Shoulder pain can be a simple case of muscle tightness due to stress or, more seriously, pain radiating into the whole arm, tendonitis, or frozen shoulder. Shoulder pain as a result of sport can be due to inflammation or a tendon tear.
Common conditions start with a tightening of the muscles around the shoulder, which causes discomfort and pain. If left unattended, this minor complaint can lead to pins and needles into the arm and hand, inflammation of the tendons or bursa and most painful of all an inability to move the arm. Frozen shoulder can happen following injury or acute tendonitis, however, it can come on without any previous injury. When the case is related to injury, the restriction in movement is quite sudden. Conversely, when there is no underlying injury, restricted movement comes on gradually over the course of months, with the individual unconsciously compensating for the lack of mobility, i.e. bending the head forward to wash hair rather than reaching up. In both cases the joint locks, dramatically limiting movement, causing severe pain and an inability to sleep.
The shoulder is the most mobile joint in the body, moving 360º. To allow this movement the ball and socket joint has a very shallow socket. Therefore, to keep the shoulder stable during movement, a group of muscles and their tendons, collectively known as the Rotator Cuff, work constantly to prevent excessive movement. These muscles, as well as others which originate from the spine can become tight and inflamed with overuse.
As with all cases, when a patient presents with a painful shoulder, it is essential to do a thorough examination and range of tests to provide a clear diagnosis. The primary aim of treatment is to reduce the pain and inflammation, followed by exercises for strength and stability. In the case of frozen shoulder, immediate pain management is the key, with gentle joint mobilisation introduced once pain is controlled.