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Rotator Cuff Related Shoulder Pain

What is Rotator cuff related shoulder pain?

Rotator cuff related shoulder pain is very common condition that causes pain at the top and outside of the shoulder, which may spread into the arm, towards the neck and shoulder blade.

The ‘Rotator Cuff’ is the name given to the muscles and tendons that stabilise the shoulder.

Rotator cuff related shoulder pain can be caused by trauma, overload, repetitive movements, or age-related changes. It commonly affects people between the ages of 35-75 years.

Each year 1 in 50 adults will seek care for new onset shoulder pain.

The rotator cuff is the most effective structure and plays a part in around 80% of shoulder pain cases

6-12 weeks of simple lifestyle changes, advice and an exercise program will lead to improvement in most cases.

In 50% of people, it resolves at around 6 months through natural history alone, meaning the body will heal itself. 

What are the symptoms?

  • Pain around the shoulder and upper arm
  • Pain on certain movements such as: reaching outwards, upwards or behind your back
  • Reduced movements and strength at the shoulder
  • Pain on activities such as: getting dressed, washing your hair, and lifting
  • Pain when laying on your shoulder
  • Affected sleep

What are the causes?

The exact cause is not always known, but there are many factors that can contribute towards it:

  • Sudden increase in load or demand placed on the shoulder, such as: decorating a room or gardening.
  • Repetitive activities that continually overload the shoulder
  • Inactivity causing deconditioning of the muscles and tendons
  • Smoking
  • Being overweight
  • Diabetes
  • Depression and anxiety
  • Thyroid problems

How long will it last?

Everyone’s shoulder pain is different and full recovery can depend on multiple factors, but most people will make a full recovery. Most people will see some improvement following 6-12 weeks of lifestyle changes, advice, and an exercise program. Tendon healing can be a slow process, and can take up to 18-24 months to fully resolve.

What can I do to help myself?

Stay Positive

This is a common problem that usually resolves over time (see times suggested above).

Modify Activities

Reduce or change any specific activities that aggravate your symptoms but do not stop completely.

Support the Shoulder in Lying or Sitting

Try placing a small rolled-up towel or pillow between the arm and the body whilst sitting or lying on the bed.

Regular Pain Relief (Paracetamol or Ibuprofen)

Check with a pharmacist for safety if unsure. If stronger pain relief is required please discuss this with your GP.

Use Heat or Ice Packs.

Apply this to the shoulder to help ease the pain (wrap the pack in a towel and check the skin regularly for signs of burns).

What else can I do?

A gradual increase in load can help the tendon structure improve. We have provided some exercises in the links below. Start with the easiest and build up to the more advanced exercises as you feel able to.

Exercises

Shoulder-Cover

Rotator Cuff Related Shoulder Pain – Early

Do I need an x-ray or scan?

In most cases, no. A good history and physical examination of your shoulder alone provides enough information to diagnose your problem. Scans and x-rays are not always useful for diagnosing shoulder pain. While a scan or x-ray may provide information it rarely alters the treatment plan. 

Imaging findings are very poorly linked with pain and often people with no pain have very similar findings on their scans/x-rays to those that do. X-rays and scans can help for a small number of people in certain situations and will be recommended by a healthcare professional if required.

What about a steroid injection?

A steroid injection may be considered to help control the pain in some circumstances. The risks and benefits would be discussed with your Physiotherapist or GP and is not always an appropriate option for all patients.

Get advice from 111 now if:

  • the pain is sudden or extremely severe
  • you cannot move your arm
  • your arm or shoulder has changed shape or is badly swollen
  • you have severe pins and needles that do not go away
  • your arm or shoulder is hot or cold to touch
  • the pain is severe and started after an injury or accident, like a fall
  • hurts when you exercise but goes away when your rest
  • you are experiencing chest pain/tightness with your shoulder pain

111 will tell you what to do. They can tell you the right place to get help if you need to see someone.

Go to 111.nhs.uk or call 111.

If your shoulder pain persists, or you are not sure what to do, you can self-refer to see a local physiotherapist who can help you with your problem.

Physiotherapy self-referral

If you are an NHS patient registered to a qualifying GP surgery, you can now refer yourself directly for MSK physiotherapy without needing an appointment at your GP practice.

You must be aged 16 or over and registered with a Wakefield GP.

Call 01924 224497 or complete the online form by clicking the link below.