The shoulder joint is a ‘ball and socket’ joint and requires the muscles and ligaments surrounding it to be strong and flexible to provide stability and motion. The main muscles are called the ‘rotator cuff’ muscles. These muscles have tendons to attach to the arm bone, but these tendons travel between bones of the shoulder joint and therefore commonly get pinched or injured, especially the supraspinatus tendon.

This tendon is one of the most injured joints because of its position between the bones.

    • Difficulty in raising the arm or carrying objects
    • Shoulder pain lasting for more than a few days
    • Swelling or significant bruising around the shoulder or arm
    • Injury that causes deformity of the joint
    • Shoulder pain that occurs at night or at rest, also disrupting normal sleep patterns



Acute Shoulder Pain

A fall onto an outstretched arm or directly onto the shoulder can cause acute pain. If you notice swelling within 8 hours of injury, bruising, specific points of severe pain, deformity, pins and needles or a sudden inability to move the arm, please seek medical advice before attending physiotherapy. Deposits of calcium may appear in the tendon which may cause swelling and tension in the tendon. This can cause a sharp pain.

Chronic Shoulder Pain

Tendinitis (The Painful Arc Syndrome)

  • Repetitive use and wear and tear may cause an inflammation in the rotator cuff (esp. Supraspinatus tendon)
  • As the tendon becomes sore and swollen, it can become pinched between the two bones.
  • The sac of fluid that cushions the tendon can also be damaged.
  • Slight swelling may be enough to affect the movement of the shoulder.
  • Sideways lifting of the arm is painful, usually in the mid-range 60 to 120 degrees.
  • Pain is worse at night and is severe with movements like putting on a jacket or blouse.

Frozen Shoulder 

  • A common condition characterized by pain with significant loss of its range of motion in all directions progressively worsening over a period of time.
  • The pain may be worse at night and often radiates to the middle of the upper arm.
Treatment Options
The treatment of shoulder pain depends entirely on the cause of the problem. Therefore, it is important to understand the cause of your symptoms before starting a treatment program.


Your doctor may prescribe some anti-inflammatories and pain-killers, Sometimes an acute pain injections of steroids are given.  


A Physiotherapist will make a detailed assessment of your condition and put together a treatment programme for your specific problems. This may include:

Specialised Treatments:

  • Radial Shockware Therapy: This involves application of very high energy shockwaves to the area to be treated, commonly for chronic rotator cuff tendinitis or frozen shoulder. It increases the circulation to the area thereby increasing body’s healing response, metabolism and thus reduces inflammation. Usually only 3-5 sessions are required.
  • Laser: Used for much localised area of pain to reduce pain and increase micro-circulation.
  • Taping: Applying adhesive tape to the skin to reduce the strain on the tissues
  • Exercise Therapy: Includes muscle stretches to maintain the shoulder movements and strengthening program for the neck and shoulder, to improve overall stability and control

General Treatments

  • Interferential Therapy: Electrical current that stimulates the peripheral sensory and muscle nerve fibres to reduce pain and inflammation
  • Ultrasound: The application of ultrasonic waves decreases tissue inflammation and reduces pain and swelling.
  • Shortwave Diathermy and Moist Heat: To aid in reducing pain and muscle spasm
  • Ergonomics Tips and Advice: Advice on improving neck and spine posture to reduce pressure on the various parts of the shoulder.
Our Tips
  • Avoid sleeping on the painful side
  • If you have sustained an injury, rest and ice therapy will be immediately important. Seek medical advice if you have experienced immediate loss of power, deformity or severe sharp pain after a fall onto an outstretched arm or directly to the shoulder
  • One good exercise for all shoulder problems is the pendulum exercise. Stand with your good hand resting on a table. Let your other arm hang down and try to swing it gently backwards and forwards and in a circular motion
  • Another good exercise is to use your good arm to help lift up your painful arm to the limit of slight stretch feeling but not a sharp pain.

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