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Versus Arthritis Shoulder Pain Information Booklet

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Versus Arthritis Shoulder Pain Information Booklet Shoulder pain Shoulder pain information booklet Contents Shoulder pain 4 How does the shoulder work? 6 What causes shoulder pain? 9 Should I see a doctor? 10 What can I do to help myself? 11 How are shoulder problems diagnosed? 18 Specific shoulder conditions 20 Treatments for shoulder pain 29 Research and new developments 33 Glossary 34 Keeping active with shoulder pain 37 We’re the 10 million people living with arthritis. We’re the carers, researchers, health professionals, friends and parents all united in Where can I find out more? 42 our ambition to ensure that one day, no one will have to live with Talk to us 43 the pain, fatigue and isolation that arthritis causes. We understand that every day is different. We know that what works for one person may not help someone else. Our information is a collaboration of experiences, research and facts. We aim to give you everything you need to know about your condition, the treatments available and the many options you can try, so you can make the best and most informed choices for your lifestyle. We’re always happy to hear from you whether it’s with feedback on our information, to share your story, or just to find out more about the work of Versus Arthritis. Contact us at [email protected] Words shown are explained in the glossary on p.34. Registered office: Versus Arthritis, Copeman House, St Mary’s Gate, Chesterfield S41 7TD in bold Registered Charity England and Wales No. 207711, Scotland No. SC041156. Page 2 of 44 Page 3 of 44 Shoulder pain information booklet Shoulder pain Many people experience shoulder problems, but they aren’t usually caused by arthritis. Your shoulder has a lot of moving parts and your pain could be caused by problems in specific muscles, tendons or other soft tissues. Sometimes you can also experience pain in your shoulder if you have a problem with your neck. However, it is possible the pain could be caused by arthritis in one or both of the two joints in your shoulder. Some shoulder problems will clear up after a short time and you may not need to see a doctor. Here are a few things you could try at home that may help your shoulder pain: • taking painkillers, such as paracetamol, and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen • applying ice packs or heat pads to the painful area • pacing yourself, resting your shoulder at times but also keeping it mobile with exercise • trying to improve your posture • thinking about which daily activities make your shoulder problem worse and ways you can avoid them. versusarthritis.org Page 4 of 44 Shoulder pain information booklet How does the shoulder work? Figure 1. Main features of the shoulder To understand more about the causes of the pain you’re experiencing it helps to know how the shoulder works. Rotator cuff Rotator cuff Your shoulders each have two joints, making them the most flexible tendon muscles parts of your body. Acromioclavicular joint The main shoulder joint, the glenohumeral, is a ball-and-socket joint. It’s called this because the top of the upper arm bone, the humerus, Acromion is shaped like a ball. This ball fits into the shoulder blade bone, which acts as the socket, giving your shoulder a wide range of movement. Subacromial bursa Collar bone The shoulder socket is very small, compared to other ball-and- (clavicle) socket joints, such as the hip. It’s held together and controlled by Outline of strong muscles and tendons, which form a protective capsule joint capsule around it, but can make it more likely to dislocate than other joints. Shoulder Inside the capsule is the synovium, which lubricates the joint with blade (scapula) synovial fluid and keeps the cartilage healthy. The cartilage helps protect your bones from any impacts and sits between the bones of your shoulder joints to stop them rubbing together. Upper arm bone Shoulder joint Above the main shoulder joint there’s a smaller plain synovial (humerus) (glenohumeral joint) joint where the top of the shoulder blade – the acromion – meets the collar bone. This is known as the acromioclavicular joint. It helps the larger joint below to move through its full range, particularly when you’re raising your arm, lifting or throwing. versusarthritis.org Page 6 of 44 Page 7 of 44 Shoulder pain information booklet What causes shoulder pain? Most shoulder problems only affect a small area and should last a relatively short time. But sometimes the problem in your shoulder could be part of a wider long-term condition such as rheumatoid arthritis, osteoarthritis or