Managing Shoulder Pain


                                

By Ian Murray – Registered Acupuncturist & Chinese Medicine Practitioner

If you suffer shoulder pain then you are not alone. Shoulder pain is the third most common musculoskeletal problem that takes a person to their GP after back pain and knee pain. When you understand how the shoulder joint is constructed you might understand why this is such a common problem. Although the shoulder functions as a ball and socket joint providing a wide range of motion, it is not a stable ball and socket like a hip. In the hip the ball is encapsulated by a bony socket. The shoulder consists of a very shallow bony depression and is supported by four main muscles to form a socket that encapsulates the ball. These muscles are often referred to as the “rotator cuff”.  Injury or weakness of any one of these muscles can often be referred to as “rotator cuff syndrome” or if the most commonly affected muscle is injured it is commonly called “supra-spinatus tendonitis”. Damage to any of these structures can result in abnormal shoulder function and pain.

As the injured shoulder functions in an abnormal manner it leads to pain and reduced range of motion and can often irritate other structures resulting in an associated painful “impingement syndrome”. There are other types of shoulder pain apart from rotator cuff syndrome such as “frozen shoulder” or “bursitis”. To determine the nature of your shoulder pain a detailed history of your complaint is taken and specific muscle strength and range of motion testing is conducted. To confirm the diagnosis, imaging such as ultrasound or MRI may be required, but is not always essential.

To avoid becoming one of the 29% of chronic pain sufferers with shoulder pain it is important not to ignore an injured shoulder. Initially staying within a range of motion that doesn’t cause pain can help to prevent further injury and is key to a prompt recovery. Do not continue recreation or work activities that cause pain. Adequate pain relief is important not just for comfort but because in general pain inhibits repair. Exercises to strengthen weakened muscles and correct poor posture can improve shoulder function, take strain off the injured structure and prevent reoccurrence. Overly tight muscles are another obstacle to healing, and these can be released with massage and acupuncture.  In well trained hands acupuncture can also be used to stimulate repair and reduce pain and inflammation to aid a quicker recovery. Herbal medicine may have a role to reduce inflammation and also speed up repair, especially in longstanding cases. In cases such as a full thickness tear other options such as surgery or a cortisone injection may need to be discussed with your GP.