The shoulder is made up of bones, muscles, ligaments and tendons. They work together soyou can reach, swing and lift. The shouldercomplex refers to thefollowing joints,acromioclavicular, sternoclavicular, glenohumeral and scapulothoracic joints.A joint is astructure in the human body at which two parts of the skeleton are fitted together.

Acromioclavicular (AC) joint: where the end of the collar bone meets the shoulder

Sternoclavicular joint: where the collar bone meets the sternum

Glenohumeral joint: connects the scapula (shoulder blade) and the humerus (upper arm bone) – see Figure 2.

A group of muscles and their tendons called the rotator cuff help to keep the joint in place and help it to move.

Facts about shoulder pain

The shoulder (glenohumeral) joint is complex and is prone to problems. Most cases of shoulder pain aren’t caused by anything serious and will ease with time. The times it takes to settle varies from person to person. Shoulder pain can be caused by misuse or overuse of tendons and muscles, the joint itself or tension in your neck muscles and these structures become inflamed and painful. Arthritis or normal age related changes as we get older can cause ‘degenerative’ changes of the tendons or of one of the joints of the shoulder complex (see Figure 1) which can also be a source of pain.

What can I do myself to get better?

Getting the balance right: When you have shoulder pain, it is important to keep a balance between rest and activity. Try to change or adapt any movements that might be causing your pain or making it worse such as repetitive movements such as painting the ceiling or heavy gardening Try to keep your shoulder moving within your pain limits to stop it getting stiff.

Exercises can be useful to ease pain and maintain the movement in your shoulder. If your pain increases when exercising, stop and rest for a few days. When your shoulder pain is better, try to resume doing your exercises to stay strong and mobile. These simple exercises may be helpful http://www.arthritisresearchuk.org/arthritis-information/conditions/shoulderpain/shoulder-pain-exercises.aspx

At Home/Work: Here are some tips to help you day to day:

  • Use a trolley or a backpack to carry shopping, or divide the weight between two bags and carry one in each hand. A bag with cross the shoulder straps can reduce the load on your shoulder
  • Don’t spend too much time looking at tablets or mobile phones. Use a stand for them or place them on a table to reduce neck strain.
  • If you use a phone frequently, don’t hold the phone between your head and shoulder. Try using a headset
  • When doing DIY (such as painting and cleaning the walls or ceiling) try to pace yourself and take regular breaks. Switch tasks and positions to reduce the load on your shoulder.

Painkillers: Over the counter painkillers may be helpful, such as paracetamol, ibuprofen or creams that you can buy at the chemist. Your pharmacist will be able to give you expert advice

Posture: Poor posture when sitting down makes shoulder problems worse, particularly if you are at a desk for a long time. Make sure your back is supported in your chair. Try a small cushion behind your lower back. If your shoulder is painful whilst you are sitting try to support your arm on the chair or desk. Changing your position often can also help. This website may be helpful: http://www.nhs.uk/livewell/workplacehealth/pages/howtositcorrectly.aspx

Sleeping: If your shoulder is painful to lie on, try to lie on your good side and use a folded pillow to support your painful arm in front of your body. If you prefer to sleep on your back, use one or two pillows under your painful arm to support it off the bed.

PRICE for minor sprains and strains:

This link may be helpful: http://www.nhs.uk/Conditions/Sports-injuries/Pages/Treatment.aspx

  • Protection – protect the affected area from further injury; for example, by using a support and avoiding painful activities.
  • Rest – Optimal loading of the elbow is advised to maintain function but avoid aggravating pain.
  • Ice – apply an ice pack to the affected area for 15-20 minutes every two to three hours. A bag of frozen peas, or similar, will work well. Wrap the ice pack in a towel to avoid it directly touching your skin and causing an ice burn.

When should I see my doctor?

Most cases of shoulder pain get better on their own or with simple self-help treatments. You should see your doctor

  • If the pain is severe
  • You have tingling, numbness in the arm or fingers
  • If the limb feels cold
  • Following an obvious injury such as a fall on an outstretched hand, hard impact or twisting of the arm or if you think you have broken your arm (for example it is severely swollen or appears to be deformed)
  • If the shoulder becomes hot, red, swollen and tender, if you feel feverish, you may have an infection of the joint, so you should see your doctor straight away.

Most common conditions of the shoulder

If you have a diagnosis which does not have a leaflet above, then please contact our clinical support team on 0300 303 8063 and they will work with our clinical team to find you some more information.