polymyalgia rheumatica. It’s fairly common for people with rheumatoid arthritis to have pain and swelling in their shoulders. Osteoarthritis is less likely to affect your shoulders than other joints, unless you’ve injured them in the past. There are several other possible causes of shoulder pain, such as: • inflammation or damage to the muscles and tendons around the shoulder • tension in the muscles between the neck and shoulder – this is usually down to your posture in your upper back or neck and is often linked to the way you stand or sit when you’re at work or using a computer • inflammation in the bursae, which normally help the muscles and tendons slide smoothly over the shoulder bones • damage to the bones and cartilage, which can be caused by arthritis. It’s also possible the pain you’re feeling in your shoulder is coming from a problem in another part of your body, such as your neck. Problems in your neck can make your shoulder blade or upper outer arm painful, when this happens it’s known as referred pain. If you’re feeling a tingling sensation in your hand or arm, as well as pain in your shoulder, it’s likely to be from a problem in your neck. Page 9 of 44 Shoulder pain information booklet Should I see a doctor? What can I do to help myself? Unless you’ve had a serious injury or get a sudden, continuous pain, There are several ways you can help yourself if you have shoulder pain: you can usually treat your shoulder pain without having to see your GP. If, after two weeks of treating yourself, you feel the pain isn’t any Painkillers better you should see your doctor or a physiotherapist. Simple painkillers, such as paracetamol, or non-steroidal anti- inflammatory drugs (NSAIDs), such as ibuprofen tablets and gels, You should also see your doctor as soon as possible if you: from a chemist or supermarket can help. • develop severe pain in both shoulders A pharmacist should be able to give you good advice on what could • also have pain in your hips or thighs work best for your condition. But don’t use them for more than two • feel feverish or unwell. weeks without seeking further medical advice. These can be signs of a condition called polymyalgia rheumatica, which needs prompt treatment. Heat or cold therapy An ice pack may be helpful if your shoulder is painful after a minor injury or if it’s swollen and warmer to touch than the other side. You can use a bag of frozen peas, wrapped in a damp towel to protect your skin. Leave it in place for no longer than 20 minutes. Alternatively, heat packs can help relieve most other types of shoulder pain, particularly if your muscles feel sore and tense. Chemists and sports shops sell reusable heat pads. Or you could use a microwaveable wheat bag or a hot-water bottle, wrapped in something dry, such as a towel, on the painful area for up to 20 minutes. Posture Bad posture or working habits – such as slouching at your desk or rounding your shoulders – can make your shoulder problems worse. Try these tips: • When you’re sitting down try to avoid leaning forwards and resting on your arms too much. Page 11 of 44 Shoulder pain information booklet • Try to relax your shoulders and let your arms hang by your If your shoulder is painful when you lie down, try: sides, rather than gripping them tightly into your sides, • lying on your good side with a pillow under your neck especially if some of the pain is coming from your neck. • using a folded pillow to support your painful arm in front • Change your position frequently. of your body • Sit in a supported upright position. • placing another pillow behind your back to stop yourself • Support your lower back with a pillow, cushion or a chair rolling onto your painful side with lumbar support to improve your upper body posture. • using one or two pillows under your painful arm for support, • If your arm is really sore keep it supported and comfortable if you prefer to sleep on your back. with a cushion or pillow on your lap. • Use a mirror to practise holding your shoulder blades down and back Reduce the strain – focus on your shoulder blades and imagine keeping your chest still Generally, it’s best to carry on with your normal activities as much and pulling the blades downwards and back towards each other. as you can – but don’t overdo it. You may need to pace yourself The below image shows the ideal posture you should have when working. more than usual and try to gradually do a bit more each day. There are ways you can do some tasks slightly differently, so you don’t hurt your shoulder. Wrong Right At home: ✗ ✓ • When vacuuming, keep your upper body upright with the vacuum close to your body, and use short sweeping movements.
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