoulder.
All these injuries can cause different problems with the rotator cuff. These range from tears (complete or partial), tendinitis/tendinopathies, and muscle strains.
Impingement syndrome
Shoulder impingement is a very common cause of shoulder pain. This condition involves the rotator cuff muscles. The rotator cuff muscles go through a narrow opening. This narrow opening is created by some bone structures, which include the acromion (top of the shoulder), glenohumeral joint (main shoulder joint) and the coracoid process. Through injury, age, sleeping awkwardly, or awkward movements the rotator cuff becomes irritated, leading to inflammation. This then leads to it becoming impinged, hence the name impingement syndrome. There are varies special tests that can be performed to help diagnose this condition, so that treatment can be given appropriately.
Arthritis
Arthritis of the shoulder, in particular osteoarthritis of the shoulder is the condition some of us may suffer from as we grow older. It’s basically wear and tear. As we grow older, the joints can become worn, leading to reduced cartilage. Sometimes the cartilage can completely disappear, meaning you have bone rubbing on bone. Where this happens, the bones can change shape. This causes the joints, muscles, ligaments, and tendons to all work differently. The altered shape of the joint and the altered way that it works leads to things rubbing against each other, which cause inflammation and pain.
For more information on general arthritis, please visit we our arthritis page
FROZEN SHOULDER OR ADHESIVE CAPSULITIS
Frozen shoulder can be quite debilitating. It can stop you from doing daily tasks or even getting a good night sleep.
The journey of recovery can be long, and you might be wondering where to start….
A frozen shoulder gives pain and stiffness in your shoulder joint. The level of pain and stiffness varies depending on the stage you are in. There are 3 stages to this condition.
- The 1st stage is the freezing stage. Any movement of your shoulder is painful. Your shoulders movement starts to become restricted.
- The 2nd stage is the frozen stage. The movement limitation reaches its worst, but your pain starts to diminish.
- The 3rd stage is the thawing stage. Your pain reduces further or can disappear. Your movement gets back to normal.
Each stage can take from few weeks to few months to resolve.
Why do I get pain?
Although the condition has been already described in the 1930s, it is still poorly understood. Patients suffering from frozen shoulder show changes in the ligaments and capsule around the shoulder. These ligaments, which normally glide freely, start sticking together resulting in restricted and painful movement. But it is still unclear what causes these adhesions to occur and why they disappear after 6-18 months.
The following risk factors have been identified for a frozen shoulder:
- If you had a previous condition that have prevented you from moving your arm for few weeks
- If you are diabetic
- If you are over 40 years old
Bursitis:
Inflammation of the bursae, which are small, fluid-filled sacs that cushion the shoulder joint, can lead to significant discomfort and restricted movement. Bursitis often arises from repetitive movements or direct pressure on the shoulder. Treatment focuses on reducing inflammation through ice therapy, rest, and anti-inflammatory medications. Exercises to strengthen surrounding muscles and improve joint mechanics are also beneficial, along with manual therapies to enhance mobility and relieve pain.
Labral Tear:
The labrum is a ring of cartilage that surrounds the shoulder socket and helps stabilize the joint. Labral tears can occur from acute trauma, such as a fall or direct blow to the shoulder, or through repetitive shoulder motions seen in throwing sports or weightlifting. Symptoms include pain, a catching sensation, and joint instability.
SLAP Lesions:
Superior Labrum from Anterior to Posterior (SLAP) lesions are a specific type of labral tear occurring at the top of the shoulder socket, where the biceps tendon attaches. These injuries are common in athletes who perform overhead activities. SLAP lesions can cause pain and a sensation of popping, locking, or grinding.
Acromioclavicular Joint Disorders:
This condition involves the acromioclavicular joint, where the collarbone meets the highest point of the shoulder blade. Disorders can range from AC joint arthritis to separations resulting from trauma or overuse. Symptoms include pain and swelling on top of the shoulder, especially when reaching across the body or lifting the arm. Treatment varies from rest and ice to physical therapy and, in severe cases, surgical reconstruction of the joint.
Calcific Tendonitis:
This condition occurs when calcium deposits form in the rotator cuff tendons, leading to acute pain and inflammation. It’s most common in adults over 30 and can cause sudden, severe pain that may be accompanied by a limited range of motion. Treatment options include shock wave therapy to break up the calcium deposits, corticosteroid injections to reduce inflammation, and physical therapy to restore movement and alleviate pain.
Thoracic Outlet Syndrome (TOS):
Thoracic outlet syndrome is caused by compression of the nerves or blood vessels that pass between the collarbone and the first rib. This can lead to pain in the shoulder and neck as well as numbness in the fingers. TOS is often seen in people who perform repetitive arm and shoulder movements.
How can we help?
Osteopathic treatment can help these conditions. We use a combination of the case history and special tests to accurately diagnose what the problem is. Then the appropriate techniques and treatment can be used. Our approach combines hands-on treatment with practical advice and exercises you can perform at home, ensuring you achieve the best possible outcomes.
Osteopathic treatment has been proven to reduce stiffness and pain around the joint.
What’s next?
Don’t let shoulder pain hold you back. If you’re ready to address your pain, consider booking an appointment with us. Whether you’ve already consulted with your GP or are seeking an alternative to more invasive treatments, our clinic offers a holistic and less invasive approach to shoulder pain relief.
Contact Worthing Osteopathic & Wellbeing Clinic today to start your journey to recovery. We’re here to support your health with expert care and a personalized treatment plan tailored to your specific needs.