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This month, GP Alice Fitzgibbon covers the common problem of shoulder pain.
Many people will suffer with a shoulder problem at some point in their life – it can have a huge effect on the ability to complete everyday tasks from getting dressed to going to going to work, especially in manual jobs.
So why is shoulder pain such a common issue? This is because the shoulder is a very flexible joint. Think of all the ways you can move your arm and reach out for things. The shoulder is quite a complicated joint (technically, it’s actually four different joints) that has a wide range of movement. It is considered to be a ball and socket joint due to the glenohumeral joint. The head of the upper arm (the humerus) is like a ball that sits within the cup-like socket of the scapula (called the glenoid). The ball and socket joint is quite shallow – hence why it can be prone to dislocation – and it relies on a lot of support from muscles, tendons and ligaments to keep everything in place.
The collective name for the soft tissues that surround the shoulder is the ‘rotator cuff’. Strains and sprains can happen to these muscles and soft tissues resulting in pain around the shoulder, with difficulty in doing certain movements too.
Occupational injuries to the shoulder can happen after a single accident or develop over time. It is recognised that people who work in construction may be high risk due to the nature of the work and the environment they work in. Occupational shoulder pain may be caused by:
- Awkward movements: Maintaining awkward positions can put additional stress on the shoulder joint and lead to injury.
- Repetitive motions: Repeating the same movement can lead to shoulder pain over time. This is often seen in painters or decorators.
- Accidental falls: This could happen to anyone at work. Uneven flooring, slick surfaces and building sites can cause slips and falls leading to shoulder injuries.
- Lifting and pushing heavy objects: This can lead to straining the shoulder, especially with poor lifting techniques.
It is important to be properly assessed if you are experiencing shoulder pain. Figuring out what the problem is may help you to be able to fix it. Physiotherapists can perform accurate assessments and initiate treatment plans for shoulder pains so you may be directed to seek help from them in the first instance.
Rest, painkillers/ anti-inflammatories and physiotherapy exercises may be advised. Sometimes further imaging- XR, ultrasound or MRI scan – can be used to look in more detail at the shoulder joint and the soft tissues around it if needed. For inflammatory conditions like tendinitis, sometimes a steroid injection can help it settle down. If there is a bigger problem such as with recurrent dislocations or tears in the muscles of the rotator cuff, then surgery may be needed by a hospital specialist.
One of the ways you can avoid getting a shoulder injury is by warming up the muscles and soft tissues before starting work if you do a physical job. A good way to do this is by stretching, as you might do before sports. Also being mindful of how you do things can help avoid unnecessary strains.
An example of this would be digging a hole. Consider where you throw the dugout earth to avoid excessive twisting. This can help both the lower back and the shoulders from necessary strain. If you have been shown the way to complete certain tasks at work, or equipment to use, it is advisable to stick to this. Job tasks can be designed with consideration to what is needed in terms of equipment and the environment to prevent injury and damage. This is known as ergonomics and is promoted by the Health and Safety Executive.
So, if you have shoulder pain, stop and get assessed. Contact your local GP surgery and they can advise who is available for you to see. In some places you may be immediately directed to a physiotherapist for assessment. It is better to try and identify any issues early in case the pain should get worse and lead to reduced movement and the need for time off work (which can have its own implications in terms of finances, especially for the self-employed). Many cases of shoulder pain will settle with time, rest and the right strengthening exercises.
For further information on shoulder pain visit Shoulder pain – NHS.
