When to See a Physiotherapist for Your Shoulder Pain

One of the most common conditions we see here at Elevation Physiotherapy relates to shoulder pain. Since shoulder problems often occur with neck problems, it is no wonder that most of us will experience shoulder pain just as often, if not more often, than even low back and knee pain.

There are good reasons why the shoulder is such a problem for most of us. Here are 8 “Fun Facts” about the shoulder:

1. The 3 most common conditions that result in shoulder pain is rotator cuff tears, osteoarthritis and frozen shoulder. In 2022/2023 in Alberta, physician visits and diagnostic imaging for shoulder, knee and and low back pain cost a total of $307 million. Shoulders accounted for 41%, low back 31%, and knees 28% of this cost (1).
2. The socket (acromion) relative to the ball of the humerus is so flat that most would say that this joint has hardly a socket at all. This is why the shoulder joint is the most mobile joint of the body thus also making it the most unstable.
3. It has a small connection to the rest of the body via the collarbone to the breast bone. The vast majority of this joint is attached to a floating platform called the scapula.
4. This makes the shoulder the most dependent on muscles for its stability and function than any other joint in the body.
5. Since it is the most mobile joint of the body, it is also the most dislocatable.
6. Most people associate shoulder problems with surgery as the only and best solution. This is quite erroneous. Rotator cuff tears, osteoarthritis and frozen shoulders respond quite well to conservative, non-surgical approaches like physiotherapy.
7. The neck often refers pain to the shoulder. Visceral organs like the heart, lungs and organs of digestion can also produce shoulder symptoms.
8. Not every shoulder problem requires diagnostic imaging (Xrays, ultrasound and MRI) for proper management. The decision to proceed with imaging needs to be made carefully and systematically only if it affects or changes your pathway of care.

When to Seek Professional Help for Your Shoulder Pain

So, if you have shoulder pain, when should you see a healthcare professional? Here are our top 5 recommendations:

1. Disrupted Sleep: The pain is bad enough to affect your sleep. Oftentimes, lying on the shoulder makes the pain worse.
2. Declining Range of Motion: You are noticing a gradual or sudden loss of movement of the shoulder. The most common restrictions noticed are placing your hand behind your back (attaching a bra strap), raising your arms overhead, and reaching to your side.
3. Declining Strength and Function: The pain is now affecting your ability to work, exercise, and perform simple household chores.
4. Neck Pain with Numbness and Tingling in Your Hands or Face: If the pain in your shoulder is associated with pain in your neck and spine and numbness and tingling in your hands, then you should see a healthcare professional as soon as you can. Numbness, tingling, and weakness are usually symptoms of nerve involvement.
5. Pain That is Spreading: Whether the pain is still stemming only from the shoulder or is in addition to another problem needs an assessment by your doctor or physiotherapist.

Physiotherapy for Shoulder Pain: An Active Approach

In the realm of rotator cuff tears, osteoarthritis, and frozen shoulders, physiotherapy treatments that emphasize mobility and strength exercises are vital. Remember that this joint is highly dependent on muscles for its stability and function. These problems cannot resolve by simply resting your shoulder and “not using it.” Nor can these problems resolve only with passive treatments like ultrasound, shockwave therapy, injections, or massage therapy. These treatments instead should be considered as adjuncts to support an active treatment program that is personalized and tailored to your specific needs and conditions. No two shoulder problems are ever the same. Cookie-cutter solutions are only good for baking cookies.

We’re Here to Help.

If you are struggling with shoulder pain, our team here at Elevation Physiotherapy has years of experience managing the most complicated shoulders. If you have had surgery or injections for any of the three conditions mentioned, give us a call. Our team would love to help!

Reference:

(1) Thanh NX, Eubank B, Waye A, et al. Costs of physician and diagnostic imaging services for shoulder, knee, and low back pain conditions: A population-based study in Alberta, Canada. British Journal of Pain. 2024;19(1):43-50. doi:10.1177/20494637241298246