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Shoulder Pain

MassageShoulder pain, stiffness and weakness are amongst the most common problems seen by our Gosforth Physio and Wellness physiotherapists.

Symptoms may be caused by local structures within or around the shoulder, or be referred from other sources including the neck or upper back. This is why it is vital to have an expert assessment to understand the exact nature and reason for your pain, stiffness or weakness

Whatever the source of your symptoms, an inability to fully move your shoulder or a sore and painful shoulder can be very frustrating.

The good news is that it’s simple to fix in the majority of cases.

Causes

In most cases, if you are suffering shoulder pain it may because your muscles are simply not strong enough or they are imbalanced.

This is mainly due to the shoulder joint being the most mobile joint in the body. If you think about how much it actually moves and how often we use it, it makes sense that we may encounter a problem or injury with it at some point in our lives.

Shoulder instability can lead to numerous other conditions such as impingement, tendonitis or a muscle tear. However, the pain may also be referred from trapped nerves (neck), or may be the onset of a frozen shoulder or osteoarthritis.

Impingement

Shoulder impingement is pain from compression of soft tissues in and around the shoulder. The rotator cuff tendons and the subacromial bursa (fluid filled sack), become inflamed and painful between the upper arm bone (humerus) and roof of the shoulder (acromion) during certain movements of the shoulder, such as arm elevation.

Tendonitis

Rotator cuff tendonitis can lead to damage, inflammation and degeneration to one or more of the rotator cuff tendons. This is usually due to gradual wear and tear associated with over-use; however, it may also occur traumatically due to a specific injury.

Tendonitis can occur at any age, although it is usually seen in patients between the ages of 40 and 60 and usually in association with impingement or bursitis.

Rotator Cuff Tear

A tear of one or more rotator cuff muscles or tendons may occur, causing weakness and / or pain in the shoulder. This is usually during or after a pushing, pulling or lifting activity or a sudden movement often with the arm held overhead.

Pain in the shoulder may radiate into the upper arm and sometimes and may increase during lifting activities, especially with the arm outstretched or above the head when lying on the affected side.

Referred Pain

Pain referred into the shoulder from another source – such as the neck or upper back – may radiate symptoms above or below the shoulder, such as the neck, upper back, arm, elbow, forearm, wrist or fingers. This may lead to pins and needles or numbness in the affected arm or hand with some reduced grip strength.

Frozen Shoulder

Frozen shoulders are not as common as the above conditions; they are rare in people under 40 years old and peak at 56 years. They occur slightly more in females than males, with the non-dominant shoulder slight more affected.

Frozen shoulder can be extremely debilitating with high inflammation, scarring and tightening of the connective tissue surrounding the shoulder joint. This will generally lead to severe shoulder pain, extreme stiffness and a very restricted shoulder movement. Approximately 5 years after resolution 6-17% of people may be affected in the opposite shoulder!

Early treatment leads to a better and quicker resolution.

There are three phases of frozen shoulder; and each can last for a number of months (18-36 months total).

• Freezing (2-6 months)
During the first phase of a frozen shoulder, pain is the most dominant complaint, with the shoulder being painful with most movements. The shoulder generally begins to start to stiffen during this phase.

• Freezing (4-12 months)
During the second phase stiffness is the main complaint, with loss of movement of the shoulder and pain levels generally reducing during this phase. Patients typically experience difficulty when elevating the arm or taking their hand behind their back. This is where the scarring of the shoulder joint capsule occurs.

• Thawing (12-36 months)
During the final phase, there is spontaneous improvement; however, range of movement may not be full and pain / stiffness may still persist to some level. The shoulder will gradually be restored with minimal pain, but some will never gain full range of movement again.

Good news

You can take very quick and safe steps to prevent or alleviate most shoulder pain episodes.

Our physiotherapists at Gosforth Physio and Wellness are highly skilled experts in diagnosis, treatment, education and prevention of mechanical shoulder pain. Early diagnosis and treatment is essential to aid speedy recovery from shoulder pain and help prevent its recurrence.

The majority of shoulder dysfunctions can be normalised after a quality assessment and injury-specific treatment and exercises.

Treatment

We use our head before we use our hands!

At Gosforth Physiotherapy and Wellness we are specialists in assessment, diagnosis, treatment and education of pain and dysfunction from neuro- musculoskeletal shoulder conditions. Once a detailed assessment is completed and we have established your diagnosis, all appropriate treatment options will be discussed with you.

You can be sure that you’re placing your health in the right hands.

Treatments include:

  • Manual Therapy
  • Mobilisation
  • Manipulation
  • Acupuncture
  • Dry needling
  • Massage
  • Taping
  • Soft Tissue Release
  • Trigger Point Muscle Release
  • Muscle Energy Techniques
  • Postural Education / Advice
  • Postural Strengthening

Physiotherapy treatment for frozen shoulder depends on what stage you are in, and is tailored to your specific needs.

For all shoulder conditions you will be taught specific strengthening, stretching and Pilates exercises to perform at home to enhance and speed up your recovery, allowing you to effectively self manage your problem.

It is very rare that an MRI scan or X Ray is required. However, if your Physiotherapist or you feel that further investigation is necessary we can arrange private scans quickly. Referrals can be arranged in 2-5 days at The Newcastle Clinic and at North Tyneside MRI Centre.

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