Ouch, my shoulder really hurts :-(

We don’t realise how important our shoulders are or how much we use them until we have pain… Brushing your hair, grocery shopping, lifting your baby, doing up your bra, making a cup of coffee or tea, sleeping at night.

Shoulder pain

Shoulder pain can either come on suddenly or gradually build up to become quite intense over time.

The common causes of shoulder pain are:

  1. Poor posture – if your shoulders are rounded day after day, it can place the shoulder joint in a position where the muscles and tendons can get compressed or pinched.
  2. Repetitive overhead reaching – the space between the shoulder tendons and shoulder blade gets smaller and smaller, eventually pinching the tendons underneath the shoulder blade.
  3. Trauma – a fall onto an outstretched arm, directly on the the shoulder or even a sudden jerky movement of the arm can result in a strain or tear to the muscles or tendons in the shoulder.
  4. Natural ageing or degeneration – with age the tendons of the rotator cuff muscles can degenerate or begin to develop arthritis (wearing down and inflammation in the shoulder joint).

Do you need to receive a diagnosis and/or get a scan?

Researchers did a study looking at imaging as a tool for diagnosing shoulder injuries. They took a group of people without shoulder pain and a group with shoulder pain. They got every person to have a shoulder scan and asked radiographers (the people taking the scans) to predict which people experience shoulder pain, based on their scans.

The study found that the radiographers could not accurately predict which people had shoulder pain and which didn’t. This is because they found that people who show shoulder injuries on a scan can often experience no pain, whilst some people who experience a high level of shoulder pain often show nothing on a scan!

TAKE HOME MESSAGE: Scans do not give us a great idea of what is going on with your shoulder, nor are they indicative of how much pain you are experiencing. This may be why your physiotherapist or doctor does not initially recommend you rush out to get one. You will receive quality and effective treatment without a firm diagnosis.

So how can we find out what is going on with your shoulder and where do we go from there?

Acute shoulder pain is very often successfully assessed and managed with conservative treatment (such as physiotherapy).

A physiotherapist will look at your movement, function and perform a series of special tests to determine the cause of your pain and the management plan. One of the first things a physiotherapist may try to determine is whether your presenting injury is more about pain, or stiffness or both.

The first step of treating acute shoulder pain is usually reducing any inflammation and managing your pain. This can be done with anti-inflammatories (consult your GP before taking any medication), ice and activity modification.

Once your pain is under control, we can get to work strengthening your shoulder muscles and improving your shoulder range of movement so you can get back to performing your daily activities without restriction.

If you are experiencing shoulder pain, BOOK ONLINE or contact us on 8555 4099 to book a consult with one of our physiotherapists.


Written by Gabi Levitan, Physiotherapist.