Shoulder Pain Physiotherapy in Bristol
The shoulder can be considered as a set of joints working together to allow controlled arm movement, making it one of the most complex regions of the body. It is comprised of: the glenohumeral joint, acromioclavicular joint and the scapulothoracic joint.
What are the common causes of shoulder pain?
Common causes of musculoskeletal related pains tend to originate from bones, ligaments, tendons and muscles. These symptoms tend to settle with time and good self-management.
These pains may be a result of an acute injury or a flare up of a long standing issue.
Could your pain coming from somewhere else?
Shoulder pain can be as result of pain elsewhere in the body, often the neck. Commonly this is known as referred pain.
To ascertain where the pain is coming from, make an appointment by following the booking link at the top of the page.
To help you consider what is the cause of your pain, please read on:
Common conditions of the shoulder
Sprains and strains
Minor injuries to the shoulder such as a mild sprain or strain are very common and should settle with time. They can often be managed at home.
A soft tissue injury to the shoulder may result in the following:
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Pain
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Swelling
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Bruising
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Stiffness and loss of function
The pain can be particularly strong in the first three weeks as this is the inflammatory phase of your body healing itself. Typically, these injuries last 4 to 6 weeks depending on the severity.
Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet.
Anti-inflammatories like ibuprofen can help with swelling, and therefore help you move more freely. Follow the instructions on the packet and discuss using them safely with a pharmacist, especially if you have any underlying health conditions
However, you should not take ibuprofen for 48 hours after an initial injury as it may slow down healing.
Up to date guidelines can be found on the NHS website: https://www.nhs.uk/medicines/ibuprofen-for-adults/
Get advice from 111 if:
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the pain is sudden or very bad
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you cannot move your arm
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your arm or shoulder has changed shape or is badly swollen
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you have pins and needles that do not go away
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there’s no feeling in your arm or shoulder
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your arm or shoulder is hot or cold to touch
Osteoarthritis of the shoulder
What is it?
Osteoarthritis is a wear and repair process and can affect the shoulder, however, this is less common than other joints. It can lead to joint pain with limitation of movement, this can affect daily activities. Osteoarthritis is the most common type of arthritis, affecting approximately 9 million people in the UK.
What are the common symptoms of Osteoarthritis of the shoulder?
Symptoms of osteoarthritis of the shoulder may include gradual onset of pain and limited movement of the joint. Stiffness first thing in the morning for less than 30 minutes. Noises coming from the joint (crepitus) on movement is also common.
Rotator cuff shoulder pain - Bristol Physio
Rotator cuff related shoulder pain (sometimes known as subacromial shoulder pain) is very common and causes pain in the shoulder and upper arm. It can spread further down the arm and up towards the neck and shoulder blade.
It can feel worse when the arm is moved away from the body such as reaching up or when placing the hand behind the back. Pain can come on slowly over time or quite quickly if the shoulder has been used for an activity that is much more demanding than it is used to doing each day.
The ‘Rotator Cuff’ is the name given to the set of muscles and tendons that all have to work together to stabilise the shoulder through movement. Rotator cuff disorders are often due to age-related changes to the tendon however they can also be caused by trauma, overload, or repetitive movements. It commonly affects people between the ages of 35-75 years.
Rotator cuff muscles and tendons – back view of right shoulder
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Supraspinatus tendon
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Infraspinatus tendon
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Teres minor tendon
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Teres minor muscle
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Infraspinatus muscle
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Supraspinatus muscle
Rotator cuff muscles and tendons – front view of right shoulder
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Subscapularis tendon
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Subscapularis muscle
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Supraspinatus muscle
What are the common symptoms?
Pain
Pain occurs in and around the shoulder joint and can spread down the top of the arm. If there has been an injury, the pain may come on suddenly. Pain is usually worse when you use your arm for activities above your shoulder level. This means that combing your hair or trying to dress yourself can be painful but writing and typing may produce little in the way of pain. Pain may also be worse at night and affect sleep.
Weakness
Occasionally your arm may also feel weak and you may have reduced movement in your shoulder. Some people feel clicking or catching.
Factors that may contribute to rotator cuff related shoulder pain:
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Rotator cuff tendons
The rotator cuff works together to hold the ball on the socket during movement of the arm. If one or more of the tendons are weak they will not be able to do their job properly. Pain may start due to an overload of the tendons this can lead to some weakness. Age related changes in the tendon can also have an effect on the strength. The good news is exercises can help the tendon strengthen and reduce pain.
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Stiffness of the shoulder
If the shoulder is stiff, the mechanics of movement and the way the tendons work to support the joint will be changed. This is why continuing to move the joint as pain allows is so important.
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Posture
How you hold your head and shoulders is important. If the head and shoulder blade are pushed forward (for example, hunched or rounded shoulders), this position forces the shoulder muscles to work in an abnormal way. This can then lead to a reduction in the mechanical efficiency of the shoulder during movement.
Frozen Shoulder Bristol Physio
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Pain can be very severe in the early stages and then reduces with time
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Movements are restricted – often external rotation and raising the arm out to the side are the most restrictive
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The shoulder joint can be stiff for a number of months
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Pain can disturb sleep
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Common age between 40 – 65 years old
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Common in people with diabetes
What is it?
The shoulder has a capsule that surrounds the ball and socket joint and is usually lax to allow for a large range of movement. Frozen shoulder, also known as adhesive capsulitis or sometimes contracted shoulder, is a gradual tightening of the capsule, accompanied by severe pain in the early stages and then restricted movement.
Research is inconclusive as to the cause of a frozen shoulder; it affects about 3% of adults at some stage in their lives. It most commonly occurs in people aged between 40 and 65 years. It is more common in people who have diabetes, an overactive thyroid, high cholesterol, a high body mass index, heart disease or a history of trauma. It is also more common in females. It may start after an injury but can commonly start for no reason at all.
What are the symptoms?
Typical symptoms are pain, stiffness and limitation in the range of movement of one of your shoulders. There is often a restriction of external rotation of the shoulder.
There are thought to be 3 stages to a frozen shoulder:
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Freezing stage can be extremely painful, especially at night. Pain may be felt down the arm as far as the wrist; the pain may be felt all the time and usually becomes worse on movement especially twisting movements as in putting your hand behind your back or behind your head. This phase can last anywhere from 2 to 9 months.
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Frozen stage is where pain gradually eases but stiffness and limitation in movement remain and can become worse. All movements of your shoulder can be affected. This phase can last anywhere from 4 to 12 months.
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Thawing stage is where the pain and stiffness gradually settle and movement gradually returns to normal, or near normal. This phase can last anywhere from 12 to 42 months.
The time taken to progress through these phases is highly variable from person to person. Occasionally some stiffness remains, although most people regain enough movement to carry out everyday activities.
Treatment from Physiotherapy: Shoulder pain
Along with advice, manipulation, strapping, muscle stimulation and home exercises, The Storm Clinic can also offer you (click on the links for more information)
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Acupuncture sessions could potentially help in reducing inflammation of soft tissue and cartilage, which may be common causes of hip pain and long-term discomfort.
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Shockwave therapy is a physical treatment that uses high-energy acoustic waves — known as shockwaves — to treat musculoskeletal pain and promote the healing of painful tissue. It works by stimulating increased blood circulation and cell growth, improving elasticity in the affected area, and ultimately reducing inflammation and pain. In some cases, it can be very effective in breaking up scar tissue or calcifications.
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Laser therapy helps to accelerate the healing process, reduce pain and reduce swelling.
To book a consultation click here
