Shoulder pain is a common complaint across people of all ages. In this blog, I simplify how we diagnose and treat shoulder pain. Basically, all shoulder pain can be diagnosed into four categories; pain that refers from the neck, a stiff shoulder, a painful shoulder with no stiffness and an unstable shoulder. Your Physiotherapist may ask questions such as is your shoulder painful, is your shoulder range of motion limited or does your shoulder have a loose/wobbly feeling?

In 20% of cases, your shoulder pain could be referred from your neck. In this case, neck movements would likely bring on your shoulder pain and treatment should be therefore focused on the neck.

In the case of a stiff shoulder, your Physiotherapist will move your shoulder and test for any restrictions in range of motion. Treatment would focus on stretching and manual therapy to regain movement but also strengthening as often your shoulder will be weak too.

If range of motion is normal, resisted tests are used to diagnose the painful but not stiff shoulder and often the diagnosis will be rotator cuff tendinopathy. Treatment in this case will focus on a strength- based program to load and re-build these tendons. Manual therapy techniques can also be beneficial in assisting with pain and increasing blood flow.

Exercise is appropriate and effective in the treatment of shoulder pain. Studies have shown that exercise is actually as beneficial as surgery for most shoulder conditions. At a course I attended recently, the speaker said that it may actually be the exercises that people complete after surgery that fixes their shoulder and not the surgery itself. Studies have shown that people are far more diligent with completing a home exercise plan after surgery in comparison to when exercises are prescribed after injury or onset of shoulder pain. So my advice is to make sure you have completed a comprehensive strengthening program before thinking about surgical intervention!

Thanks for reading,

Nichola O’Ceallaigh

Physiotherapist