Shoulder

A number of factors have been associated with shoulder pain. These include:

• A sprain/strain or injury such as a fall onto your shoulder, lifting, awkward movements etc. 
• A sudden increase or decrease in your normal activity or exercise levels.
• Muscle weakness.
• Nerve irritation - pain travelling from the neck into the arm and sometimes affecting the hand.
• Other conditions such as osteoarthritis, rheumatoid arthritis or fibromyalgia.
• Increased stress, worry or low mood.
• Poor sleep, fatigue or feeling run down.
• Other lifestyle factors such as being overweight and smoking.
• A flare up of longstanding shoulder pain.
• Often frustratingly no specific reason. 

These include:

• Pain around the front, side or back of the shoulder. Sometimes pain may travel to or from the neck and arm.
• Restriction in movement and or strength in your shoulder and arm.
• Disturbed sleep in the night especially if laying on the painful side.

You may experience constant or intermittent (comes and goes) symptoms that are made worse by certain activities and eased by others.

• In the first few days after an onset of shoulder pain changing or reducing your usual activities may help. However, there is strong evidence that keeping active and gradually returning to all your usual activities and exercise will help you recover.
• It is normal to experience some pain during your recovery, but it does not mean you are damaging your shoulder.
• It is recommended to try to continue at work or return as soon as you are able. Your employer, GP or health practitioner will be able to advise on how to return to your normal work duties.

Self help tips

• Apply a heat or icepack to the painful area – for up to 15 minutes. Never apply heat or ice directly to the skin.
• Pain medication can help to reduce the pain and help you move more comfortably, which can help your recovery. Speak to your local pharmacist about medication or other methods of pain relief . It’s important to take medication regularly.
• Keep moving. Regular movement and exercise is safe and helpful for shoulder pain. It is important to build up gradually – the exercise or activity you enjoy most, is likely to help your recovery.
• Try and get a good night’s sleep –place a pillow along your back to stop you rolling onto your painful side.
• Good sleep habits and managing stress may help you cope better with your pain.

Please see our condition specific self help guides below, with exercises and management advice for you to try to self manage your condition. 

TBC

• Shoulder pain is common WITHOUT any damage to the joint.
• X-rays and scans often DO NOT show the cause of your pain.
• Creaking or clicking sounds are common in the shoulder and are RARELY a sign of harm or damage.
• Your shoulder can become stronger and healthier with regular movement and exercise.
• Improving your sleep and general health is all also important for your shoulder pain.
• Research proves an exercise programme is just as effective as surgery for many shoulder conditions in the long term.
• Your shoulder pain can often improve with the right management.

Call your GP surgery if:

• Your pain is getting worse.
• You have tried daily the self-help tips for 3-4 weeks and your symptoms have not improved.

Seek immediate medical advice if:

• You have had a significant injury such as a fall from a height or a blow to the arm and are unable to lift your shoulder and/or arm.
• You have sudden loss of power and/or feeling in one or both arms.

• X-rays or scans are NOT usually required to diagnose shoulder pain.
• X-rays or scans are NOT able to tell us how much pain you are experiencing.
• X-rays and scans often show osteoarthritis, rotator cuff tears, tendinopathies and bursitis which are common in people WITHOUT shoulder pain and is unlikely to change the way you manage your pain.
• X-rays and scans are best used where a serious injury (e.g. a broken bone) or conditions such as cancer or infection are suspected.

• If you’re off work sick for seven days or less, your employer will normally ask you to complete a self-certificate for sick leave as soon as you return to work.

• If you're off work sick for more than seven days your employer will normally ask for a fit note (or Statement of Fitness for Work) from your GP.

• You can read more information here: Getting a fit note (www.nhs.uk)

• British Elbow & Shoulder Society
• Versus arthritis shoulder pain booklet
• Arthritis Research UK shoulder exercises

Maintaining a healthy lifestyle

Making healthy lifestyle changes can help you improve your overall health and wellbeing. Some of the main areas to address are shown below:

Exercise - NHS

Healthy weight - NHS

Tips to help you lose weight - NHS

Fall asleep faster and sleep better - Every Mind Matters - NHS

Eat well - NHS

Alcohol advice - NHS

Quit smoking - NHS

Mental health - NHS

Psychological talking therapies - LSCFT

Mental health support for veterans, service leavers and reservists - NHS

It’s important to consider addressing these lifestyle changes alongside your physiotherapy treatment. Your clinician will be able to offer further advice or signpost you to other organisations or local services for further support with improving your wellbeing.