Shoulder pain - Arthritis Research UK | Arthritis Research UK

28 Pages·2013·1.5 MB·English

Condition
Shoulder pain
Shoulder pain
This booklet provides information
and answers to your questions
about this condition.
Arthritis Research UK
produce and print our
booklets entirely from
charitable donations.
What is
shoulder pain?
The shoulder is the most mobile
joint in the body and can be
affected by a number of painful
conditions. In this booklet we’ll
explain what causes shoulder pain
and what you and your healthcare
team can do to ease the problem.
We’ll also suggest where you can
find out more about coping with
shoulder pain.
At the back of this booklet you’ll find a brief glossary of
medical words – we’ve underlined these when they’re
first used.
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Arthritis Research UK
Shoulder pain
What’s inside?
2 S houlder pain at a glance
5 H ow does the shoulder work?
5 W hat causes shoulder pain?
6 S hould I see a doctor?
6 What can I do to help myself?
– Painkillers
– Ice
– Rest and exercise
– Posture
– Reducing the strain
– Complementary medicine
10 H ow are shoulder
problems diagnosed?
– What tests are there?
12 Specific shoulder conditions
16 W hat treatments are there
for shoulder pain?
– Physical therapies
– S teroid injections
– Surgery
19 R esearch and new
developments
20 Glossary
21 Where can I find out more?
24 We’re here to help
At a glance
Shoulder pain
Most shoulder
problems only
affect a small area
and don’t last
very long.
Shoulder problems are very common
but they’re not usually caused by arthritis
and they generally improve in a relatively
short time and with simple treatments.
In most cases you won’t even need
to see your doctor.
What can I do to help myself?
How is it diagnosed?
There are several ways you can help
A diagnosis is usually based on your
yourself, including:
symptoms and an examination of your
• taking painkillers shoulder, but may sometimes require:
• applying an ice pack • blood tests
• balancing rest and exercise • x-rays, ultrasound or magnetic
• checking your posture resonance imaging (MRI) scans
• thinking about whether your daily • nerve conduction tests.
activities might be contributing to your
shoulder problem and what you can
What causes it?
do to reduce the strain.
The shoulder is a complex structure,
and pain can be caused by problems
When should I see my doctor?
with the muscles, tendons and other soft
tissues or by arthritis in the joints of the
You should see your doctor if:
shoulder. Sometimes pain in the shoulder
• you have severe pain after is related to a problem in the neck.
a definite injury
• you have severe pain or stiffness in both
shoulders
• you also feel feverish or
generally unwell.
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Arthritis Research UK
Shoulder pain
What treatments are there?
The usual treatments include:
• painkillers and anti-inflammatory
tablets
• physiotherapy and exercise.
Other treatments are sometimes
needed, such as:
• steroid injections
• surgery.
What else might help?
Pay careful attention to your posture
both at work and at home.
Shoulder pain isn’t always
caused by a problem in
the shoulder. For example,
problems in the neck can
cause a pain or tingling
across your shoulder blade.
Other causes may
include damage to
muscles, tendons
and the capsule,
or arthritis.
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Shoulder pain
How does the There’s also a smaller joint (the
acromioclavicular joint) where the top of
shoulder work?
the shoulder blade meets the collarbone,
The shoulder is the most mobile joint above the main shoulder joint.
in the body. The main shoulder joint
(the glenohumeral joint) is a ball-
and-socket joint, which allows a very What causes
wide range of movement. The joint shoulder pain?
is surrounded by a tough fibrous sleeve
Most shoulder problems will only affect
called the capsule which helps to hold
a small area and are relatively short-
the joint together. The inner layer
lived. But sometimes shoulder problems
of the capsule (the synovium) produces
may be part of a general condition such
a fluid which nourishes the cartilage
as rheumatoid arthritis, osteoarthritis
and lubricates the joint. A group of four
or polymyalgia rheumatica. Rheumatoid
muscles and their tendons make up the
arthritis quite often affects the shoulders.
rotator cuff, which controls movement
Osteoarthritis is less likely to affect the
and also helps to hold the joint together.
