Shoulder pain and one of the most common causes
Shoulder pain is extremely common and affects people of all ages. Mr Harry Brownlow, an expert shoulder surgeon at Circle Reading Hospital, explains one of the most common causes.
Location of the pain is key
Most people are surprised when they hear you can actually get shoulder-related pain from your neck, all the way down to your elbow. The most common place to feel the pain is actually over the side of the arm, which is a classic symptom of a problem with your rotator cuff.
Quite often it can be a dull ache in the arm, but it can be severe enough to affect your sleep and quality of life. If you’re playing tennis, any overhead shots can trigger periods of sharper pain.
This pain in your upper arm, especially when you move it above shoulder height, is typical of what we call ‘referred pain’ from the shoulder. It may settle down after a while, but a trigger such as lifting something onto a shelf can cause your symptoms to flare up again.
What is your rotator cuff?
Your rotator cuff is arguably the most important group of muscles around the shoulder. They’re crucial as they control the fine movement, rotation and leverage of the arm.
These four main muscles travel across the shoulder and insert into the top of your humerus, or upper arm bone. They all then merge and come into one larger conjoined tendon or hood, which all then work together.
Why are injuries so common?
Your shoulder is a very mobile joint that takes a huge amount of force every day. Because of this flexibility, you can quite easily overstretch these muscles.
Racket sports in particular may increase the pain from these muscles, with patients aged between 30 and 60 most likely to have rotator cuff issues. A mis-hit serve is a common culprit, even in experienced tennis players who have played for many years.
It’s not only racket sports though as any unusually intense activity, such as a gardening project with heavy lifting, could trigger the pain. You may start to feel pain in your arm later that evening which becomes persistent and a longer term issue.
Tear or impingement?
Rotator cuff injuries usually either relate to a tendon tear, or more commonly what we call an “impingement”, where tendons are causing pain but are not yet torn.
A tear will significantly change the mechanics of how your shoulder works. This may not heal on its own, as there is a poor blood supply to those tendons. Once it’s torn, and is causing significant problems, surgery may be the best option. The tear can be triggered by many things including a large impact or trauma.
An “impingement” generally calms down over time with correct management and the right exercises, but can rumble on as an ongoing injury for some time. This can be hugely frustrating if you’re trying to return to a sport in particular.
The three main treatment options
After a thorough assessment and relevant scans such as an X-ray or ultrasound, there are usually three groups of treatment options we can look at together.
You may decide you’re happy to live with the discomfort and perhaps change your lifestyle to help relieve the symptoms. You may also decide to keep going with physiotherapy for a bit longer as well.
If the pain is more persistent however, then I may recommend an injection delivered directly into a specific area of the shoulder using ultrasound guidance. Combined with ongoing physiotherapy, this has proven to be an effective treatment option for many patents I’ve seen over the years.
If everything to date hasn’t solved it then surgery may be the next step. Many modern operations are done through keyhole surgery meaning you can often leave hospital on the same day. Recovery is typically much quicker than traditional techniques, which all helps to get you back to doing the things you love faster.
It’s quick and easy to book a consultation
Whether you’re paying for your own treatment, or using private medical insurance, we can book you in within days to see a shoulder specialist at Circle Reading Hospital. Get your recovery started by calling us today.
Call us on: 01189226888