Helpful Measures Against Persistent Shoulder Pain

Understanding shoulder pain

In order to treat shoulder pain effectively, it is important to understand its causes and symptoms precisely. Shoulder pain can have many different reasons and can express itself in different ways.

Causes of shoulder pain

The causes of shoulder pain are varied and can result from both acute injuries and chronic conditions. The most common causes include:

• Injuries:
  • Muscle and ligament strains
  • Clavicle fractures
  • Acromioclavicular joint separation
• Conditions:
  • Calcific shoulder
  • Shoulder osteoarthritis
  • Impingement syndrome
• Chronic overloading:
  • Tendon inflammation
  • Bursitis
  • Rotator cuff tear

Cause – description

• Clavicle fracture – break of the collarbone, often caused by falls or accidents
• Calcific shoulder – calcium deposits in the tendon lead to severe pain and restricted movement
• Impingement syndrome – structures in the shoulder joint become trapped, causing pain and restricted mobility

You will find further information on the causes of shoulder pain in our articles on acromioclavicular joint separation and shoulder osteoarthritis.

Common symptoms and complaints

The symptoms of shoulder pain can vary considerably and often depend on the underlying cause. The most common complaints include:

• Pain:
  • Pulling or stabbing pain in the shoulder region
  • Pain on movement of the arm
• Restricted mobility:
  • Difficulty lifting or rotating the arm
  • Stiffness of the shoulder, particularly in the morning
• Loss of strength:
  • Weakness in the affected arm
  • Difficulty holding objects
• Swelling and inflammation:
  • Visible swelling in the shoulder region
  • Local warmth and redness

Symptom – description

• Pain – the intensity can range from a slight pulling sensation to severe, stabbing pain
• Restricted mobility – symptoms can affect lifting the arm or rotational movements
• Loss of strength – reduced ability to load the arm or to grip and hold objects

For detailed information on specific shoulder complaints, visit our article on the treatment of impingement syndrome and on shoulder arthroscopy.

Diagnosis and treatment

The diagnosis and treatment of shoulder pain play a decisive role in relieving the symptoms and restoring the function of the shoulder.

Diagnosis of shoulder pain

In order to determine the cause of shoulder pain, the orthopaedic specialist takes a thorough history and carries out a physical examination. Questions are asked about the symptoms, how long they have lasted and possible triggering factors. Imaging procedures and other diagnostic tests may also be used.

History and physical examination

• History:
  • Questions about where the pain originates and how it has developed
  • Identification of triggers and factors that provide relief
  • Previous conditions and injuries of the shoulder
• Physical examination:
  • Inspection of the shoulder for swelling, discolouration and deformity
  • Palpation to detect tenderness and muscular tension
  • Mobility tests to assess range of movement and strength

Imaging procedures

Procedure – description

• X-ray – identifies bone fractures and osteoarthritis
• MRI (magnetic resonance imaging) – visualises soft tissue, including tendons and ligaments
• Ultrasound – assesses tendons, muscles and fluid-filled structures

These methods allow an accurate diagnosis to be made and a suitable therapy to be started.

Treatment options

The treatment of shoulder pain depends on the cause and severity of the complaints. It can include conservative measures and surgical procedures.

Conservative treatment

• Drug therapy:
  • Painkillers (analgesics)
  • Anti-inflammatory medication (NSAIDs)
• Physiotherapy:
  • Strengthening and stretching exercises to stabilise the shoulder
  • Manual therapy to relieve pain and improve mobility
• Further measures:
  • Kinesiology taping to support the musculature
  • Radial and high-energy shock wave therapy to promote healing

Surgical treatment

For serious shoulder problems, surgery may be required. Possible options are:

Procedure – description

• Shoulder arthroscopy – minimally invasive procedure for examining and treating shoulder damage
• Tendon reconstruction – repair of torn tendons, for example in rotator cuff tears
• Artificial shoulder joint – implantation of an artificial joint for irreparable damage and severe osteoarthritis
• Shoulder stabilisation surgery – correcting instability and dislocations by reinforcing the ligaments and joint structures

The choice of the appropriate treatment method is made in close consultation between you and the treating orthopaedic surgeon, in order to achieve the best possible results and relieve the pain permanently. For further information on the relevant treatment options and specialised procedures, visit our page on acromioclavicular joint separation and calcific shoulder.

Helpful measures at home

Shoulder pain can often be relieved with simple measures at home. Targeted self-help and special exercises can strengthen the shoulder musculature and reduce pain.

Self-help for shoulder pain

There are various methods of relieving shoulder pain at home. These include:

• Cold and heat applications: cooling pads or warm compresses can help to reduce pain and inflammation.
• Gentle stretching exercises: regular stretching can increase the flexibility of the shoulder and release tension.
• Ergonomic adjustments: an ergonomically designed working environment can help to minimise the load on the shoulder. You can read more about this in our section on ergonomic workplace design.

