How to deal with shoulder pain

November 2022

I’ve got shoulder pain. What should I do?

 

If you’ve fallen and broken something, chances are that you have had an X-ray and know exactly what you’ve done, but for the vast majority of our patients without a traumatic history, a comprehensive physiotherapy assessment is a good place to start. If you have pain that is affecting your quality of life, affecting your sleep or making you adjust your daily activities, it might be time to book that appointment.

What is wrong with my shoulder?

 

The shoulder is made up of many ligaments, muscles and tendons, and it can sometimes be hard to know exactly what is wrong with it. Some examples of common shoulder problems include: muscle strains, torn muscles (including rotator cuff tears), ligament sprains, dislocation, arthritis, inflammation of tendons or the fluid pouches around the joint (tendonitis orbursitis) or a frozen shoulder. Each different problem has its own treatment pathway and we sometimes get combinations of them, just to make it a little bit more complicated again! Pain in the shoulder region can also come from your neck or upper back, so your physiotherapist will likely start any assessment by ruling in or out your neck and upper back as a cause of your shoulder pain.

 

When should I make an appointment?

 

As soon as you like. Some people like to make an appointment as soon as they have pain and some like to see if the pain will pass for a while first. As physiotherapists, we like to see you sooner rather than later, so we are dealing with one problem and not all the other things that go wrong when you change the way you move and hold yourself. Seeing you early often means we only need to see you for a small number of sessions.

 

What should I wear?

 

We need to see the area to be able to assess it, so we will ask you to remove clothing on your top half, down to your underwear. Sometimes, it is possible to assess our female patients with a strap top on. Please wear a ‘normal’ bra for your assessment and avoid sports bras that cover a large area of your back or have straps that are too tight to move across to see and palpate what we need to for a thorough assessment.

 

Will it hurt?

 

Honestly, there is likely to be some discomfort during or after your assessment. However, you can ask us to stop at any point and we do not usually need to push you into pain, it’s just an unfortunate side effect of us assessing a painful area.

 

How long will it take to get better?

 

Shoulder pain is notoriously variable. Some patients are better within one session, some take many months or years to reach their full potential. Your physiotherapist will be able to give you a good idea on timescale once they have done a thorough assessment to understand what the likely cause of your pain is.

 

Do I need a scan?

 

Most of our patients don’t have any sort of imaging done. If we are concerned about your progress at any point, we will happily refer you to your GP to have further investigations carried out. Sometimes, a scan is required to understand whether there is a specific problem with the joints/tendons/ligaments/muscles around the shoulder. If you have a suspected frozen shoulder, your GP will often send you for an X-ray to check there isnothing else going on in the shoulder region that could cause your pain.

 

Should I hold off my painkillers before my appointment?

 

No, take your painkillers as normal. We often find that we can carry out a more comprehensive assessment if patients are more comfortable.