Shoulder pain

Shoulder pain can be extremely disruptive. The shoulder joint, or glenohumeral joint, and it’s surrounding structures are complex and often highly sensitive. We can categorise shoulder issues in a variety of ways and we can experience pain or dysfunction in our shoulders for an array of reasons. However, often these issues are not specific to a particular tissue, structure or reason, giving us more generalised symptoms and dysfunctions. It can often be helpful to consider these issues as ‘non-specific shoulder pain’ or simply a ‘stiff and painful shoulder’ or a ‘weak and painful shoulder.’ Either way, understanding your shoulder pain is the most important first step of treating it.

  • Subacromial shoulder pain, classically referred to as ‘impingement’ refers to pain in the front of the shoulder which can often be tendon related, or secondary to overuse or weakness around the shoulder.
  • Shoulder instability: This may be pathological or as a result of an injury which has created laxity or reduced congruency of the structures which provide stability to the shoulder joint, such as a dislocation.  This can increase friction and irritation in and around the shoulder joint.
  • Tendinitis or bursitis: Inflammation of the tendons of the shoulder joint or the bursae (fluid-filled sacs that provide smooth movement and cushioning) which cover most of the joint.
  • Rotator Cuff Injuries: Tears or strains in the muscles and tendons that stabilise the shoulder joint can lead to pain and can often significantly restrict range of motion.
  • Frozen Shoulder (Adhesive Capsulitis): A condition which is classically identified by profound stiffness and very limited range of movement.
  • Arthritis: Shoulders are susceptible to degeneration referred to osteoarthritis or rheumatoid arthritis which is characterised by inflammation, pain and stiffness.
  • Nerve issues: Conditions like thoracic outlet syndrome or nerve irritation in the shoulder, brachial plexus or neck can lead to pain but is typically identified as tingling or numbness in the shoulder, arm or hand.

The symptoms of shoulder pain can vary based on the underlying cause, but commonly include:

  • Dull, aching, or sharp pain in the shoulder area.
  • Weakness in the affected arm or difficulty lifting objects.
  • Limited range of motion or difficulty moving the arm.
  • A feeling of stiffness, meaning it is difficult to take the shoulder through the range of movement which is available
  • Swelling, tenderness, or warmth around the shoulder.
  • Numbness or tingling radiating down the arm.
  • Clicking or popping sensations during movement.
  • Trauma: Direct impacts, falls, or accidents can cause fractures, dislocations, and soft tissue injuries in the shoulder area which can result in tendon injuries, bony or joint injuries.
  • Overuse: Repetitive motions, such as those involved in sports like tennis or swimming, or occupational activities like lifting heavy objects, can lead to muscle strains, tendonitis, and other overuse injuries.
  • Dislocations: The shoulder joint can become dislocated when the ball-shaped head of the upper arm bone pops out of the shoulder socket.
  • Sprains: Ligaments that connect bones can be stretched or torn, causing sprains and instability.
  • Nerve Injuries: Nerves in the shoulder region can be pinched, compressed, or injured, leading to pain, numbness, or weakness.
  • Osteoarthritis: Over time, wear and tear on the shoulder joint can lead to osteoarthritis, causing inflammation, pain, and reduced range of motion.
  • Calcific Tendonitis: This occurs when calcium deposits form in the tendons of the shoulder, leading to inflammation and pain.
  • Referred Pain: Pain originating from other areas but felt in the shoulder due to shared nerve pathways.
  • Physiotherapy: Tailored exercises programming, movement re-education and manual therapies like massage and mobilisations improve shoulder strength, function and range of movement.
  • Activity Modification: Avoid activities that aggravate the pain and give the symptoms time to settle down
  • Anti-Inflammatory Medications: Prescription medications to reduce inflammation and pain.
  • Lifestyle Changes: Improving posture, maintaining a healthy weight, and avoiding overuse can prevent recurrence.
  • Education and Self-Care: Learning proper body mechanics, posture, and self-care techniques can help prevent future issues.
  • Shockwave: In some cases, particularly if the issue is tendon related, 

To address shoulder pain, you can start by consulting a few different types of healthcare professionals, depending on the severity and potential underlying cause of your pain:

