When Your Shoulder Starts Getting in the Way of Everything
Putting on a jacket.
Reaching into the back seat of the car.
Lifting your arm to wash your hair.
Getting something down from a shelf.
Rolling onto your side in bed.
You don’t realise quite how much you use your shoulder until suddenly almost everything seems to annoy it.
Shoulder pain can be sharp and sudden, a deep persistent ache, a frustrating loss of movement, or pain that only appears when your arm reaches a particular position. For some people it begins after an obvious injury. For others, it gradually creeps in until sleeping, exercising or doing completely ordinary things becomes uncomfortable.
And because the shoulder is such a mobile and complex area, there isn’t one universal explanation for why it hurts.
Pain may involve the muscles or tendons around the shoulder, the joint itself, the tissues surrounding it, or sometimes even structures outside the shoulder altogether. Shoulder pain can occasionally be referred from the neck or related to nerve irritation rather than originating in the shoulder itself.
At The Urban Alchemist in Carlton North, our multidisciplinary team offers several approaches that may form part of shoulder pain management depending on your symptoms and what’s contributing to them.
These may include chiropractic care, myotherapy, remedial massage and acupuncture.
The first step isn’t deciding which treatment you need.
It’s working out what your shoulder is actually doing.
Book an Appointment for Shoulder Pain
Not sure who to book? Contact our team on (03) 9347 9247.
What Does Shoulder Pain Feel Like?
Shoulder problems don’t all feel the same.
You might experience:
- Pain at the front, side or back of the shoulder
- A deep ache inside the shoulder
- Pain travelling into the upper arm
- Pain when reaching overhead
- Pain when reaching behind your back
- Difficulty putting on clothing
- Pain when lifting or carrying
- Shoulder weakness
- Stiffness or reduced movement
- Clicking, catching or grinding
- Pain when lying on the affected side
- Shoulder pain that wakes you at night
- Pins and needles, numbness or tingling
- Pain that seems to travel between your shoulder and neck
Shoulder pain is often felt at the front of the shoulder or top of the arm and may appear only during certain movements. Weakness and restricted movement can also occur.
Those differences matter.
A shoulder that’s becoming progressively stiff behaves very differently from one that hurts only after throwing a ball – and both are different again from pain travelling from your neck into your shoulder and arm.
Why Does My Shoulder Hurt?
There are plenty of structures packed into a relatively small area.
Your shoulder includes several joints plus muscles, tendons, ligaments and other soft tissues working together to provide an enormous range of movement.
That’s brilliant when everything is cooperating.
It also means “shoulder pain” isn’t a diagnosis.
Some common possibilities include rotator cuff problems, bursitis, frozen shoulder, arthritis, muscle or tendon injuries, joint injuries and pain referred from the neck or nerves. Sometimes several factors overlap, and in some cases it isn’t possible to identify one precise anatomical cause.
Rotator Cuff-Related Shoulder Pain
The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, helping stabilise and move your arm.
Rotator cuff problems are a common source of shoulder pain and can develop gradually or follow an injury.
Symptoms can include:
- Shoulder or upper-arm pain
- Weakness
- Difficulty lifting your arm
- Pain during overhead movements
- Reduced shoulder movement
- Pain when lying on the affected side
Rotator cuff injuries range from relatively minor strains through to tendon tears, and treatment depends on factors including the extent of the injury, your activity level and your age.
Shoulder Bursitis
A bursa is a small fluid-filled structure that helps reduce friction where tissues move around a joint.
When a shoulder bursa becomes irritated or inflamed, you may experience pain, tenderness and restricted movement, particularly when raising your arm overhead.
One trap here is assuming that seeing “bursitis” written on an ultrasound automatically explains everything you’re feeling.
Imaging findings need to be interpreted alongside your symptoms and physical assessment – not treated as the entire story.
Frozen Shoulder
Frozen shoulder – also called adhesive capsulitis – isn’t just a shoulder that’s “a bit tight.”
It usually develops gradually and can cause significant pain and progressively restricted movement as the capsule surrounding the shoulder becomes thickened, inflamed and tight.
People often notice difficulty with movements such as:
- Reaching overhead
- Putting a hand behind the back
- Dressing
- Reaching for a seatbelt
- Sleeping comfortably
- Rotating the arm outwards
Frozen shoulder typically progresses through freezing, frozen and thawing stages, and recovery can be slow. Healthdirect notes that without treatment it may take between one and three years.
If your shoulder is becoming progressively more restricted – not simply painful – it’s worth having it properly assessed.
Shoulder Strains and Injuries
Sometimes the cause is refreshingly obvious.
You fell.
Lifted something awkwardly.
Went too hard at the gym.
Took up tennis after not touching a racquet for 15 years and apparently expected your shoulder to receive the memo.
