Shoulder pain and injury: what it means and how it’s treated

Our shoulders have a lot of important jobs. Because we use our shoulders all the time, shoulder problems are very common and can have a variety of causes.

Chronic shoulder problems

Shoulder problems can cause the rest of your arm to hurt as well. Often, these pains are described as an ‘ache’ while your arm is still, or ‘sharp pain’ with movement of the shoulder. Shoulder pain may be caused by the muscles around the shoulder joint, the ligaments which help stabilise the joint, or even due to the bones of the joint itself.

‘Chronic’ refers to ongoing or gradual onset pain or injury, usually the result of an illness or repetitive strain due to overuse. Common chronic shoulder conditions include torn rotator cuffs, osteoarthritis, and neck issues causing shoulder pain.

A torn rotator cuff refers to a tear in the group of muscles which help to move and stabilise our shoulder joints. A rotator cuff muscle may tear due to an injury, but more commonly it occurs from general wear and tear. If you have trouble lifting your arm, then this group of muscles may be to blame.

Osteoarthritis is also common in the shoulder joint. This describes the cushioned surfaces at the end of a bone becoming worn and happens very commonly as we age. Symptoms often include pain and stiffness around the shoulder joint, which is usually worse first thing in the morning.

Due to the complexity of the shoulder, and its close proximity to the neck and spine, pain in the shoulder can sometimes come from the neck. If this is the case, symptoms may be worse with sustained postures, like sitting at a computer or on the couch, or certain neck movements. Alongside the pain, you may also experience things such as pins & needles, numbness and pain in the arm and hand.

One thing to look out for is severe pain which interrupts your sleep. If this occurs, it is important to visit your doctor, as it may be a sign of something more serious.

Acute shoulder problems

‘Acute’ refers to a sudden onset, severe issue or injury. Sudden injuries to the structures of the shoulder can occur with things such as falling onto the arm or shoulder, impact to the shoulder during contact sports, throwing or even lifting heavy items.

The shoulder joint is a ‘ball and socket’ joint which means it is capable of moving in lots of different directions. In order to do this, the socket is naturally quite shallow, so there are lots of ligaments and muscles to help keep the shoulder strong and stable. We use our arm continually, and therefore there are several very common issues that can develop

Ligaments, tendons and cartilage around the shoulder joint can become strained or sometimes torn. These types of injuries are called ‘soft tissue’ injuries and can cause irritation, swelling and pain around the shoulder, and sometimes locking or clicking with movement.

In cases like these, it is recommended to apply the R.I.C.E.R method:

• REST the joint, limiting movement
• Apply ICE for 15 minutes every 2 hours to reduce swelling
• Apply gentle COMPRESSION, such as a compression bandage
• ELEVATE the area above heart level, to reduce the amount of pain and swelling
• And REFER, by going to see your GP or physiotherapist for guidance and management

If there has been a sudden strong force to the shoulder which results in strong pain and reduced ability to move the shoulder joint, it may be possible that a bone has been fractured.

If needed, you will be referred to a specialist doctor by your GP or physiotherapist. Other assessments may be required, such as MRIs or x-rays. These are only used if a fracture is suspected, if the extent of your injury is unclear, or if further information is required in order to manage your rehabilitation. Another reason may be for a surgical opinion.

With any type of shoulder problem, your GP will be able to guide you according to the extent of the injury, and the management that is required.

A physiotherapist will also help you with your assessment and recovery, to manage your healing and symptoms, gradually building up your strength and control, and developing your function so you can get back to enjoying life.

At Ramsay Health Care, we work with multidisciplinary teams made up of orthopaedic surgeons, medical staff, specialist nurses, physiotherapists and exercise physiologists. For more information, contact us.