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Shoulder pain

Shoulder pain is very common. One in three people will experience shoulder pain at some point in their lives. Although shoulder pain can be very uncomfortable it is rarely serious and will normally settle within 6-12 weeks without any treatment.


Common causes

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

  • A sprain/strain or injury such as a fall onto your shoulder.
  • 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.
  • Following a period of increased stress, worry or low mood.
  • Following a period of poor sleep, fatigue or feeling run down.
  • Other lifestyle factors such as being overweight and smoking.
  • A flare up of longstanding shoulder pain.


Common symptoms

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.
  • Waking in the night especially if laying on the painful side.

You may experience constant or intermittent (comes and goes) symptoms that are aggravated by certain activities and reduced by others.


What can I do to help it?

  • 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.
  • Try to stay 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.

Try some of these self-help tips to aid your recovery:

  • Apply a heat or icepack to the painful area – for up to 15 minutes. Never apply heat or ice directly to the skin.
  • A short course of simple pain medication as advised by your pharmacist or GP may help reduce pain and allow you to move more comfortably.
  • 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.


Facts about shoulder pain

  • 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.
  • An exercise programme is just as effective as surgery for many shoulder conditions in the long term.
  • Steroid injections may offer short term pain relief for some shoulder conditions. However, only 1 in 5 people will experience pain relief after an injection.
  • Your shoulder pain can often improve with the right management. So even if you have had it a long time regardless of your age, DO NOT give up and get a good plan that you can stick to.


When should I seek medical advice?

Call your GP surgery if

  • Your pain is getting worse.
  • You have tried 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.


Do I need an X-Ray or scan?

  • 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.


Do I need a fit note?


Useful websites and resources

Reproduced with kind permission by the author, Professor Jeremy Lewis.

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