Shoulder injuries can involve muscles, tendons, ligaments, joints or bones. Significant injuries may include rotator cuff tears, fractures or dislocations and require appropriate medical assessment.
Overuse and Repetitive Activity
Not every shoulder problem starts with one dramatic moment.
Repeated overhead work, lifting, throwing, swimming, racquet sports and other repetitive activities can place considerable demands on the tissues around the shoulder.
Rotator cuff problems, for example, may develop gradually through repetitive lifting or overhead activity as well as occurring after an accident.
Sometimes the answer isn’t “never do that movement again.”
It may involve temporarily modifying the activity, improving strength and capacity, and gradually building the shoulder’s tolerance back up.
Arthritis
Osteoarthritis and inflammatory joint conditions can also affect the shoulder.
Osteoarthritis involves changes within the joint that may develop with age or following previous injury. Other inflammatory conditions, including rheumatoid arthritis, may also affect shoulder structures.
Medical assessment may be appropriate when arthritis or systemic inflammatory disease is suspected.
Is the Pain Actually Coming From My Shoulder?
Here’s something worth knowing:
Sometimes the place that hurts isn’t the place causing the problem.
Pain felt around the shoulder can sometimes originate from the neck or spine, and nerve-related problems can cause pain, numbness, tingling or other symptoms extending into the shoulder and arm.
Clues that your neck or nerves may deserve assessment include:
- Neck pain occurring alongside your shoulder pain
- Pain travelling down the arm
- Pins and needles
- Numbness
- Symptoms changing when you move your neck
- Weakness that doesn’t seem limited to one painful shoulder movement
This doesn’t mean every sore shoulder is secretly a neck problem.
It means the shoulder shouldn’t always be assessed in isolation.
Neck Pain
Read more about Neck Pain
Why Does My Shoulder Hurt at Night?
Night pain is one of the most frustrating features of shoulder problems.
You finally find a comfortable position.
Roll over.
And – hello shoulder.
Pain while lying on the affected side can occur with shoulder problems including rotator cuff injuries, and frozen shoulder can also make finding a comfortable sleeping position difficult.
If your shoulder pain is persistent at rest, worsening or regularly disturbing your sleep, it’s worth getting assessed rather than simply finding increasingly elaborate pillow arrangements.
Healthdirect recommends medical assessment for shoulder pain that isn’t improving or is getting worse, particularly when pain is present at rest.
Do I Need a Scan for Shoulder Pain?
Not necessarily.
This is an area where more information isn’t automatically better information.
Many shoulder problems can initially be assessed through your history and physical examination without imaging. X-rays, ultrasound, CT or MRI may be useful in particular situations – for example following certain injuries or when the result is likely to change management.
And scans can reveal structural changes that aren’t necessarily responsible for your symptoms.
So we don’t believe every painful shoulder needs to be immediately introduced to an MRI machine.
If imaging is clinically appropriate, your doctor or relevant healthcare practitioner can help determine what type of investigation makes sense.
How Is Shoulder Pain Assessed?
A good shoulder assessment starts with understanding the story.
Did the pain begin suddenly or gradually?
Was there an injury?
Which movements hurt?
Is your shoulder weak or simply painful?
Can you move it through its usual range?
Does it hurt at night?
Are there neck symptoms?
Any numbness or tingling?
What activities do you need your shoulder to perform?
Physical assessment may then look at things such as:
- Shoulder range of motion
- Strength
- Pain during particular movements
- Movement of the shoulder blade
- Neck movement where relevant
- Neurological signs where appropriate
- Functional movements related to your work, exercise or everyday life
The goal isn’t to perform 47 impressive-looking tests.
It’s to gather enough useful information to decide what appears to be happening and what the next step should be.
What Treatments Can Help Shoulder Pain?
There isn’t one shoulder treatment that makes sense for every shoulder.
Treatment depends on the likely cause, how long you’ve had symptoms, the severity of the problem, your health and what you need to get back to doing.
Depending on the diagnosis, management may involve activity modification, rehabilitation and strengthening, manual therapy, pain management, injections or – in some cases – surgery.
At The Urban Alchemist, several therapies may be appropriate for some musculoskeletal shoulder presentations.
Myotherapy for Shoulder Pain
Myotherapy can be particularly useful when muscular pain, movement restriction or reduced strength and capacity are significant parts of the presentation.
Your myotherapist may assess how the shoulder and surrounding muscles are functioning and use a combination of hands-on techniques, movement strategies and rehabilitation appropriate to your symptoms.
Myotherapy
Chiropractic Care for Shoulder Pain
Shoulder pain doesn’t always exist in isolation.
