What is Shoulder Pain?

Shoulder pain describes any physical discomfort or unpleasant sensations felt around the shoulder region. It can be separated into acute and chronic shoulder pain. Acute shoulder pain describes pain that has recently occurred, such as an injury or a collision to the shoulder. While chronic shoulder pain describes discomfort which has lasted for more than three months. Shoulder is the third most common physical complaint to Australian general practitioners (GPs). According to the University of New South Wales, 19 out of every 1000 Australian adults will report shoulder pain [1]. This roughly extrapolates to 300,000-400,000 people living with shoulder pain. Patients can describe shoulder pain in several ways, including ‘a pinched nerve in the shoulder’, ‘shoulder blade pain’ and ‘pain when lifting arm’. Due to the complexity of the shoulder anatomy and region, there are many structures that could be responsible for this. Shoulder muscles, ligaments, bones, bursae, joints and nerves are just some of the many potential areas that may be responsible.

Shoulder Pain Symptoms

Symptoms related to shoulder pain may vary depending on what could be causing it. Generally, shoulder pain describes any discomfort around the shoulder joints. Examples of common areas of pain include the scapula (i.e. shoulder blade), acromioclavicular joint (i.e. tip of the shoulder) and glenohumeral joint (i.e. the main shoulder joint). Depending on the specific condition and/or injury, the pain can be triggered by specific movements or remain constant throughout the day. Examples of common symptoms that are also reported by those with shoulder pain, include:

Pain when raising to or above shoulder height (sometimes known as a painful arc)
Being worsened by specific shoulder movements (e.g. carrying, lifting, moving, etc.)
Joint stiffness
Shoulder and arm weakness
Numbness and tingling which can also travel down the arm
Pain can vary from dull, achy and sharp

Shoulder Pain Causes

There are several conditions and injuries that can lead to shoulder pain. Examples, include:

Shoulder sprains
Muscle strains
Rotator cuff tears and conditions
Shoulder tendonitis and tendinopathy
Frozen shoulder (also known as adhesive capsulitis)
Shoulder bursitis
Referred nerve pain from the neck
Muscle spasms
Shoulder arthritis (e.g. osteoarthritis, rheumatoid arthritis, etc.)
Labrum tears and injuries
Fractures
Tumours

Tests and Diagnosis

Depending on your circumstances and symptoms, your GP may be able to provide you with a diagnosis. However, you may also be required to undertake additional testing to help guide your treatment plan.

Physical Assessments

After the first part of the consultation, your GP might perform a series of physical assessments for your shoulder. You may be required to expose your shoulder for the GP to assess through telehealth. This may allow your GP to observe your ability for your shoulder to move and perform certain activities (e.g. lifting, carrying, etc.) (if necessary).

Imaging Examinations

Your GP may refer you for imaging investigations to help with a diagnosis. X-rays, MRIs, CT scans and ultrasounds are examples of imaging investigations which can help detect any abnormalities or injuries to the affected area.

Shoulder Pain Treatments

After your GP assesses your shoulder, they may be able to recommend a range of treatment options which may help relief or resolve your shoulder pain. Your GPs recommendations could be based on several conditions, including your age, general health, diagnosis and other treatments that you have tried.

Lifestyle Changes

Outside of physical shoulder injuries, there may be other factors that may be related to your shoulder pain. Examples include, your occupation, posture, previous injuries, stress and your day-to-day habits. As a result, your GP may provide suggestions about how you can prevent and manage your shoulder pain through some strategies around your day-to-day life.

Medications

To help ease your shoulder pain, your doctor may recommend or prescribe pain medications. These medications may allow for better sleep, helping you cope with your daily activities and providing you with immediate relief.

Injections

Your GP may also recommend injections, such as corticosteroid and hydrodilation solutions (depending on your specific shoulder condition) [2]. You may be recommended to a specialist to help guide these injections, with or without ultrasound guidance.

Physiotherapy

Your GP may also recommend seeing a physiotherapist for your shoulder pain. Physiotherapists are qualified health professionals that specifically help patients with physical conditions, such as shoulder pain, back pain and sciatica. By working closely with your GP, your physiotherapist may help you develop a suitable treatment plan for your shoulders. Depending on your injury, your physiotherapist may utilise a range of treatments options, including:

Corrective and strengthening exercises for shoulder pain
Taping
Lifestyle Strategies
Taping
Massage
Manual therapy (e.g. joint mobilisations, manipulations, etc.)
Electrotherapy (e.g. TENS, interferential, etc.)
Dry needling

Medical Specialist

For more severe and/or chronic conditions, your GP may also refer you to an orthopaedic specialist. They will be able to provide you with their expert opinion about what other treatments may be able to assist with your shoulder pain condition (e.g. injections, surgery, etc.).

Recovery

Most episodes of acute shoulder pain are caused by mild strains, sprains and muscular tightness around the shoulder. Typically, these types of injuries will resolve within several days or weeks. However, more severe injuries (e.g. fractures, nerve conditions, etc.) may take several months to recover. Under some circumstances, these types of injuries need an immediate consultation with a medical doctor for urgent assessment and treatment. Chronic conditions that have lasted several months or years may require further medical input to resolve or prevent flare-ups.

Complications

Most signs of shoulder pain are mild and lead to short-term discomfort (e.g. stiffness, aches, etc.). More severe shoulder conditions may lead to more significant complications, including:

Chronic (long-term) pain
Temporarily using a sling to protect the shoulder
The need for surgery to repair the damaged area
Difficulty with essential daily tasks (e.g. personal hygiene, cooking, lifting, etc.)
Difficulty participating in sports, leisure and social activities
Financial hardship from not being able to work

Shoulder injuries and pain that has lingered for more than a week requires immediate oversight from GP. Depending on your circumstances, your GP will be able to help you assess the shoulder area and determine the most appropriate treatment plan going forward.

Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.

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