Areas of the body (shoulder)

What is shoulder pain?

Shoulder pain is pain that is felt in the shoulder area, at the top of the arm. It is a sign that the joints, muscles or other parts of the shoulder are injured, strained or not working properly. About one in 10 people experience shoulder pain at some time in their lives. Shoulder pain is common, but it is not usually an early sign of arthritis.

Shoulder pain is common but is rarely due to any serious disease. Staying active will help you get better faster and prevent more problems.

When is shoulder pain due to arthritis?

About one in five people with arthritis may have arthritis involving their shoulders. You may have difficulty and pain when moving your shoulder, with some people experiencing "frozen shoulder", when the shoulder joint is so stiff and painful and hard to move that it feels like the joint is frozen.

Shoulder pain is most commonly felt in the front of the shoulder or in the upper part of the arm. Pain is usually felt when moving the arm and you may notice it with only certain movements. Most shoulder problems do not cause pain when the arm is not moving. However, many people find it painful when lying on the sore side in bed at night. Pain that travels right down to your hand, with tingling in your fingers, may be from a problem with your neck, rather than your shoulder.

If you been diagnosed with axSpA and have shoulder pain this could be due to enthesitis, inflammation of the site where a ligament or joint attaches to the bone.

Should I see a doctor?

You should talk to your doctor or other health professional if your pain is bothering you or is persisting. They will ask you about your symptoms, examine the movement of your shoulder and assess your arthritis. Your doctor may check for any serious medical problems that could be causing your pain, but these are rare. You should see your doctor if:

you have shoulder pain after a fall or accident
your pain does not settle down or starts getting worse, especially if you have pain when you are resting your shoulder
your pain travels down your arm to your hand, with tingling in your fingers
you have symptoms such as losing weight, fever or night sweats.

What can I do?

Talk to your healthcare team. It is normal to worry about the cause of your pain and how it will affect you. Talking to your doctor or other health professional about your worries can be helpful.

Learn ways to manage pain. Talk to your healthcare team about ways to relieve your pain. For example, there are medicines that can help with shoulder pain. Always talk to your doctor or pharmacist about your medicines. Remember that medicines aren’t just your prescription or over-the counter medicines. Medicines also include any creams or ointments or vitamins and ‘natural’ medicines you might be taking and these can have side effects your doctor may need to discuss with you.

Stay active. Your shoulder is designed for movement. The sooner you get your movement and strength back, the sooner your shoulder will feel better. You may need to rest or reduce some activities when the pain is bad but resting for more than a day or two usually does not help and may do more harm than good. See a physiotherapist or other health professional for advice about exercises to keep your shoulder moving.

Find different ways to do things. If your shoulder pain is making your daily activities difficult, you may need to find new or different ways of doing things. An occupational therapist may also be able to give you some ideas about how you can do things differently or recommend a range of aids or assistive devices that can make things easier.

Acknowledge your feelings and seek support. It is natural to feel scared, frustrated, sad and sometimes angry when you have pain. Be aware of these feelings and get help if they start affecting your daily life.

There are many other treatments for shoulder pain that have not been well proven. Some unproven treatments may still be useful, however further research is needed.

These treatments include:

acupuncture
mobilisation of the shoulder
transcutaneous electrical nerve stimulation (TENS)
laser therapy, ultrasound and other electrotherapy treatments by a physiotherapist.