Rotator cuff Rotator cuff
tendon muscles Figure 1
Main features
Acromioclavicular
of the shoulder
joint
Acromion
Subacromial
bursa Collar bone
(clavicle)
Outline
of joint
capsule
Shoulder blade
(scapula)
Upper
arm bone
(humerus)
Shoulder joint
(glenohumeral joint)
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shoulders, but it can sometimes follow Should I see a doctor?
on from previous shoulder injuries.
Unless you have a traumatic injury or
There are several possible causes experienced sudden and continuing
of shoulder pain, including: pain, there’s no need to see your
• inflammation or damage to the muscles doctor straight away. But if the pain
and tendons around the shoulder isn’t improving after about two weeks
then you should see your doctor
• tension in the muscles between the
or a physiotherapist in case you have
neck and shoulder (common in some
a more complex problem.
workers or people with poor upper
back and neck posture) However, you should see your doctor
as soon as possible if:
• inflammation in the sac of soft tissue
• you develop severe pain in
(bursa) that normally allows the muscles
both shoulders
and tendons to slide smoothly over the
shoulder bones • you also have pain in your hips
• damage to the bones and cartilage, or thighs
which can be caused by arthritis. • you also feel feverish or unwell.
Shoulder pain isn’t always caused These can be signs of a condition called
by a problem in the shoulder joint. polymyalgia rheumatica, which needs
For example, problems in the neck can prompt treatment.
cause pain that’s actually felt over the
shoulder blade or in the upper outer See Arthritis Research UK booklet
arm (this is known as referred pain). Polymyalgia rheumatica (PMR).
If your shoulder pain is accompanied by
a tingling sensation in your arm or hand,
this is also more likely to be caused by a
What can I do to
problem in the neck.
help myself?
Specific shoulder problems are described
in more detail later in the booklet. There are several ways that you can
help yourself if you have shoulder pain.
See Arthritis Research UK booklets These include using painkillers and ice,
Osteoarthritis; Rheumatoid arthritis. balancing rest and exercise and being
careful about your posture.
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Arthritis Research UK
Shoulder pain
Painkillers Rest and exercise
Simple painkillers or anti-inflammatory Aim for a balance between rest and
tablets and creams that you can buy activity to prevent the shoulder from
at the chemist can be helpful, but don’t stiffening. Try to avoid the movements
use them for more than two weeks that are most painful, especially those
without seeking medical advice. that hold your arm away from your body
and above shoulder height. However, it’s
See Arthritis Research UK drug important to remain generally active even
leaflets Non-steroidal anti-inflammatory if you have to limit how much you do.
drugs; Painkillers.
When raising your arm, you can reduce
the strain or pull on your shoulder by:
Ice • keeping your elbow bent and in front
If your shoulder is inflamed (warmer of your body
to touch than the other side), an ice pack • keeping your palm facing the ceiling
may be helpful. Leave the ice pack in place
when reaching up.
for 10 minutes or so, making sure you
To lower your arm, bend your elbow,
protect your skin from direct contact with
bringing your hand closer to your body.
the ice by wrapping it in a damp towel.
Another good tip is to use your good arm Posture
to help lift up your painful arm. Some Don’t sit leaning forwards with the arm
people find that placing a cushion or held tightly by your side. This position
rolled towel under the armpit and gently can make the problem worse, especially
squeezing it can ease the pain. if some of the pain is coming from
your neck.
The exercises in the pull-out section at
the back of the booklet will help ease pain • Your upper body posture improves if
and prevent future symptoms. your lower back is supported. When
You may find it more comfortable sitting, keep a pillow or cushion
doing these exercises after applying ice behind your lower back, with your arm
to your shoulder. supported on a cushion on your lap.
• If your shoulder is painful to lie on,
See Arthritis Research UK booklet the following positions may reduce
Keep moving. the discomfort:
• Lie on your good side with a pillow
under your neck. Use a folded pillow
to support your painful arm in front of
your body. Another pillow behind your
back can stop you rolling back onto
your painful side.