Your shoulders each have two joints, making them the most flexible parts of your body.

The main shoulder joint – the glenohumeral – is a ball-and-socket joint. It’s called this because the top of the upper arm bone – the humerus – is shaped like a ball. This ball fits into the shoulder blade bone, which acts as the socket, giving your shoulder a wide range of movement.

But, the shoulder socket is very small, compared to other ball-and-socket joints, such as the hip. It’s held together and controlled by a covering of muscles, which are secured to the bones by strong cords called tendons.

These muscles and tendons form a capsule around the joint and support its movements, but can make it more likely to dislocate than other joints.

Inside the capsule is the synovium, which produces fluid that lubricates the joint and keeps the cartilage healthy. The cartilage helps protect your bones from any impact and sits between the bones of your shoulder joints to stop them rubbing together.

Above the main shoulder joint there’s a smaller joint where the top of the shoulder blade – the acromion – meets the collar bone.

This is known as the acromioclavicular joint. It helps the larger joint below to move through its full range, particularly when you’re raising your arm, lifting or throwing.

CAUSES OF CHRONIC PAIN

Most shoulder problems only affect a small area and should last a relatively short time.

But sometimes the problem in your shoulder could be part of a wider, long-term condition such as, osteoarthritis or polymyalgia rheumatica.

It’s fairly common for people with rheumatoid arthritis to have pain and swelling in their shoulders.

Osteoarthritis is less likely to affect your shoulders than other joints, unless you’ve injured them in the past.

There are several other possible causes of shoulder pain, such as:

• inflammation, where your shoulder becomes hot, red, swollen and painful as a natural reaction to an infection or injury
• damage to the muscles and tendons around the shoulder
• tension in the muscles between the neck and shoulder – this is usually down to your posture in your upper back or neck, and is often linked the way you stand or sit when you’re using a computer or at work. A physiotherapist or a chiropractor can show you how to go through your activities of daily living in an ergonomic way
• inflammation in the bursa – a fluid-filled cushion which normally helps the muscles and tendons slide smoothly over the shoulder bones
• damage to the bones and cartilage, which can be caused by arthritis.

It’s also possible the pain you’re feeling in your shoulder is coming from a problem in another part of your body, such as your neck.

Problems in your neck can make your shoulder blade or upper outer arm painful. When this happens it’s known as referred pain or radiated pain. If you’re feeling a tingling sensation in your hand or arm, as well as pain in your shoulder, it’s likely to be from a problem in your neck.

WHEN TO SEE A DOCTOR

Unless you’ve had a serious injury or get a sudden, continuous pain, you can usually treat your shoulder pain without having to see your doctor.

If, after two weeks of treating yourself, you feel the pain isn’t any better you should see your doctor or a physiotherapist.

You should also see your doctor as soon as possible if you:

• develop severe pain in both shoulders
• also have pain in your thighs
• feel feverish or unwell.

These can be signs of the condition called polymyalgia rheumatica, which needs prompt treatment.

DIAGNOSIS

Each shoulder problem has its own pattern of symptoms that can help your doctor or a  physiotherapist make a diagnosis. Most conditions make it painful to use or move your shoulder, but some make your shoulder feel stiff.

Your doctor or physiotherapist will need to see which movements are the most painful, as this could show where the problem is. They will usually ask how the problem started, how it has developed and how it affects your daily activities.

If you can, try to write a few notes about when and how the problem started and what makes it feel worse before your appointment. This will help you get a more accurate diagnosis.

Usually your physiotherapist or doctor can recommend the best course of treatment once they’ve diagnosed what your condition is. However, they may send you for further tests if they suspect your problems are being caused by arthritis or a more complicated condition.

 

 For more info on how to take control of your health, and tackle chronic pain in a smart way, please reach out to:

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