Rheumatology

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Shoulder Pain

Understanding Your Shoulder
  • The shoulder is one of the most mobile joints in the body, but also one of the most delicate.
  • It is made up of three bones and rotator cuff tendons which connect the muscles to the bones and help move the shoulder .Because the rotator cuff tendons are small and delicate, they can be easily injured during everyday activities.
Common Causes of Shoulder Pain

1. Frozen Shoulder (Adhesive Capsulitis)

  • Tightening and thickening of the shoulder capsule
  • Results in severe stiffness and reduced movement — especially raising the arm overhead or moving it backwards
  • Often develops gradually and can last 6–8 months or longer

2. Rotator Cuff Tendon Problems (Tendinopathy or Tears)

  • Damage to one or more rotator cuff tendons
  • Pain occurs when raising the arm — often felt halfway up
  • You can usually move the shoulder but it may be painful

3. Other Conditions

  • Osteoarthritis of the shoulder
  • Rheumatoid arthritis or other inflammatory arthritis
  • Calcium deposits in tendons (calcific tendinitis)
  • Shoulder joint instability or injury
How to Protect Your Shoulder
  • Keep your elbow close to your body when doing tasks
  • Avoid reaching overhead or lifting heavy objects above shoulder level
  • Avoid pushing the arm backwards forcefully
  • Limit heavy lifting, especially away from the body
  • Use both hands for lifting when possible

2. Achilles Tendonitis (Tendinopathy)

Treatment Approach

1. Rest & Activity Modification

  • Rest the shoulder from painful movements but do not keep it completely still
  • Modify your work and household activities to reduce strain

2. Physiotherapy

  • Frozen Shoulder:
    • Gradual stretching and mobility exercises
    • Performed twice daily
    • Aim is to restore movement without causing severe pain
    • Patience is key — recovery may take months
  • Rotator Cuff Problems:
    • Avoid repetitive overhead movements
    • Begin strengthening exercises for the damaged tendon with guided movements
    • Focus on building strength without aggravating the pain

3. Medications

  • Pain-relief tablets and anti-inflammatory medication to reduce pain and swelling
  • These help enable physiotherapy and normal daily activity

4. Injections

  • Steroid injections are highly effective for:
    • Frozen shoulder — to release the stiffness
    • Rotator cuff tendinopathy — to reduce inflammation
  • PRP (Platelet-Rich Plasma) injections may be used if symptoms persist despite other treatments

5. Surgery

  • Rarely needed, but may be recommended if:
    • A full rotator cuff tear prevents you from lifting your arm
    • Frozen shoulder remains very stiff despite months of treatment
  • Surgery is usually performed early in complete tendon tears to improve recovery chances
Home Care Tips
  • Apply an ice pack to the shoulder for 15 minutes after activity
  • Avoid sleeping on the painful shoulder
  • Use gentle pendulum movements to keep the joint from becoming too stiff
  • Follow your prescribed exercise plan consistently
Summary

Most shoulder pain can be improved with:

  • Protecting the joint from strain
  • Regular targeted exercises
  • Early physiotherapy and, if needed, injections

Prompt and appropriate care prevents long-term stiffness and weakness.

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