Until we answer this question, treating the pain will be a hit and miss and considering the number of conditions which may cause shoulder pain, more often than not, it will be a ‘miss’! We can make many (potentially incorrect) assumptions:
- Older people are more likely to have arthritis (but this often incorrectly blamed and it doesn’t automatically cause pain)
- Active and sedentary people can have rotator cuff tears (but believe it or not, research shows this is quite common and usually not pathological)
- If you’ve recently had a car accident, you may assume you have whiplash (which may or may not cause pain, even into the shoulder)
- If you’ve suddenly and enthusiastically started a new activity, you may have a tendinopathy (AKA tendonitis but your tendons could be perfectly fine despite sudden exercise)
- If you’ve had an xray you may have been told its impingement (but research supports the existence of this diagnosis less and less)
- If you recently had physical trauma it could be a fracture (or your bones may be perfectly intact)
- If you have very limited shoulder mobility it could be the dreaded frozen shoulder (but this isn’t very common and many other conditions also cause pain and restricted mobility)
- If you’ve neglected your strength training you might have weak shoulders
(Does weakness cause pain? Really??)
MOST IMPORTANTLY, you could also simultaneously fall into each and every one of the above scenarios or not have a single one of those conditions! Pain and musculoskeletal dysfunction is a complex environment and in the interest of efficiency or wanting to show competence or confidence, health professionals, patients, friends and even Google will easily lead us on any incorrect path. Taking one or 2 elements into account and ignoring the others brews incorrect assumptions, poor responses to treatment and lasting symptoms!
Consider the following:
- How did your symptoms come about (traumatic, instantaneous onset or did it develop over time)
- Does your pain intensity fluctuate from day to day or is it very consistent?
- Does the pain location change / move around / spread or become more localised?
- Did the current pain actually migrate from another area?
- Do you have other medical conditions which may impact your shoulder?
- Do you have headaches or pins and needles in either arm accompanying the shoulder pain?
- Is it the shoulder joint or the shoulder blade?
As professionals specialised in the health and functional capacity of the neuromusculoskeletal system we need to consider all the above and more before we can even consider a possible diagnosis and even then, there are likely still 3 or 4 possibilities we need to rule out to get to the bottom of it all.
If you’ve allowed someone’s (be that your own or that of a health practitioner) momentary judgement of your symptoms determine your diagnosis and the required treatment, and especially if such treatment fell short of providing an impactful and lasting improvement, perhaps your real answer is still out there!
If you have any doubt as to whether you can see improvements despite already having received any repeated or ongoing treatments for your shoulder, we’d be happy to assist your shoulder with a another look from a fresh pair of eyes.
Your health and physical wellbeing should be a priority deserving of quality care. Make sure to discuss any concerns you may have directly with your preferred physiotherapist, so that you can receive the appropriate guidance for your unique situation.