Shoulder pain is one of the most common of all complaints. And of all the most common shoulder complaints, pain when lifting the arm probably tops the list again.
Perhaps you’re even experiencing that kind of pain right now. You reach up to a shelf and your shoulder seems to ‘catch’. You turn to strap your child into their car seat and get a sudden jolt of discomfort.
What’s going on?
There are of course several reasons why your shoulder might be hurting when you elevate it; the possibilities range from certain collarbone injuries to osteoarthritis in a joint.
But for now let’s focus on the reason that most people tend to experience shoulder pain when lifting their arm.
The most likely culprit
Culprit Number One is a shoulder impingement. This is essentially a friction problem. At the top of your arm is a set of powerful, flexible tendons and ligaments called the Rotator Cuff. These tendons support your shoulder and keep your arm bone securely in its socket. When things are working as they should, the tendons glide smoothly through their movements with the help of bursae (little sacs of fluid under the collarbone). But if you develop a problem in the Cuff, they can become irritated – and this may cause them to inflame and narrow the space between bone and tissue. It’s a bit of a vicious circle. Inflammation causes swelling. Swelling causes impingement. Impingement causes more swelling, and so on. When you lift your arm, you narrow the space between bone and tissue even further. Result? Pain in the shoulder – usually in the top or outer part. The other possibility is that you have strained, or even torn, one of the Cuff tendons. This will give you similar symptoms, but pain at rest or at night is more common.
The most likely cause
Shoulder impingements and rotator cuff problems can happen suddenly or gradually, but they are usually provoked by a new or vigorous kind of activity. Perhaps you recently repainted the ceilings at home, or started a new workout at the gym. Or maybe the problem started when you were playing tennis or badminton – some kind of action where the arm goes up, perhaps rotates, pulls on the shoulder. The cause may be quite obvious, or not so obvious. (If you have stiffness in your shoulder alongside the pain, this might indicate a ‘frozen shoulder’; you can find out more about that here.)
When to seek help
Many Rotator Cuff issues disappear on their own. When you first experience pain on elevation, the first thing to do is stop any repetitive, high-arm activities that might have caused it. Follow that with rest (though not complete inactivity, or the tissues can stiffen up). You could use an anti-inflammatory painkiller like ibuprofen, if you can take it. In time, the pain symptoms should ease. If the pain runs from days into weeks, however, it’s time to get medical advice. There are various levels of help that we can give you. The first step is some imaging (an MRI scan) and a consultation. The next step would be physiotherapy: we’ll put you in touch with a therapist who can help you to rebuild your shoulder strength and movement with specific exercises (the exercises often focus on strengthening the lower Cuff, to help offload the key supraspinatus muscle in your Rotator Cuff). If the problem continues, we could look to steroid injections – and ultimately surgery, if necessary.
Rest, then, is the first port of call. But if you find your shoulder pain persists, or if it’s worrying you for any reason, please get in touch. We’ll be happy to have a look and put your mind at rest. Sometimes a swift diagnosis, whatever the outcome, can be its own kind of medicine.