  • Physiotherapist: A physiotherapist is often the most helpful first port of call for shoulder pain.  They are healthcare professionals who specialise in anatomy, structure and function of joints.  They can provide individualised guidance on rehabilitation exercises, activity modification and  symptom management to improve shoulder pain and function.  In cases where physiotherapists can’t help, they are best placed to make an accurate recommendation on which health professional you should see instead.
  • GP: GP’s can evaluate your condition well in the context of your overall health and medical background.  They can often provide basic initial treatment and refer you to specialists if needed.
  • Orthopedic doctor: If your pain is related to musculoskeletal issues or injuries, an orthopedic doctor specialises in the diagnosis and treatment of bone and joint conditions, including shoulder arthritis or serious joint disorders.
  • Pain Management Specialist: For more persistent or chronic pain, a pain management specialist can offer comprehensive approaches, including medications, injections, and therapies.

Yes, exercise can be beneficial for shoulder pain.  Exercise can help improve shoulder strength, flexibility, and range of motion, which can aid in recovery and reduce the risk of or improve preparedness for future issues. However, the type and intensity of exercises should be tailored to your specific condition and guided by a healthcare professional.

  • Strengthening Exercises: Strengthening the muscles around the shoulder can provide better stability and support. Examples include resistance band exercises, dumbbell exercises, and bodyweight movements.
  • Mobility or stretching exercise: Gentle stretches can help maintain or improve shoulder flexibility. Stretches should be done carefully to avoid further strain.
  • Cardiovascular exercise: Engaging in low-impact cardiovascular activities like walking or stationary cycling can improve overall circulation and support the healing process.
  • Stability Exercises: These exercises can help improve your overall shoulder function and coordination, particularly for ‘unstable’ shoulders such as those which have suffered dislocation

Whether or not you’ll need surgery for shoulder pain depends on several factors, including the underlying cause of your pain, the severity of your condition, and how well you respond to conservative treatments. In many cases, shoulder pain can be effectively managed without surgery. Conservative treatments, such as rest, physical therapy, medications, and lifestyle modifications, are often the first line of approach.

Surgery is typically considered when:

  • Structural Issues: Conditions like recurrent shoulder dislocations, certain types of impingement, and joint instability might necessitate surgery to stabilise or correct the structural problem.
  • Nerve Compression or Damage: In cases of severe nerve compression or damage, surgery might be needed to relieve pressure or repair the nerve.
  • Acute Trauma: Traumatic injuries, such as complex fractures or dislocations, might require surgical intervention for proper healing.

Chews Health top tip for shoulder pain

Make sure you and your clinician have gotten to the bottom of what is causing your shoulder pain.  This does not mean you always need to know the specific tissue, muscle, tendon or bursa which is affected.  Often, boiling your shoulder issue down to ‘non-specific’ or ‘weak and painful’ or ‘unstable’ or ‘stiff and painful’ are specific enough criteria to be able to formulate a thorough and rigorous treatment plan.

Everyone’s condition is unique and therefore needs a tailored plan to help resolve it.  This must be tailored to your needs, working on what you struggle with in the areas and positions you struggle in. 

