28th MARCH 2018
The shoulder is a complex joint with a huge range of movement and creates the possibility for complex arm movements. This mobility is made possible by the design of the 4 joints involved — the Gleno/humeral (ball and socket) joint, the joints at either end of the collar bone and the surface between the scapular and the ribs (Scapulo-thoracic joint).
Your Osteopath is trained to assess you and determine the nature of your shoulder pain and if necessary refer you on for further investigations.
Causes of shoulder pain
Shoulder pain is very common and can arise from a variety of causes. Some of the conditions that occur in the shoulder include
• Rotator cuff problems – pain in the shoulder or upper arm, particularly when lifting the arm, rotating and lying on it or using the sore muscles. It is often the result of repetitive overuse of the arm and shoulder or injury during a sport or activity. Age and degenerative change as a consequence of overuse or old injury from years ago can also play a part.
• Acromioclavicular joint pain – painful joint on the tip of the shoulder where the collarbone and shoulder blade join. This can be the consequence of occupation, age or traumatic injury.
• Frozen shoulder or adhesive capsulitis – is the painful and gradual stiffening of the shoulder capsule (the tissue that surrounds your shoulder joint) and the shoulder can often become so stiff and painful that it limits your ability to use your arm in everyday activities. This can occur spontaneously especially in late middle age. It can be secondary to trauma, or other ongoing disease processes such as arthritis, diabetes, Thyroid disease, gall bladder and pancreas issues and breast cancer.
• Osteoarthritis – progressive wearing away of the cartilage of the joint leading to the two bones of the joint rubbing together causing pain. Patients who have had previous trauma or shoulder surgery are most likely to develop osteoarthritis in later life. Symptoms include swelling, stiffness, aching and sharp, stabbing pains.
• Shoulder instability – dislocation or excessive movement of the shoulder joint.
• Referred shoulder pain – pain is experienced in an area away from the actual injury or problem e.g. pain in shoulder which is usually referred from the neck or upper back. Referred pain can also be from some visceral problems. For instance an inflamed gall bladder will refer pain to the right shoulder girdle. Angina and heart problems often refer into the left side.
Shoulder problems are often complex with multifaceted components. We have often had little strains and sprains and altered the way we use our arm, the position we sleep in and the way we hold ourselves. Our posture whilst at work, play and driving for instance can have a significant effect. We will work with you to try and understand the causes of your pain and the way to resolve this. This may involve a combination of Osteopathy, physiotherapy exercise for rehabilitation and sometimes massage.
Depending on your age and fitness and the diagnosis and any associated health conditions Osteopaths will use a variety of soft tissue, rhythmical articulation and stretching mobilizations to improve your shoulder mobility and reduce pain and tension. Developing better muscle control can be very helpful.
The muscles of the shoulder start at the base of the head (the sub occipital area) and extend to the bony crests of your pelvis. The most obvious of these at the back are the trapezius and the latissimus dorsi and at the front the pectoral muscles wrap around your rib cage. Under these Muscle groups there are smaller muscles with more precise fine control mechanisms.
Your treatment plan will always be individual with all these things in mind and often involve working on your neck and lower back and pelvis to improve your balance and mobility. We may offer specific exercise through our physiotherapist, to either strengthen or loosen you and, offer postural and possibly lifestyle advice.
Wherever necessary either initially or during the course of your treatment we may refer you to your GP for further investigations such as Blood tests X-rays or Scans. Sometimes to arrange secondary referral to a consultant.
Through the clinic we have access to private Ultrasound and MRI scanning services.