Shoulder pain

The shoulder joint is complex. Many things can cause shoulder pain. In younger people, shoulder pain is more likely to be due to an accident or injury. However, as you get older, natural wear and tear occurs in the shoulder joint and the rotator cuff tendon. Over time, this may become persistent

Your osteo will assess the area of pain and discuss activities and lifestyle factors that might be relevant to your condition. They will work with you to:

• improve muscle flexibility in the shoulder area
• improve range of joint motion in the mid back, neck, shoulder blade and shoulder
• address postural strains and bad habits
• provide advice on maintaining flexibility and strength around the shoulder region
• provide exercises for stretching and recovery
• help you change the way you do some activities, to help reduce pain and prevent further injury

How you manage shoulder pain depends on the injury or cause of the pain. Speak with your osteopath about the best exercises and lifestyle activities for your situation.

Ice may help if you have pain, swelling or bruising. Heat packs may be useful to reduce swelling and discomfort.

Should I rest or get active? It depends on what is causing your condition and how severe it is. If you return to activity too fast it may hinder your recovery. Sometimes pain levels are the best indicator. Your osteo will guide you on the best approach for your condition.

Try the following to manage and avoid shoulder pain:

• Get advice on work-station ergonomics. Your osteopath can help!
• Change position regularly (e.g. if you work at a desk, try standing for 10 minutes and moving around for 5 minutes every hour) link to a graphic on the 45-10-5 rule?
• If you tend to hunch your shoulders, lay flat on your back
• Stretch your chest regularly
• Swap arms when you are carrying heavy weights like shopping bags or children

References and further reading

• Osteopathy Australia. 2019. Shoulder Pain – Patient Brochure
• RACGP Shoulder injuries management in general practice
• Musculoskeletal Australia. Understanding shoulder pain
• Better Health Channel. Shoulder Pain
• Health Direct. Shoulder Pain

Not all therapies work on all people. Your osteopath is trained to work with your particular symptoms and apply the appropriate treatments. Many therapies have been found in clinical studies to be useful.

Manual therapy, needling and exercises, alone or in combination, may help relieve pain and improve movement for patients with no serious health condition (e.g. a nerve problem). Studies support the use of these therapies for common shoulder problems such as shoulder pain, frozen shoulder, shoulder impingement and rotator cuff injuries.

References:

Ong, J., et al ‘The effect of dry needling for myofascial trigger points in the neck and shoulders: A systematic review and meta-analysis’, Journal of Bodywork and Movement Therapies (2014); 18

Van den Dolder, A., et al ‘Effectiveness of soft tissue massage and exercise for the treatment of non-specific shoulder pain: a systematic review with meta-analysis’, British Journal of Sports Medicine July (2012); 48(16)

Ho, CY., et al ‘The effectiveness of manual therapy in the management of musculoskeletal disorders of the shoulder: a systematic review’, Manual Therapy (2009); 14
Brantingham, J., ‘Manipulative Therapy for Shoulder Pain and Disorders: Expansion of a Systematic Review’, Journal of Manipulative and Physiological Therapeutics (2011) June; 34 (5)

Brantingham, J., ‘Manipulative Therapy for Shoulder Pain and Disorders: Expansion of a Systematic Review’, Journal of Manipulative and Physiological Therapeutics (2011) June; 34 (5)

National Council for Osteopathic Research, ‘Exercise therapy in the management of shoulder pain: a summary of the recent relevant research’, National Centre for Osteopathic Research (June 2017)