Moderate to severe shoulder pain can significantly affect your quality of life. The shoulder is a ball and socket joint that has a wider range of motion than any other joint in your body. It is strengthened and stabilised by a group of eight muscles, with tendons attaching these to the bones. The most important of these muscles are the four rotator cuffs, which are used to raise and rotate the arms.
The flexibility of the shoulder joint means it is particularly susceptible to injuries and degenerative conditions. These can impact your ability to perform simple everyday activities, such as brushing your hair or reaching above your head, and this can restrict your quality of life.
Common conditions that cause shoulder pain include:
Adhesive Capsulitis, also called frozen shoulder. This is a painful condition that limits the movement of the shoulder, leading to extreme stiffness and loss of function. It occurs when the shoulder joint capsule (the connective tissues that surround the joint) becomes stiff and inflamed. There are three distinct phases to adhesive capsulitis – the “freezing” stage, where the pain slowly increases and the shoulder becomes increasingly immobile. This lasts from six weeks to nine months; the “frozen” stage, where the pain may ease off but the shoulder remains stiff, making it difficult to do everyday activities; and the “thawing” stage, where the pain and movement in your shoulder slowly improves. This stage lasts from six months to two years.
Researchers don’t fully understand why adhesive capsulitis develops, but women are more susceptible than men and it most often occurs between the ages of 40 and 60. A shoulder injury that means you need to keep the joint immobilised (such as a fracture or rotator cuff tear) increases the risk of adhesive capsulitis. Treatment for frozen shoulder involves using hot and cold compresses, anti-inflammatory medication and physiotherapy. If the pain and stiffness persist, you may be offered surgical manipulation under anaesthetic to stretch the tight joint capsule, or shoulder arthroscopy to cut through the tight sections of the joint capsule (capsular release).
Rotator Cuff Injury – The rotator cuff is a group of muscles and tendons in the shoulder that keep the upper arm bone in the shoulder socket and help you lift and move your arms away from your body. You may tear your rotator cuff, leading to shoulder pain, difficulties raising or moving your arms and weakness in the shoulder joint. The pain may be worse at night or when you rest your arm and you may feel a popping or crackling sensation when you move your arm. Some people experience a dull ache while others are affected by a sharp, stabbing pain.
A partial rotator cuff tear means that the tendon is still attached to the arm bone, however, with a complete rotator cuff tear, the tendon is pulled away from the bone altogether. Rotator cuff tears may be caused by a traumatic injury, such as a fractured collarbone or dislocated shoulder, however, it is more commonly associated with wear and tear to the tendon due to ageing. People over 40 are most at risk. The condition does not heal without surgery, however, it is possible to improve functionality by strengthening the shoulder muscles. For a complete tear, you may need to have arthroscopic surgery to reattach the tendon to your upper arm bone and remove any bone spurs that have developed. After surgery, you will need to wear a sling to immobilise the arm while the tendon heals.
Shoulder Bursitis is painful inflammation and swelling of the tiny fluid-filled sacs in your shoulder, called bursae. These sacs cushion the spaces between the bones and the connective tissues. They can become irritated as a result of injury, overuse or infection. The subacromial bursae cushion the area between the rotator cuff tendons and the acromion. You may develop different forms of shoulder bursitis. Chronic shoulder bursitis (which means the problem recurs) is the most common form of the condition. Acute bursitis is the result of some kind of shoulder injury, while infectious bursitis is caused by an infection elsewhere in the body that spreads to the shoulder bursae. Symptoms include pain, swelling, stiffness and tenderness.
Shoulder bursitis is a common sporting injury or repetitive strain injury, particularly in sports that involve repeatedly throwing a ball, or manual work that involves making forceful arm movements (such as hitting a hammer). Painters, carpenters and plumbers may be especially at risk. At-home treatments for bursitis include using ice to relieve pain, doing exercises recommended by a physiotherapist and taking anti-inflammatory medication. If you have infectious bursitis, you will be prescribed antibiotics. Most shoulder bursitis is treated without surgery, however in some severe cases you may need surgery to remove or repair damaged tissue. This is performed using arthroscopic surgery.
Other common causes of shoulder pain include shoulder impingement syndrome, shoulder strain, dislocated shoulder, tendinitis and osteoarthritis.
If you are experiencing pain that is affecting your quality of life or if you need advice about diagnosing and treating shoulder conditions and injury, contact us. We can provide a detailed diagnosis and recommend the most effective treatment plan.
Orthopaedic Consultant & Surgeon | London
Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist).
Telephone: 020 376 15987
Email: admin@thamesshoulderandelbow.co.uk
Our Locations
Hospital of St John and St Elizabeth, St John’s Wood – Directions
BMI The Syon Clinic, Brentford – Directions
HCA Chiswick Medical Centre, Chiswick – Directions
West Middlesex University Hospital, Chelsea and Westminster Foundation Trust, Isleworth – Directions