Exercises to strengthen the shoulder musculature

Targeted exercises to strengthen the shoulder musculature can help to relieve shoulder pain and prevent future complaints. Here are some simple exercises that can be carried out at home:

• Shoulder circles: standing, slowly circle the shoulders forwards and backwards. This exercise promotes circulation and releases tension.
• Wall press-ups: place your hands shoulder-width apart on a wall and slowly bend towards the wall and push back again. This exercise strengthens the shoulder and chest musculature.
• Lateral arm raises: take dumbbells or water bottles in both hands and raise the arms sideways to shoulder height, then lower them again. This exercise strengthens the lateral shoulder muscles.

Here is an overview of the exercises with possible repetitions:

Exercise – repetitions – sets

• Shoulder circles – 10 to 15 – 3
• Wall press-ups – 10 to 12 – 3
• Lateral arm raises – 8 to 10 – 3

These exercises can help to strengthen the shoulder musculature and improve mobility. Make sure you perform the exercises slowly and in a controlled manner in order to avoid injury.

For professional support, or if the pain persists despite these measures, you should consult an orthopaedic specialist. You will find further information in our section on seeking professional help.

Ergonomics and prevention

Ergonomic workplace design

Ergonomic workplace design is essential for the prevention of shoulder pain. A comfortable and well-arranged workplace, both in the office and at home, can minimise the load on the shoulders.

• Chair: an adjustable chair with a good backrest and armrests can help to encourage a healthy sitting posture.
• Desk height: the correct desk height ensures that the arms rest at a 90-degree angle and the shoulders can relax.
• Screen position: the screen should be placed directly in front of you at eye level, in order to avoid overloading the neck and shoulder musculature.
• Keyboard and mouse: these should be positioned so that they are comfortably within reach without raising the shoulders.

Ergonomic measure – description

• Chair with armrests – supports the arms and reduces the load on the shoulders
• Adjustable desk height – encourages a neutral wrist position
• Screen at eye level – reduces neck and shoulder pain
• Ergonomic keyboard and mouse – improves hand and shoulder position

Preventive measures for healthy shoulders

In addition to ergonomic workplace design, there are further preventive measures that help to avoid shoulder pain.

• Warm-up exercises: before physical activity, the shoulders should be prepared with gentle stretching and warm-up exercises.
• Regular breaks: regular breaks and changes of position are important, particularly when sitting or working at a computer for hours at a time.
• Strengthening exercises: specific exercises to strengthen the shoulder and back musculature can help to increase the resilience of the shoulder joints.

Recommended exercises include:

• Raising and lowering the shoulders: this can help to relax the shoulder musculature.
• Circling arm movements: promotes flexibility and strengthens the musculature.
• Wall pushing: this exercise strengthens the shoulder and chest musculature.

Preventive measure – description

• Warm-up exercises – prepare the shoulder musculature for movement
• Regular breaks – prevent overloading
• Strengthening exercises – increase the resilience of the shoulders

For further in-depth information on specific health topics and treatment options for shoulder pain, please visit our articles on acromioclavicular joint separation and shoulder arthroscopy.

Seeking professional help

If shoulder pain persists, it may be necessary to seek professional help. An orthopaedic specialist is trained in the diagnosis and treatment of musculoskeletal conditions and can help to identify the underlying cause of the pain and develop suitable treatment strategies.

When should you consult an orthopaedic specialist?

There are certain situations in which a visit to an orthopaedic specialist is recommended:

• Persistent pain: when the shoulder pain does not subside despite self-help measures and home remedies.
• Restricted mobility: when movement of the shoulder is severely restricted.
• Severe pain: in cases of acute, intense pain.
• Injuries: after an accident or injury that leads to shoulder problems.
• Existing conditions: where conditions such as osteoarthritis or tendon tears are already known.

Related topics:

• Osteoarthritis therapy
• Shoulder osteoarthritis
• Shoulder surgery

Treatment options with an orthopaedic specialist

An orthopaedic specialist has various treatment methods available to relieve shoulder pain and restore the function of the shoulder. Here are some common options:

Treatment option – description

• Drug therapy – painkillers and anti-inflammatory medication
• Physiotherapy – exercises to strengthen and mobilise the shoulder
• Injection therapy – injecting cortisone or hyaluronic acid into the joint
• Surgical procedures – surgical measures for severe injuries or conditions

Additional treatment options

• Tendon therapy: for damage to the tendons of the shoulder.
• Shoulder arthroscopy: minimally invasive procedures for diagnosis and treatment.
• Artificial shoulder joint: for severe joint wear.
• Shoulder stabilisation surgery: for the treatment of instability.
• Impingement syndrome treatment: to relieve chronic pain caused by narrowing of the shoulder space.

Related topics:

• Tendon therapy
• Shoulder arthroscopy
• Artificial shoulder joint
• Shoulder stabilisation surgery
• Impingement syndrome treatment

A visit to an orthopaedic specialist can be the first step towards relieving persistent shoulder pain and restoring shoulder function.