What is shoulder pain and how common is it?
Your shoulder is a ball and socket joint and is directly involved with other parts of the shoulder girdle including the shoulder blade (scapula) and the thorax (upper back). The shoulder is a very mobile joint and therefore depends on surrounding musculature and other supports for stability. While the shoulder joint is extremely mobile, it is often described as one of the most unstable joints due to its very shallow socket. It is no wonder we see a lot of different shoulder problems! Shoulder pain can be experienced in the joint itself but also areas surrounding the shoulder. The neck is a common source of shoulder pain and can contribute to pain felt around the neck and shoulder region, shoulder blade and upper back.
A systematic review of general population studies found that up to 67% of people will experience shoulder pain at some point in their life.
Who gets shoulder pain?
Shoulder pain can occur across the lifespan, however it seems to be more prevalent in people of working age. We often see traumatic shoulder injuries such as dislocations as a result of sporting injuries, in particular contact sports. Shoulder injuries are also very common in overhead athletes, such as baseball and other throwing/overhead sports.
Could my neck be contributing to shoulder pain?
A common overlooked source or contributing factor for shoulder pain is the neck. The neck has 7 vertebrae, all with individual nerves. All of these nerves, in particular C4/5 can contribute to pain in the shoulder as they innervate different areas of skin in the shoulder and arm region (otherwise known as dermatomes).
There is an enormous amount of heterogeneity when it comes to symptoms of shoulder pain. Shoulder pain is often accompanied with clicking or catching and some may describe a sense of instability and/or weakness. Often those with shoulder pain will report difficulty with elevation of the arm and have an arc of pain while lifting the arm. Shoulder pain is often accompanied with functional limitations such as putting clothes on, picking things up etc.
How can Physio help?
Your Physiotherapist will conduct a thorough assessment, to determine possible causes and contributing factors of your shoulder pain. The first priority of the assessment is to exclude anything sinister (otherwise known as Red Flags). While we know that only a small proportion of people will present with pain that is sinister in nature, it is really important not to miss these presentations. Your consultation will also include a thorough history taking of your problem, assessing range of movement and strength and any relevant functional tests, as well as screening your neck to see whether or not it is a possible contributing factor.
Provided there are no Red Flags or contraindications, your Physio will then work with you to establish some goals for your treatment and then create an individualised treatment plan. This may include education, activity modification, exercise to improve strength and or mobility and manual therapy for symptom relief. Shoulder pain can often be extremely disabling and reduce our ability to do day to day activities like getting dressed and even disturb our sleep. Your Physiotherapist will provide individualised treatment to ensure you can get back to your regular routine as soon as possible!