Shoulder problems are very common and there are many different causes for pain. The shoulder is the most mobile joint in the body and therefore is also the most unstable making it prone to stress and strain. It is often affected by painful problems that limit movement, especially such things as brushing or washing your hair, putting a jacket on or lying on the painful shoulder at night.

Movement takes place at the main shoulder joint (glenohumeral joint) as well as the shoulder blade which moves over the back of the chest. A group of specific muscles called the rotator cuff plays a very important part in the working of the shoulder, helping to move it and hold the joint together.

Where is the pain coming from?

Not all pain felt in the shoulder region actually comes from a problem in the shoulder joint. When there is a problem in the shoulder joint, pain is often felt over the front of the shoulder, upper part of the arm or around the shoulder blade. It can also refer pain so that you feel it spreading down the arm to the elbow. However, if the pain spreads further or if you have tingling or pins and needles then the pain is most likely coming from a problem in the neck. If the pain is more at the side of the neck then there is often a problem in the neck. Pain at the top of the shoulder joint may also come from a small joint at the end of the collarbone (the acromioclavicular joint or ACJ).

Inflammation around a tendon or capsule of the joint can be a source of shoulder pain. This is one of the more common reasons for shoulder pain. Arthritis in the shoulder joint is uncommon. Each shoulder problem has its own pattern which helps give an indication of where the problem is, thus helping the diagnosis. Most conditions cause pain with use and movement, and it is always helpful to note which movements or activities are most painful. Many people have difficulty sleeping as it is often very painful to lie on the affected shoulder.

What should I avoid?

Try to avoid movements that are painful as this can lead to more inflammation. Movements that are especially provoking are those that hold you arm away from your body and above shoulder height for prolonged periods. When lifting your arm up you can reduce the strain or pull by remembering the following points:

• Keep your elbow bent and in front of the body.
• Keep your palm facing the ceiling when you reach up.
• To lower your arm, bend your elbow, bringing your hand nearer your body.

Also check your posture as it can be tempting to sit leaning forwards with the arm held tightly close by your side. This can actually make the problem worse especially if the pain is coming form your neck. When sitting try to have your arm supported on a cushion on your lap.

"most shoulder pain comes from the soft tissues around the joint"

For most people an x-ray is not needed to diagnose the problem, they are often normal even if you have severe pain. This is because most shoulder pain comes from the soft tissues around the joint (muscles, tendons, capsule, cartilage etc) which then cause the shoulder to become restricted.  If a tear is suspected in one of the rotator cuff tendons then a scan is very useful.

What is a ‘Frozen Shoulder’?

A frozen shoulder is where the tissues around the joint tighten and stop you from moving the shoulder – the correct name is adhesive capsulitis. There is no actual change in temperature the name purely means that the joint cannot be moved.

There are three main stages:

Stage 1: involves severe pain although there is still considerable movement.

Stage 2: movement becomes very limited and makes normal activities very difficult.

Stage 3: inflammation reduces and more movement is possible, however there is often still a lot of pain.

Frozen shoulders can follow an injury or can just happen suddenly those who have diabetes are more prone to it.

Frozen shoulder usually lasts for 18 months to 2 years. Chiropractic treatment can help reduce the pain and give you back the movement.  Once the pain begins to ease it is important to regain your shoulder movement which can be helped with some home exercises that your chiropractor will recommend.   

Chiropractic treatment is effective in treating shoulder problems, it is always best to seek treatment early so as to prevent compensatory problems occurring in the neck and spine. We will carry out a thorough physical examination which will target the structures involved and find out what the problem is. The treatment is then tailored to your individual complaint and advice will be given on activities to avoid, stretches and home exercises.