Why Does My Shoulder Hurt?

Shoulder pain is a common problem. For younger people, pain is more likely to be due to an accident or injury. As you age however, natural wear and tear occurs in the shoulder joint and the rotator cuff tendon. This may become persistently painful over time and may cause limited strength and movement, and loss of shoulder function.

The good news is that with appropriate treatment, pain will improve so you can get back to doing the things you enjoy.

The shoulder

Your shoulder is a complex, highly mobile structure made up of several components. There are two joints:

  • glenohumeral joint – where your upper arm bone (the humerus) connects with your shoulder blade (scapula)

  • acromioclavicular joint – where the top of your shoulder blade meets your collarbone (clavicle).

Strong connective tissue forms your shoulder capsule. This keeps the head of the humerus in place in the joint socket. The joint capsule is lined with a synovial membrane. It produces synovial fluid which lubricates and nourishes the joint.

Strong tendons, ligaments and muscles also support your shoulder and make it stable.

Frozen Shoulder

Also known as adhesive capsulitis, frozen shoulder is a common condition characterised by pain and stiffness in the shoulder with severe loss of range and motion. It can occur either as the primary condition or secondary to an underlying condition.

Although the frozen shoulder may “thaw out” given time, full range of motion may not always return. The condition is considered to be self-limiting meaning that it can last between 18 – 24 months, however while most patients recover completely, many others can be left with long term pain and residual motion restriction.

Standard Care

Standard treatment options for frozen shoulder include nonsteroidal anti-inflammatory medications, oral or injectable corticosteroids may also be prescribed. Physical therapy including gentle range of motion exercises, ultrasound, massage, kinesiological taping, electrical stimulation, or laser stimulation.

Corticosteroid injections may be considered, along with physical therapy to reduce pain and improve range of movement. Surgical options are capsular distension through hydro-dilation, joint manipulation under anaesthesia and capsular release.

Acupuncture Treatment

Studies have shown that acupuncture can provide pain relief, improve range of motion and speed up recovery time. Shoulder pain is one of the conditions listed in the Acupuncture Evidence Project for which there is moderate evidence supporting the use of acupuncture as an effective treatment. Acupuncture is often used in the treatment of injuries as it has been found to release powerful pain relieving substances within the body.

What to expect

Following the first treatment it is possible to feel an improvement in range of motion and reduction of pain. While this is a positive sign, it does not necessarily indicate instantaneous recovery. It may however indicate that the body is responding well and that a follow up treatment soon after is advisable to maintain this momentum. A common mistake made by patients is believing they are fully recovered after just one treatment and going back to normal duties which can further set back recovery time or even worsen the injury.

Similarly, if the state of the condition does not change or temporarily worsens, this does not necessarily indicate a negative response. The length of time someone has had shoulder pain may affect the body’s response time to treatment and it will most likely take more than one session to gain noticeable relief.

Course of treatments

As is the case with most musculoskeletal conditions, weekly treatments for at least several weeks are generally advised in the initial stages to gain momentum and see effective results before spacing the treatments out to once per fortnight/ per month. While it is not uncommon for positive results to be seen immediately after a single treatment or in the following hours or days, the effects of acupuncture can also be cumulative so a treatment plan consisting of multiple treatments may be advised in order to see more effective results.

There are a wide range of factors that determine the amount of time and treatments required for any patient’s condition. Duration and severity of the condition play a big part in determining the length and extent of your treatment plan. If the condition is less severe and has only been present for a short amount of time, then a greater response with faster recovery time is more likely. With chronic and more severe conditions, weeks or perhaps even months of consistent, yet less frequent treatments may be required in order to restore full function, rebuild wasted muscle tone or for the condition to be manageable.

Other factors that play a role in response to treatment are age and and general health of the patient. What you do after your treatment also has an effect on how well you respond. The more you can do post-treatment to complement the acupuncture, the better your results will be. This may include performing assigned stretches, or using prescribed herbs or liniment to support the acupuncture, or not exerting yourself in the time following the session which may undo the treatment.