Where assessment suggests that movement or musculoskeletal factors involving the shoulder, upper back or neck are relevant, chiropractic care may form part of a broader management plan.
Treatment should be based on your individual presentation rather than simply “adjusting” something because your shoulder hurts.
Chiropractic
Remedial Massage for Shoulder Pain
When muscle tension, soreness or overuse are significant features, remedial massage may help manage symptoms and improve comfort as part of a broader approach.
For persistent shoulder problems, however, hands-on treatment alone may not be enough. Building strength and gradually restoring the shoulder’s capacity can be just as important.
Remedial Massage
Learn more about Remedial Massage
Acupuncture for Shoulder Pain
Some people choose acupuncture as part of their shoulder pain management.
Whether it’s appropriate depends on the nature of the shoulder problem and your individual circumstances, and it shouldn’t delay medical assessment when a significant injury or other concerning condition is suspected.
Acupuncture
Rehabilitation and Strengthening
For many shoulder problems, gradually restoring movement, strength and tolerance to activity is an important part of recovery.
That might mean initially modifying aggravating movements and then progressively rebuilding the shoulder’s ability to lift, push, pull, reach, throw or perform whatever your life actually requires.
Healthdirect identifies stretching, rehabilitation and strengthening exercises as common components of conservative rotator cuff management.
The goal isn’t necessarily to protect your shoulder forever.
It’s to help it become capable again.
Medical Treatment
Some shoulders belong with a doctor.
Depending on the condition, medical management may include medication, corticosteroid injection, specialist referral or surgery. Frozen shoulder, significant traumatic injuries and some persistent rotator cuff problems are examples where medical assessment may form an important part of care.
If your presentation suggests that hands-on therapy isn’t the appropriate next step, we’ll tell you.
What Can I Do at Home for Shoulder Pain?
If you’ve had a significant injury or have concerning symptoms, get assessed rather than attempting to rehabilitate yourself from an internet article.
For uncomplicated musculoskeletal shoulder pain, useful strategies may include:
- Temporarily reducing movements that significantly aggravate the pain
- Avoiding complete immobilisation unless specifically advised
- Continuing comfortable movement where appropriate
- Gradually returning to normal activity
- Using cold after a recent injury if you find it helpful
- Using heat later for muscular comfort if appropriate
- Following an appropriate strengthening or rehabilitation program
Healthdirect notes that cold may help in the first few days after an injury, while heat can later help relax shoulder muscles. Treatment may also involve strengthening and appropriate activity modification.
What we don’t want is six months of:
“My shoulder hurts when I move it, so I’ve stopped moving it.”
For many musculoskeletal problems, avoidance can eventually become part of the problem.
When Should I See a Doctor About Shoulder Pain?
Most shoulder pain isn’t a medical emergency.
But there are situations where you shouldn’t simply book bodywork and hope for the best.
See a doctor if:
- Your shoulder pain followed a fall or significant accident
- Your pain isn’t improving or is getting worse
- You have significant pain while resting
- You’re having increasing difficulty moving the shoulder
- You develop unexplained fever, night sweats or weight loss
- You have other symptoms that concern you
Healthdirect recommends immediate medical attention following an injury if the shoulder appears deformed, you cannot use the shoulder, pain is intense or sudden swelling develops.
Shoulder Pain Can Rarely Be a Sign of a Heart Attack
This is important.
Shoulder or arm discomfort can occasionally be related to a heart problem rather than the shoulder itself.
If you have shoulder pain accompanied by symptoms such as chest tightness or difficulty breathing, call Triple Zero (000) for an ambulance.
Don’t book a shoulder appointment.
Get urgent medical help.
A Multidisciplinary Approach to Shoulder Pain
The person with a mildly irritated shoulder after increasing their gym training doesn’t necessarily need the same care as someone with frozen shoulder.
And neither needs the same care as someone who fell heavily and suddenly can’t lift their arm.
That’s why our approach isn’t:
“Shoulder pain = treatment X.”
At The Urban Alchemist, our multidisciplinary clinic allows us to consider several conservative treatment approaches when appropriate, while recognising when a GP, physiotherapist, sports doctor, imaging provider or orthopaedic specialist may be a better next step.
The aim is to find an appropriate pathway – not squeeze every shoulder into whichever treatment happens to be available.
Book an Appointment for Shoulder Pain
Not sure who to see? Contact our team on (03) 9347 9247.
Why does my shoulder hurt when I lift my arm?
Pain while raising the arm can occur with several shoulder conditions, including problems involving the rotator cuff or bursa.
The location and timing of your pain, strength, range of movement and how the symptoms began all help determine what may be contributing.
If the problem persists or significantly restricts your movement, have it assessed rather than assuming it’s simply “inflammation.”
Why does my shoulder hurt when I sleep on it?
