Shoulder Pain Relief: A Physiotherapy Guide

Shoulder pain is a common issue that can significantly impact daily life. In this blog post, we will explore various aspects of shoulder pain, including the most common conditions and the role of physiotherapy. We will also discuss the common signs and symptoms, and effective self-management strategies. We'll also introduce eMed physiotherapy as an innovative solution to make quality care more accessible for helping your shoulder pain.

Types of shoulder pain: 

Shoulder pain can arise for a number of reasons and due to different structures around the shoulder. Physiotherapy assessment will aim to identify the likely cause and offer a comprehensive tailored approach based on your presentation. Here are some of the top causes of your shoulder pain.

1. Subacromial Pain: This refers to pain inside the shoulder joint, known as the subacromial area, and is commonly due to inflammation of structures including the bursa, the fluid-filled sac that cushions the shoulder joint), the rotator cuff (group of tendons and muscles that give the shoulder stability).  The cause of pain is often due to muscles surrounding the shoulder being weak or overloaded.
   Symptoms: Weakness, pain with arm movement especially as raising arm upwards, difficulty lifting, pain lying on that side. 
2. Frozen Shoulder (Adhesive Capsulitis):Frozen shoulder is characterized by the gradual development of stiffness and reduced range of motion in the shoulder joint, caused by inflammation of the joint capsule.
   Symptoms: Gradual stiffness, limited range of motion, pain at rest and lying down.
3. Instability (Dislocations/Subluxations):Shoulder instability refers to when the shoulder joint is prone to dislocations or subluxations, resulting in a feeling of the shoulder "slipping" and recurrent episodes of pain.
   Symptoms: Feeling of shoulder being unstable and “slipping out of place", recurrent dislocations, shoulder pain.
4. Osteoarthritis: Osteoarthritis in the shoulder involves the age related gradual change in the joint cartilage at the end of your bones, leading to stiffness, pain during movement, and reduced range of motion
   Symptoms: Joint stiffness, pain with movement, reduced range of movement.
5. Fractures: Shoulder fractures, often caused by trauma like a fall, resulting in sudden and intense pain, swelling, bruising and limited mobility due to the breakage of bone within the shoulder joint.
   Symptoms: Sudden intense pain, swelling, bruising, limited mobility.

Read more: Unravelling Scoliosis: How Physiotherapy Can Make a Difference

What Can a Physiotherapist Do to Help?

Physiotherapists play a crucial role in managing shoulder pain by taking a detailed history, and assessing the shoulder to decide on the best management strategy.  Treatment usually involves a combination of exercises for strength and mobility, and sometimes manual techniques. Shoulder rehabilitation programs focus on improving strength, flexibility, and mobility. Physiotherapy aims not only to relieve pain but also give advice on self management strategies, prevent future injuries and enhance overall shoulder function. This is why hands-on treatments alone are rarely enough. 

Referred shoulder pain from the neck:

Referred shoulder pain from the neck typically arises when pain originating in the cervical spine (neck) radiates or is perceived in the shoulder region. This is usually linked to inflammation of soft tissue structures around the neck, or the nerves that come from your neck being irritated, often termed a ‘trapped nerve’. The referred pain can be sharp, achy, or even feel numb, and it may be accompanied by other symptoms such as tingling or weakness in the arm. Accurate diagnosis is therefore crucial to identify the underlying cause of your shoulder pain, and advise on an appropriate course of treatment, which may include physiotherapy. 

When to Seek More Urgent Help:

While physiotherapy is effective for many shoulder conditions, certain symptoms may indicate the need for urgent medical attention. Please seek urgent medical attention if you have a sudden severe shoulder pain, you cannot move your arm, your shoulder looks different or is very swollen, your arm or shoulder is hot to touch,  you have constant pins and needles or numbness in your arm or shoulder, your pain started after an accident or fall, or you feel feverish or unwell. Other things like shoulder pain linked with chest pain or difficulty breathing should also prompt urgent medical assessment.

These can be signs of something serious. You can call 111 or get help from 111 online. Or go to your nearest urgent treatment centre. 

Myth Buster:

Dispelling myths is crucial for informed decision-making. One common myth is that rest is the only solution for shoulder pain. While rest may be beneficial initially, it often doesn’t resolve the problem, as in that time muscles weaken and movements can become stiff. Targeted exercises and physiotherapy play a crucial role in long-term pain relief and functional improvement.

How Long Does shoulder pain last?

The duration of shoulder pain management varies depending on the severity and underlying cause. Consistency in following prescribed exercises and lifestyle modifications is crucial for optimal outcomes. While some individuals may experience relief within a few weeks, a more extended treatment plan may be necessary for others.

How to Effectively Self-Manage:

Physiotherapists empower patients with tools for self-management. This includes arm pain exercises, shoulder mobility exercises, and specific routines to improve shoulder function. Self-management also involves maintaining good posture, incorporating heat or cold therapy, and adopting lifestyle changes to prevent further issues.

eMed Physiotherapy:

eMed physiotherapy offers a brilliant solution to seeing a physiotherapist. It offers accessible and convenient care despite busy schedules or geographical constraints. Through virtual consultations, patients can receive expert assessment and guidance, personalized exercise plans, and ongoing support from the comfort of their homes. eMed physiotherapy consults are carried out by qualified highly trained physiotherapists, ensuring individuals can get immediate advice on the best management of their symptoms. 

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Shoulder pain is a complex issue, but with the right physiotherapy assessment you can get the right intervention and self-management strategies, find relief and regain function. eMed physiotherapy allows access to quality care, making it easier for those experiencing shoulder pain to embark on a path towards recovery. If you're dealing with shoulder pain, consult with a physiotherapist and explore the benefits of a comprehensive approach to shoulder pain relief.

References

• American Physical Therapy Association. (2018). American Physical Therapy Association (APTA). Retrieved from https://accessphysiotherapy.mhmedical.com/content.aspx?bookid=2976&sectionid=250220169[17].
• Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/
• National Institute for Health and Care Excellence. (2020). Type 2 diabetes in adults: Management (NICE Guideline NG28). Retrieved from https://www.nice.org.uk/guidance/ng28/resources/type-2-diabetes-in-adults-management-pdf-1837338615493[18].
• National Institute for Health and Care Excellence. (2021, June 14). Autism spectrum disorder in under 19s: support and management. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK11822/[16].

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• Journal of Orthopaedic & Sports Physical Therapy
• The Journal of Bone & Joint Surgery
• Physical Therapy Journal
• World Health Organization (WHO)
• Chartered Society of Physiotherapy (CSP)
• American Physical Therapy Association (APTA)