Shoulder Pain: Why isn't it Going Away?

Welcome back to another edition of Wealth of Health, Gold Coast Physiotherapy's health blog. This month, we delve into a common yet often overlooked issue that affects thousands of people worldwide and that is shoulder pain. Shoulder pain can be a frustrating and debilitating condition, it can arise from various factors, making it difficult to pinpoint and get the correct diagnosis and management. If you've been struggling with persistent shoulder pain that just won't go away, you're not alone. In this blog, we will delve into the common symptoms, causes and the latest evidence for effective treatment of shoulder pain. Our team at Gold Coast Physiotherapy are dedicated to providing you with the best in evidence-based care to help you regain your body's health and function. 

Understanding Shoulder Pain

Shoulder pain can manifest as a dull ache, sharp shooting pains, or show up as limited range of motion. It might be localized to the shoulder area or radiate to the arm, neck, or upper back. Some of the common causes of shoulder pain include:

Rotator Cuff Injuries

Tears or inflammation in the rotator cuff muscles can result from overuse, trauma, or age-related wear and tear.

Shoulder Impingement

This occurs when the rotator cuff tendons become irritated and inflamed due to repetitive overhead movements or poor posture.

Bursitis

Inflammation of the bursa sac that cushions the shoulder joint, usually caused by repetitive motions or direct trauma.

Frozen Shoulder (Adhesive Capsulitis)

Characterized by stiffness and reduced mobility, this condition often develops gradually and can be linked to autoimmune or hormonal factors.

Arthritis

Osteoarthritis or rheumatoid arthritis can affect the shoulder joint, leading to pain and stiffness.

Cervical Spine Referral

Problems in the neck area can refer pain to the shoulder, making it challenging to identify the source of the pain accurately. This is quite commonly associated with pain that radiates through the shoulder, upper back and down the arm.

The Assessment - lets get to the cause of your problem

As important as getting a diagnosis like a rotator cuff tear or shoulder bursitis is, why has this injury occurred in the first place? In order to fix your problem, it is imperative to get to the root or underlying cause of your pain or dysfunction. At Gold Coast Physiotherapy, our approach to treatment begins with a comprehensive assessment. A thorough clinical examination takes into account your family, medical and social history, physical ability and activity level which may predispose you to injury. We also assess all regions related to shoulder function, including the neck, shoulder blade, arm, thoracic spine and low back. Commonly we find that underlying mechanical imbalances are the actual reason of the pain. An example that we see in clinic is that of an under active upper trapezius muscle causing an overactive, overloaded and painful rotator cuff. So you see just treating the overactive and painful rotator cuff will not  solve the problem but rather temporarily provide relief. The need in this example is to strengthen the underactive trapezius to reduce the load on the rotator cuff. 

Structures don't fail without reason so understanding why a structure is strained, pinched, painful or became stiff is where the real solution is found. This is where a well-trained physiotherapist earns their keep. By assessing and determining the real reason for your injury your therapist will then guide you to ensure imbalances are addressed and that the painful structures need never be placed under such stress to get injured again. Afterall, the goal of health is not to alleviate symptoms temporarily but rather to establish and maintain optimal function so to prevent the chance of future concerns.

Physiotherapy Intervention

So, after a thorough assessment and understanding of the root cause of your problem. Your therapist will get to work on delivering an evidence-based treatment to meet the specific needs of your shoulder. To break it down simply, we place focus on 3 key components in treatment. 

   1. Manual Therapy

Hands-on techniques, such as joint mobilizations and soft tissue mobilisation of the shoulder, thoracic spine, neck and arm are often integral components for effective rehabilitation of shoulder pain. Manual therapy can help relieve pain, reduce muscle tension, and improve joint mobility.

   2. Active Movement and Exercise Prescription

Exercise for rehabilitation of shoulder pain is imperative. Our therapists often prescribe targeted exercise programs designed to specifically address the needs of your shoulder. Most commonly our programs look to address the imbalances, most commonly by strengthen weak/inactive muscles, correcting movement patterns, improving posture and enhancing mobility. Again, this is in the interest of greater body function and prevention of future recurrence or concerns. A recent literature review published in the Journal of Orthopaedic & Sports Physical Therapy 2020, has shown that:

"Exercise is the most important management strategy of subacromial shoulder pain"

    3. Education, Support and Lifestyle Modification

"Once you know you can change". Understanding what the problem is, and how is has occurred is arguably the most important step towards getting better. Following a thorough explanation, our therapists will further elaborate on how certain habits and activities may be contributing to your shoulder pain  and empower you to make positive lifestyle changes that support your recovery. Sometimes it's as simple as a tip on the most appropriate sleeping postures, or on the best work place / station set-up or it could be a 5-10 day trial of therapeutic taping to allow for adequate support and healing. In some cases, our therapists may work with you to create an activity modification plan whilst your shoulder heals. Then when you begin reaching key milestones, with gradual exposure your therapist will reintroduce the previously aggravating activities. Such modifications will all be dependent on the nature, severity and circumstances surrounding your injury. Our patients often say that these small tweaks in their rehabilitation program make all the difference when it comes to speeding up their recovery and getting back to the things they love.

Let's Get You Better

If you've been dealing with lingering shoulder pain, there is no better time to take action and seek professional help. Our team of dedicated physiotherapists at Gold Coast Physiotherapy are expertly trained to provide you with effective solutions to overcome shoulder pain and regain your quality of life. Don't let shoulder pain hold you back from doing the things you love. Click here to book an appointment with one of our experienced physiotherapists and take control of your health. Remember, you don't have to face shoulder pain alone – we are here to support you to live a healthy and pain free life.