Pain when lying on the affected side is common with several shoulder problems, including rotator cuff injuries. Frozen shoulder can also cause significant night pain and difficulty finding a comfortable sleeping position.
Persistent night pain is worth discussing with a healthcare professional.
How do I know if I have a rotator cuff injury?
Rotator cuff problems may cause shoulder or upper-arm pain, weakness, restricted movement, pain with overhead activity and pain when sleeping on the affected side.
Those symptoms aren’t unique to rotator cuff injuries, however, so an assessment is more useful than trying to diagnose yourself from one movement.
What’s the difference between bursitis and a rotator cuff problem?
They’re not necessarily completely separate problems.
The rotator cuff consists of muscles and tendons that help move and stabilise your shoulder, while bursae are small fluid-filled structures that reduce friction around joints.
Shoulder bursitis can occur alongside problems involving the rotator cuff, so a scan containing both words doesn’t necessarily mean you have two unrelated injuries.
How do I know if I have frozen shoulder?
Frozen shoulder usually involves both pain and a substantial progressive loss of shoulder movement.
It often develops gradually and moves through stages in which pain and stiffness change over time. If your shoulder is becoming increasingly difficult to move – particularly when reaching overhead, behind your back or rotating your arm – seek an assessment.
Can neck problems cause shoulder pain?
Yes. Pain experienced around the shoulder can sometimes originate from the neck or spine, and nerve irritation may produce pain, tingling, numbness or other symptoms in the shoulder and arm.
Neck Pain
Should I rest a painful shoulder?
Sometimes temporarily modifying aggravating activities makes sense, particularly after an acute injury.
That doesn’t usually mean completely avoiding shoulder movement indefinitely. Depending on the condition, gradually restoring comfortable movement and strength may be an important part of recovery.
If you’re unsure what you should or shouldn’t be doing, get the shoulder assessed.
Should I use ice or heat?
After a recent shoulder injury, cold may help manage symptoms during the first few days. Heat may later feel helpful for relaxing sore muscles.
Neither one fixes the underlying problem, though. Use whichever is appropriate and comfortable rather than treating the ice-versus-heat debate like a religious war.
Do I need an ultrasound or MRI?
Often, no.
Many shoulder conditions can initially be assessed without imaging. Ultrasound, X-ray, CT or MRI may be useful in particular circumstances, especially after certain injuries or when symptoms aren’t improving as expected.
Your healthcare professional can advise whether imaging is likely to add useful information.
Can massage help shoulder pain?
Massage may be useful when muscle soreness, tension or overuse are relevant to your symptoms.
However, not every shoulder problem is primarily muscular, and persistent weakness, significant movement restriction or an acute injury deserves appropriate assessment.
Remedial Massage
Can myotherapy help shoulder pain?
Myotherapy may be appropriate for some musculoskeletal shoulder problems, particularly where muscle function, movement, strength or load tolerance are relevant.
The appropriate treatment depends on what’s contributing to your symptoms.
Myotherapy
Can chiropractic help shoulder pain?
Chiropractic care may form part of management for some shoulder presentations, particularly where relevant musculoskeletal factors involving the shoulder, neck or upper back are present.
A good assessment should determine whether chiropractic care is appropriate rather than assuming every painful shoulder needs the same treatment.
Chiropractic
How long does shoulder pain take to get better?
There isn’t one useful answer.
A minor muscle strain may settle relatively quickly. Other shoulder conditions can take considerably longer. Frozen shoulder, for example, can evolve over many months and sometimes years.
Your diagnosis, severity, general health, activity demands and how your shoulder responds to management all influence recovery.
How do I know which practitioner to book?
You don’t necessarily need to know.
If you’ve had a major injury, your shoulder is visibly deformed, you suddenly can’t use your arm, or your symptoms are severe or concerning, seek medical assessment.
For established musculoskeletal shoulder pain, myotherapy, chiropractic or remedial massage may be appropriate depending on the presentation.
If you’re unsure, contact our reception team on (03) 9347 9247. Tell us what’s happening and we’ll help you choose a sensible starting point rather than making you diagnose your own shoulder before you’re allowed to book.
Shoulder Pain Treatment in Carlton North, Melbourne
If your shoulder is making it difficult to sleep, work, exercise, reach overhead – or simply put your damn jumper on without performing an elaborate manoeuvre – it’s worth finding out what’s going on.
The first step isn’t choosing your favourite treatment.
It’s understanding the problem.
At The Urban Alchemist in Carlton North, our multidisciplinary team offers a range of approaches that may form part of shoulder pain management, including myotherapy, chiropractic care, remedial massage and acupuncture.
And if your shoulder needs medical investigation, imaging or another type of healthcare altogether, we’ll tell you.