Living with persistent shoulder pain?
Shoulder pain can make everyday activities surprisingly difficult. Reaching overhead, getting dressed, sleeping comfortably or lifting even light objects may become painful.
Many shoulder problems improve with time and rehabilitation, but persistent symptoms often require a more detailed assessment to identify the underlying cause.
As a Consultant in Pain Medicine, I assess people with persistent shoulder pain and develop an individual treatment plan. Depending on the diagnosis, treatment may include rehabilitation, medication, image-guided injections or specialist pain procedures where appropriate.
Common Causes
Frozen Shoulder
Painful stiffness with progressively reduced movement.
Often develops gradually and can last many months.
Rotator Cuff Disorders
One of the most common causes of shoulder pain.
Pain reaching overhead.
Weakness.
Pain at night.
Shoulder Arthritis
Wear-and-tear of the shoulder joint.
Pain and stiffness.
Reduced movement.
Shoulder Bursitis & Tendinopathy
Inflammation of the soft tissues around the shoulder.
Pain lifting the arm.
Pain lying on the affected side.
Pain Referred from the Neck
Sometimes shoulder pain is actually caused by irritation of structures within the cervical spine.
When Should You See a Specialist?
A specialist assessment may be appropriate if:
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Symptoms have lasted longer than three months
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Physiotherapy has not improved your symptoms
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Pain regularly disturbs your sleep
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Daily activities remain difficult
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Previous injections have only provided short-term relief
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You wish to understand whether image-guided injections or other treatments may be appropriate
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You are uncertain whether surgery is necessary
Treatment Options
Education and Activity Modification
Simple changes to posture, movement patterns and activity levels can sometimes reduce pain while allowing the shoulder to recover.
Physiotherapy
Targeted rehabilitation remains one of the most effective treatments for many shoulder conditions.
Medication
Medication may help reduce pain and enable rehabilitation.
Image-Guided Injections
For selected patients, injections may reduce inflammation, relieve pain and facilitate rehabilitation.
Radiofrequency Ablation
For selected patients with persistent shoulder pain, particularly glenohumeral arthritis, radiofrequency ablation of the articular nerves may provide longer-lasting pain relief when conservative treatment has not been sufficient.
Surgical Referral
Some shoulder conditions benefit from orthopaedic assessment. Part of the consultation is determining whether surgery is likely to help or whether non-operative treatment remains the most appropriate option.
Frequently Asked Questions
Is shoulder pain always caused by a torn rotator cuff?
No.
Shoulder pain may arise from the rotator cuff, frozen shoulder, arthritis, bursitis, tendons or even the neck. Identifying the correct diagnosis is the key to choosing the most appropriate treatment.
Why is my shoulder pain worse at night?
Night pain is common in several shoulder conditions, particularly rotator cuff disorders, bursitis and frozen shoulder. The exact cause varies depending on the underlying diagnosis.
Do I need an MRI?
Not always.
Many shoulder problems can be diagnosed clinically. Ultrasound or MRI may be recommended when imaging is likely to influence treatment decisions.
Can injections cure shoulder pain?
Injections are not a cure but may reduce pain, improve movement and make rehabilitation more effective. Their role depends on the underlying condition.
Can shoulder pain come from my neck?
Yes.
Pain originating in the cervical spine can sometimes be felt mainly in the shoulder. A specialist assessment helps distinguish between these causes.
Can I avoid surgery?
Many people with persistent shoulder pain improve without surgery through a combination of rehabilitation, targeted pain treatments and activity modification. When surgery is likely to be beneficial, this will be discussed as part of your assessment.
