Shoulder Pain

What Is the Shoulder and Why Is It Important?

The shoulder is a highly mobile joint that connects the arm to the body. It allows a wide range of movement for daily activities such as lifting, reaching, and dressing.

The joint includes:

The ball-and-socket joint (humerus and scapula)
Muscles and tendons (rotator cuff)
Bursa (fluid-filled sac for cushioning)
Ligaments and capsule

Common Causes of Shoulder Pain

1. Rotator Cuff Tendinopathy

Overuse or degeneration of the tendons
Common in people who perform repetitive overhead work
Pain worsens with lifting or reaching

1. Frozen Shoulder (Adhesive Capsulitis)

Thickening and tightening of the capsule surrounding the joint
Leads to pain and stiffness and reduced movement due to stiffness
Can be associated with diabetes, thyroid issues, or previous injury
Usually progresses in stages over months

Symptoms

Rotator Cuff Tendinopathy:

Pain at the side of the shoulder, worse at night
Difficulty reaching overhead or behind the back
Weakness when lifting

Frozen Shoulder:

Progressive pain and stiffness
Reduced range of movement in all directions
Difficulty sleeping on affected side

Diagnosis

Clinical history and physical examination
Ultrasound or MRI (if needed)
X-rays – to rule out arthritis or other causes

Management

Step 1: Pain Relief

NSAIDs or paracetamol for short-term relief
Ice packs (15 min, 2–3 times a day)

Step 2: Activity Modification

Avoid overhead lifting, pushing, or carrying heavy objects
Use correct posture at work and while sleeping

Step 3: Physiotherapy – this differs on diagnosis – so before physiotherapy the proper diagnosis must be made if not the condition may worsen.

Most important treatment in both conditions
Focus on:
- Range of motion
- Strengthening exercises
- Posture correction
May take several weeks to months

Step 4: Injections

Corticosteroid injections can reduce inflammation and pain
PRP (Platelet Rich Plasma) may be considered in selected cases

Step 5: Surgery (rarely needed)

Only considered if symptoms are severe and unresponsive to months of treatment
Arthroscopic surgery for tendon repair or capsule release

Home Care Tips

Avoid sleeping on the affected side
Perform gentle stretches daily as per physio advice
Don’t completely rest the arm – gentle movement prevents stiffness
Avoid jerky or rapid arm movements

Recovery Timeline

Tendinopathy may improve over 6–12 weeks with therapy
Frozen shoulder often resolves gradually over 4-6 months
Consistency in physiotherapy is key to recovery

When to Seek Medical Help

Pain not improving after 6–8 weeks of therapy
Sudden weakness or injury
Severe night pain affecting sleep
Signs of infection (fever, warmth, swelling)

Final Message

Shoulder pain is common but manageable.
With timely physiotherapy, posture correction, and appropriate medication, most people recover well without surgery.

🩺 Stay active, follow your doctor’s advice, and don’t delay care.

Rheumatology