Claire Mc Hugh, 2024

Understanding Shoulder Pain:
Causes, Treatment, and Prevention Tips from MVP Health

Shoulder pain can be a complex and uncomfortable experience for anyone.

The shoulder joint is one of the most dynamic joints in the body and it is used in most daily activities, therefore shoulder pain can be very debilitating for anyone who experiences it.

Fact: 50% of people will experience shoulder pain in their lifetime!

POSSIBLE DIAGNOSIS/CAUSES OF SHOULDER PAIN

The two main causes for shoulder pain seen in our clinic are:

  1. Rotator Cuff Related Shoulder Pain (RCRSP)

  2. Subacromial Shoulder Pain


WHAT IS THE ROTATOR CUFF?

A group muscle which surrounds the shoulder joint and keeps the shoulder joint securely in place, as well as being involved in all movements of the shoulder. Due to the shoulder joints high degree of movement, the rotator cuff complex is essential for active stability of the shoulder joint.

WHAT DOES SUBACROMIAL MEAN?

The acromion is the top outer edge of your scapula (shoulder blade) which meets with the clavicle (collar bone) and makes up the acromioclavicular joint. Subacromial is the term used for the space that lies underneath the acromion bone. 

INJURY RISK FACTORS

The major risk factors for shoulder pain include: age, overuse, underuse, occupation, repetitive overhead use and smoking. 


TREATMENT

Assessment by a therapist to determine the possible cause of your pain is essential to selecting the appropriate treatment. Exercise therapy is the gold standard and recommendation for the majority of shoulder pain cases. As exercises need to be specific and progressive for shoulder pain rehabilitation, it is important that you are prescribed such exercises by a professional.

DO I NEED A SCAN?

There are times when a scan may be indicated but with a most shoulder pain cases there is no evidence to suggest that a scan will be helpful. 

One study found that 96% of men with NO pain found pathology related to the shoulder on scanning results, while another study showed 50% of college baseball players exhibit partial thickness tear of their rotator cuff (RC) on scanning but NO pain and no limits to their sporting ability. So remember, pain is not always related to structural changes!  

DO I NEED SURGERY?

Many shoulder injuries, including partial tears to the RC muscles, can be managed successfully through physiotherapy led exercise programs. 

Shoulder surgery is NOT the gold standard for treatment of RCRSP and research has shown no clinically important differences between subacromial decompression and exercise led therapy.

WHAT CAN PHYSIO/CHIRO DO TO HELP?

Firstly, a diagnosis to the cause of your shoulder pain is needed, then your clinician will prescribe specific and safe exercises which should be done based on your injury. They will then guide you through your rehab program to progressively load the shoulder in order to recover from the injury.

Scanning and/or surgery is indicated in some cases and the physio/chiro can help with the decision whether further referral to either is needed and/or help with the post operative care guided by the specialist involved.

Patience is key! Rehab for shoulder injuries may last between 3-12 months. 

If you are experiencing shoulder pain please note that a ‘wait and see’ approach is unlikely to help the injury. Early diagnosis and rehabilitation will likely prevent your shoulder pain from increasing and reduce your overall rehabilitation time.