We regularly see clients with shoulder pain at Wellthy Clinic. Shoulder pain can be tricky but we find the best results are achieved with a global approach (not just treating your shoulder!). In this article we discuss different shoulder conditions. How we can help you with a combined approach of hands on Osteopathy and/or Cranial Osteopathy, Studio Pilates (mixture of rehab strengthening and stretching) and Nutritionist advice. In this article we cover some common shoulder conditions and suggest how we can help you.
Rotator Cuff Strains & Tear
You will experience pain in the shoulder or your upper arm. Especially when lifting the arm, when you lie on your affected side or use the sore muscles. Typically, you can associate the onset back to a particularly movement or repetitive overuse of the arm and shoulder. There are four rotator cuff muscles that support and stabilise your upper arm bone (humerus) into your shoulder joint. Tendons also attach from your muscles around your shoulder joint. Strains, impingement and tears can arise to these muscles and tendons (most commonly your supraspinatus muscle and tendon). Repetitive movements with hunched shoulders can increase the likelihood of experiencing impingement and tears. Typically you will not be able to raise your arm if you have torn your rotator cuff tendon/s.
Adhesive Capsulitis (Frozen Shoulder)
You will experience a painful and gradual stiffening of the shoulder capsule (the tissue that surrounds your shoulder joint). The shoulder can become so stiff and painful that it limits your ability to use your arm in everyday activities. The condition can affect your sleep and can have a long recovery time (up to 18 months). The cause is unknown though particular triggers are identified, such as following an infection, after an injury to the shoulder, or compensation for other parts of the body.
Referred Shoulder Pain
Pain in your shoulder can actually be referred from your neck and upper back. Likewise it can be referred from your lungs, diaphragm, liver or gallbladder. Therefore it is important to identify the cause of your shoulder pain in order to achieve the best results. Typically if neck or upper back movements are producing pain (not shoulder movements) they are more likely to be the cause of your pain. However if shoulder or other movements aren’t reproducing your pain, a visceral referral (liver etc) should be considered.
Progressive wearing away of the cartilage of the joint leading to the two bones of the joint rubbing together causing pain. Patient who have had previous trauma or shoulder surgery are most likely to develop arthritis in later life. Symptoms include swelling, stiffness, aching and sharp stabbing pains.
Acromioclavicular joint pain
Your shoulder complex is made up of four joints: glenohumeral, acromioclavicular (AC), sternoclavicular and scapulothoracic joints. Your AC joint (ACJ) is where your acromion meets your clavicular (collar bone). These joint can become inflamed, painful to touch and painful on shoulder movements. Typically you will experience ACJ pain or sprain after a fall or after weight lifting. However it is possible to experience pain due to poor posture with protracted shoulders after many years causing increased mechanical loading through your ACJ.
Osteopath for Shoulder Pain
When your muscles or ligaments are overstretched, your shoulder may feel unstable. It is common in young athletes where they have been demanding repetitive movements (throwing, rugby etc). These activities over time can stretch the shoulder ligaments and cause instability. Your rotator cuff muscles which surround the shoulder joint will then tighten to stabilise the joint which can lead to a dull deep achy pain.
Is where your upper arm (humerus) comes out of it’s normal shoulder joint position. Your shoulder ligaments and muscles will be affected and sometimes tears can occur. A dislocated shoulder requires medical attention to gently traction the joint to put the shoulder back into place. Once this happens you are more susceptible to further dislocations. To try and avoid surgery a rehab program to stabilise and strengthen your shoulder muscles will be beneficial.
Can an Osteopath Help with Shoulder Pain?
Yes definitely, firstly it is most important to understand why you are experiencing shoulder pain. Hands on Osteopathy to then treat you shoulder, upper back and neck to reduce pressure into your inflamed shoulder will be beneficial. At Wellthy Clinic we also advice on strengthening and stretching exercises and give nutrition advice to optimise your recovery time. A recent randomised controlled trial suggested five osteopathic treatments over a period of eight weeks led to statistically significant and clinically relevant positive changes of pain and disability in patients suffering from shoulder pain (Schwerla et al 2020).
What is the Most Painful Shoulder Condition?
Frozen shoulder probably wins! But all shoulder pains are really challenging as they affect your everyday activities and your ability to do what you want to do.
What is the Best Treatment for Shoulder Pain?
Hands on manual therapy - Osteopathy, Pilates strengthening and stretching rehab exercises and Nutrition advice in our opinion.
Can an Osteopath Help with Shoulder Bursitis?
Yes. A bursa is a fatty pad within the body. Itis refers to inflammation so the question is why is the bursa inflamed? An Osteopath will address the posture and try to reduce mechanical loading through your shoulder to optimise the inflammatory process. This is a longer term solution to address the cause of the problem as opposed to poking the sore bit or injecting the bursa with steroids.
Do Osteopaths Massage?
Osteopaths will do a combination of hands on muscular stretching, joint articulation and manipulation (if appropriate). They can incorporate some massage aimed to reduce muscular tension into a session if they feel this is required.
What Does a Pinched Nerve in the Shoulder Feel Like?
Shooting pain, pins and needles, burning sensation or feeling of numbness are the most commonly reported feeling for pinched nerves.
How Can an Osteopath Help?
Shoulder pains can be very tricky and can take a long time to resolve. An Osteopath will firstly work with you to try and understand the cause of your shoulder problem. Then provide hands on muscular stretching, rhythmical joint articulation and manipulation (if appropriate) to try and improve the range of motion within your shoulder, upper back, neck and indeed whole posture. We will give specific rehab stretching and strengthening exercises, nutrition and lifestyle advice to address your barriers to recovery to ensure the best results.
Osteopath for Shoulder Pain Conclusion
Shoulder pain is a common condition and can be really challenging as we use our shoulders in many everyday movements. Your shoulder joint is a very mobile joint but does come at the expense of having reduced stability. Which in turn can be lead to injury. However with hands on effective treatment and advice you can feel better.
What involved within an Osteopath session?
- Take a case history to find out about you and your problem. We listen to you.
- Perform assessments and necessary tests to reach a diagnosis.
- Always be professional and safe
- Provide hands-on treatment
- We treat the bigger picture, rather than just the sore bit
- We give exercise, nutrition and lifestyle advice to give your body the best chance of recovery