Shoulder pain is a very common propblem that I see in the clinic, and having suffered with it myself which resulted in me needing surgery, I can definitely empathise with what patients are experiencing. Here are some things to consider that I will frequently talk to patients about in clinic.
[If you aren’t one of my patients and are not sure if this advice is suitable for you, then please discuss it with your health care professional.]
1. Sleep position
People sleep in all kinds of weird and wonderful positions. It might be on your front with your arms under the pillows, or on your side with one arm up and under your head. Regardless, almost across the board, if you’ve got shoulder pain, you won’t be able to sleep on your painful side. I know what this is like, having had shoulder surgery, and what I tell my patients is what I did after that. Sleep on the opposite side and cuddle two pillows with your affected arm (well, to my patients in Wales I say, cwtch two pillows…).
This does a number of things.
Firstly, it supports your arm and doesn’t allow it to fall across your body, which might be painful, and is certainly a stretch that could become painful through the night.
Secondly, it stops you rolling over onto your front and leaning on the shoulder that could be painful as well.
Finally, by cwtching the pillows, it tends to tell your subconscious that you are doing it for a reason and not to chuck the pillows out and turn over onto your other side.
I would say this works in about 80% of cases.
2. Putting your coat on!
Most people never think about how they put a coat on (or a shirt or jumper for that matter). They do it the same way every time. You never think, today I’ll put my right arm in first, then tomorrow, my left. And probably because of that, people will struggle on with how they get dressed, even if it’s causing them pain.
The simple answer for this is to put your painful arm in first, and then if it’s a bit of a struggle putting your other arm in, particularly if you don’t usually do it that way, it won’t matter because it won’t be hurting.
3. The Top 5
I’ll often say to patients, that if I turned up at your house (don’t worry, I won’t!), carrying a clipboard and wearing a yellow vest, and looked at all the activities you did on a daily basis, I bet we could find a Top 5 things that you do that aggravate your pain.
It might be reaching up to wash your hair in the shower, or putting deodorant on, or even reaching into the back of a cupboard that you might do on a regular basis. Because these things are normal, every day things, you don’t think twice about doing them, yet they are flaring your pain every time you do them.
So, do a little survey of your daily activities and work out what Top 5 things aggravate your pain.
4. Driving
One of the most common aggravating factors that patients describe is driving. This is largely because you are reaching your arms forward, carrying the weight of them and placing strain around your shoulder. Clearly you should be holding the steering wheel in both hands to be driving properly, but, if it’s possible to slide the whole car seat further forward and still be in control of the vehicle, then this is a good idea. The distance between your shoulder and the steering wheel will be less, requiring less muscle power to keep your arms holding the wheel and reducing strain.
5. Keep taking the tablets
Most shoulder problems will have a degree of inflammation as an issue. Shoulder impingement, frozen shoulder and any traumatic injury will have inflammation as a feature. That means that an anti-inflammatory drug – like ibuprofen or naproxen – has the potential to be effective to reduce the inflammation, which may well reduce your symptoms. So, if you can take anti-inflammatories, then they are worth trying when you have a shoulder problem. If you do decide to take them, it’s worth doing so as a ‘course’, because the inflammatory process is a series of stages, so taking the meds ‘as and when’ won’t be anywhere near as effective. I usually recommend trying them for a week or ten days to assess their effect.
6. Pacing
Lots of patients say that when they do this activity or that thing, it aggravates their pain. And the chances are they do these things quite regularly. Well what if you stopped doing them? Or didn’t spend so long doing them as to cause pain? That is called pacing. In terms of the shoulder, things like ironing for example, might cause you pain after half an hour. So, in that case, iron for 20 minutes, no longer. And that means if you’ve got a pile of laundry that will take you an hour to iron, you should break that up into three separate sessions. Yes, it’s inconvenient, and it’s a lot easier to get it done in one go, but if you split it into three, you won’t have pain. So, far from giving into it, as some people think, you are getting round your symptoms and your problem whilst still allowing you to do the activities you need to do on a daily basis.
7. Creams, lotions, heat and ice
So, people will get prescribed anti-inflammatory creams, will buy tiger balm, or try ice packs or wheat bags that they put in the ‘ding.’ Which should they use?
The answer is that it largely doesn’t matter – if you find something that works, then run with that. Yes, in the first 72 hours of having a problem, ice is probably the treatment of choice. After that, whatever works, works. It’s worth noting that you shouldn’t use anti-inflammatory creams if you are taking anti-inflammatory tablets at the same time.
Summary
Shoulder pain is massively common and can be caused by a number of different conditions. That said, if you can try some of these tips, it may well reduce some of the aggravating factors and even help reduce the pain.
Please do get in touch if you’ve got a problem you’d like me to take a look at.