Shoulder pain

Steps to help shoulder pain and improve recovery 

Physiotherapy

Physiotherapy assists your body’s natural repair and recovery mechanisms. It strengthens the muscles, helps to remodel the bones, and evidence shows that it improves pain and importantly, functioning. You can get things started by completing the following self-referral: Physio self-referral form

The Physiotherapy team will then be in contact to arrange an initial appointment.

Whilst waiting, start your recovery now! Try the activities in the links below, which have been produced the Chartered Society of Physiotherapists (CSP): https://www.csp.org.uk/conditions/managing-pain-home This means you will have already started the  repair and rehabilitation process, which can be fine-tuned when you see your physiotherapist. 

Simple painkillers

When we have a joint, tendon or muscle problem, completing Physiotherapy or day to day activities can be hard. Simple forms of pain relief taken half an hour before activity helps you get the most out of the movements you can get through.

Paracetamol, non-steroidal anti-inflammatories (if you are able to tolerate them) in tablet form such as Ibuprofen or non-steroidal anti-inflammatories in gel form, such as Ibugel.

Heat or cold packs are often helpful as well. Often people will find cold packs helpful after an initial injury, but heat packs if the pain has been there for longer. However, please use whichever works best for you.

Understanding pain, improves pain

Pain is…a pain. It gets in the way of the things we do, and naturally can become a burden. The way we relate to pain is complex but gaining some control over it is important to make sure it doesn’t get out of hand.

If you live with long term pain, the video in this link could transform the way you think about pain and is really worth watching:

https://www.tamethebeast.org/#tame-the-beast

The physiotherapy is making my Shoulder pain worse! 

It can be normal for pain to worsen during or after physiotherapy. It is a bit like running for the first time in a long while. Your body feels stiff and it takes time to strengthen. However, as time go by, you will get stronger and you will feel your symptoms starting to improve.  

I have seen the physiotherapist and it hasn’t worked. What now?

If you have had a few sessions with your physiotherapist and your pain is not improving, discuss with them what the next steps should be. Options might include referrals to specialists such as extended scope physios (who can arrange for more advanced treatments and imaging e.g. Xrays or MRIs) and orthopaedics.

I don’t want to see a physiotherapist. I want to see a surgeon.

Referrals by GPs to surgeons are nearly always rejected. The surgeons request you have been through physiotherapy first, this is because for most people it works so well. 

For those patients that do go onto see a surgeon the physiotherapy input is still very important. The information they can pass onto the surgical team means that everyone can get the most out of any surgical appointments. 

I am still in pain. What about codeine, morphine, and other opiates?

Many patients wonder about taking stronger opiate-based therapies such as codeine. We tend not to prescribe them anymore because long term opiate use can make pain worse.  Most people who take these drugs for more than 2-4 weeks develop a tolerance and addiction to the medication. Tolerance means your body may need an increased dosage to feel the same effect. Opioid tolerance and addiction can cause withdrawal symptoms when the medication is stopped.

Most people know that opiates can be addictive, but they don’t know that taking opioids over a long period of time may in fact increase a patient’s sensitivity to pain (hyperalgesia). This happens because long-term use of opiate painkillers causes a decrease in your ability to tolerate pain and an increase in sensitivity to pain. Many of the patients we see on long term opioids long term are still in high levels of pain, or may see their pain increase, long after the original cause of pain has healed.  

When to call us

If you have any of the following symptoms call the surgery shoulder so that we can make sure you do not have a joint infection or a more severe problem: 

1. If your shoulder is swollen, red, hot, tender to touch, or you are unable to move the joint 
2. You have shoulder pain and nausea/vomiting/fever/rigor(shakes) 
3. If you have pain in the middle of a bone, not a joint. 
4. If you have had any weight loss 
5. If you have new bone pain and you have had cancer in the past
6. You have read through this information, taken all the steps and are still needing advice.

Please note, that the advice below gives an overview which covers the majority of joint and muscular problems, it cannot be an exhaustive guide. So once you have read through this information, taken all the steps and are still needing advice, then please contact us.

How long will my Shoulder pain last?

With most musculoskeletal injuries, you can expect the first 2-3 weeks to be the worst in terms of a new injury, or a flare up. 

After this, the pain begins to settle. It may not be smooth and you still may get spikes/aggravations in this time, which tend to lessen and ease off somewhere between 6-12 weeks after the initial pain. A really useful video that describes this process can be found here:https://www.youtube.com/watch?v=xU2ksSnMDU0

The most important thing is giving your body time.

We hope this information helps.