Our Specialists

Melanie Clarke
Melanie Clarke
2023-02-22
We’ll be forever grateful to Chews, the guys are the absolute BEST IN CLASS when it comes to a fully tailored recovery plan. Our son is a young elite competitive acrobatic gymnast who sadly had a high impact fall at gymnastics dislocating and fracturing his elbow and needed surgery, for a gymnast that trains many hours over 4 days week it was devastating blow, especially with GB competitions coming up. Once out of cast (wk 4 post opp) we started 2 x weekly physio sessions with Richard Saxton (who specialises in child’s physio), he was thorough, diligent and his amazing assessments fully supported the coaches at our sons gym to help build a safe recovery plan. The sessions with Richard and Sanford were fun, engaging and they took great care to help improve full mobility and strength. At week 7 post op our son was doing skills we thought would have taken 4mths to achieve, by week 10 he was back to full impact training, even our hospital follow up with the senior elbow consultant was blown away by the physio support we’d had and the rapid recovery. If it wasn’t for Chews we 100% would not be back training this quickly and not have had the reassurances it was safe to do so…..we’ve definitely found a physio for life. Thank you from the bottom of our hearts Team Chews. From Mel & JJ x x
Ruth Shearn
Ruth Shearn
2023-02-21
Have waited a few months post-treatment to write a review - just to be certain! Quite simply, I can't recommend these guys highly enough. I went to them with two badly damaged knees (miniscus tears). Having had three arthroscopes over the years, I was completely resigned to needing surgical intervention again. The Chews team had different ideas. After showing me the latest research findings, they assured me my knees could be rehabilitated without a scalpel. I had just a handful of sessions with them and am delighted to report that, six months on, my knees are great! I'm running 5k twice a week (don't laugh, I loathe running and am no spring chicken) without any pain and have taken up tennis. Everyone at Chews is passionate about their subject, knowledgeable, reassuring and friendly. I wouldn't go anywhere else.
Dave Stuart
Dave Stuart
2023-02-06
I have had a chronic back condition to varying degrees for many years which more recently has forced me to have weeks off work at a time. I was recommended Chews Health by a colleague having tried other physios in the past. However, I always felt that something was missing from the plan. My back muscles would on occasion go into spasm, or my disk to impinge on my nerve, affecting my mobility and effectively setting me back to square one. I came to Chews health a bit wary and was considering surgery due to how much my back was affecting my quality of life and mental health. It has not been a straight forward recovery, but i have made significant progress through having a thorough history taken, my ongoing concerns listened to, and being provided with a clear explanation of not only the exercise plan but additionally explaining why my body was responding in varying ways. This has educated about my condition and provided me with the tools to self manage my condition more effectively should it deteriorate again.. It has not been plain sailing, but I have absolute faith in Jack and his team.
lobo
lobo
2023-01-09
I had to attend Chews Health for help with pain in my elbow and they have been a fantastic help. I am now back to 100%.
The S
The S
2023-01-05
I can thoroughly recommend Chews Health physio. Sessions from diagnosis to rehabilitation are stimulating as well as therapeutic. Jack’s holistic, insightful approach goes beyond fixing the initial problem - he builds the confidence and self-knowledge to help maintain fitness and avoid strains and niggling injuries in the future. His message that the body needs exposure to regular challenges has inspired my journey towards optimum health.
Sam Butler
Sam Butler
2022-12-21
Excellent physiotherapy. After ACL and meniscus surgery I contacted Chews Health to find out about how they could help me feel more confident about returning to more intense sport after my injury. I felt listened to and we worked on a series of different of exercises that tested my knee. Very helpful and I now feel much more confident in my abilities.
feralie Bennett
feralie Bennett
2022-11-23
I saw Richard Saxton for a chronic pain in my achillies. 2 visits, with massage and exercises: clear concise instruction, both written and verbal to do at home were realistic & adapted for my ability - I now no longer require pain relief & can walk the dogs pain free & even manage a few hills. A follow up call to review my progress was also appreciated. The clinic was clean & well equipped. Would highly recommend.
Philip Conroy
Philip Conroy
2022-11-16
When I had severe back pain I was seen within 24 hours. The problem was resolved after 3 weeks of physiotherapy and exercises. I subsequently took up the annual gym membership package which includes regular reviews by the Physiotherapists. I feel this has benefitted me greatly as I had no previous experience of gyms and ensured I was using the equipment in the correct manner. At all times the staff have been very friendly and professional.
Maureen Morris
Maureen Morris
2022-11-10
Helped me tremendously. Lovely people - everyone very very supportive.
Cecilia Wright
Cecilia Wright
2022-10-31
I had been suffering from plantar fasciitis for some months and went Chews Health in the summer for shockwave treatment, after my podiatrist said she had heard good reports about it. Until then I had been resting, exercising it, icing it, using insoles etc., none of which had made much difference. I booked six treatments at the start (recommended) and by the time of the last treatment It was hardly noticeable, so much better! I’ve had two further treatments over the last month, just to be on the safe side, and I’m doing some exercises now to build up the strength in my calf and foot. Chews Health comes with heartfelt recommendations from me, they are friendly, very knowledgeable and best of all - they have fixed my sore foot!