Shoulder pain is incredibly common as we get older. But one of the biggest mistakes we see people make is assuming it is simply part of ageing.
They notice a bit of pain when reaching overhead. They struggle to put a coat on. Sleeping on one side becomes uncomfortable. They start taking the occasional painkiller to settle it down.
And rather than getting it looked at, they adapt.
They stop sleeping on that side. They use the other arm more. They avoid certain exercises at the gym. They ask someone else to reach into the high cupboard. They take painkillers when it gets particularly uncomfortable.
The problem is that shoulder pain that is gradually getting worse should not simply be accepted, particularly if you are over 50.
There are a number of different conditions that can cause shoulder pain, and most of them can be treated very successfully. But the earlier you understand what is causing the problem, the easier it usually is to put the right plan in place.
The Signs You Shouldn’t Ignore
Not every painful shoulder means there is something seriously wrong. In fact, most shoulder problems we see are very treatable.
But there are certain signs that tell us it is probably time to get it assessed rather than continuing to hope it disappears.
One of the biggest is pain at night.
You might find that you can no longer lie on the painful shoulder. You fall asleep normally but wake up when you roll onto it. Some people eventually struggle to find any comfortable sleeping position at all.
Another common sign is losing movement.
This can happen gradually, which is why people do not always notice it initially.
Reaching behind your back becomes difficult. Putting your arm into a jacket becomes uncomfortable. Reaching up to a cupboard gets harder. For women, fastening a bra can become increasingly difficult. Washing or styling your hair might suddenly require more effort.
The third thing to watch is your reliance on painkillers.
If you are regularly taking medication just to manage your shoulder, you are managing the symptom rather than understanding why it is there.
Other signs include pain when lifting your arm, weakness, difficulty carrying things, pain when exercising and gradually having to change how you perform normal everyday activities.
The key thing is change.
If your shoulder is becoming more painful, more restricted or affecting more areas of your life, it deserves investigating.
Could It Be a Frozen Shoulder?
One condition we commonly see in people over 50 is frozen shoulder.
A frozen shoulder can initially seem relatively harmless. It might start as an ache around the shoulder that you assume will settle.
But over time, the shoulder can become increasingly painful and increasingly stiff.
The medical term is adhesive capsulitis. Essentially, the capsule surrounding the shoulder joint becomes irritated and stiff, significantly restricting how the shoulder moves.
One of the classic features is that you do not just have pain. You start physically losing movement.
People will often tell us they cannot reach behind their back anymore. They cannot lift their arm properly. Getting dressed is difficult. Sleeping becomes a nightmare.
And because the process can happen gradually, people adapt without realising how much movement they have actually lost.
Frozen shoulder is particularly common between the ages of 40 and 60, and there are certain factors that can increase your risk.
But the important thing is getting the diagnosis right.
Not every painful shoulder is a frozen shoulder.
Problems involving the rotator cuff, arthritis, tendons and other structures around the shoulder can produce similar symptoms. Occasionally, pain felt around the shoulder can even be coming from somewhere else, such as the neck.
This is why simply searching your symptoms online and trying a few shoulder exercises is not always the best approach.
The first job is working out what you are actually dealing with.
The Cost of Ignoring Shoulder Pain
When we talk about the cost of ignoring shoulder pain, we do not just mean money.
We mean what it starts costing you in your everyday life.
At first, you might stop doing one particular exercise because it hurts.
Then you stop going to the gym as often.
You stop playing golf because your swing is uncomfortable.
You stop swimming because reaching overhead hurts.
You avoid carrying the grandchildren.
You wake up several times every night because you cannot get comfortable.
None of those things necessarily happen overnight. It is often a gradual process.
Your world simply gets a little smaller.
There can also be a knock on effect from constantly compensating. If you cannot move one shoulder properly, you naturally find other ways of completing tasks. That can mean relying heavily on the opposite arm or changing the way you move your neck, back and upper body.
Sleep is another major issue.
If shoulder pain is waking you several times a night, night after night, it is not just a shoulder problem anymore. Poor sleep can affect your energy, mood, work, exercise and general quality of life.
Then there is the loss of movement.
Particularly with conditions such as frozen shoulder, waiting until the shoulder has become extremely stiff can leave you with a much bigger rehabilitation job than if you had sought help when you first noticed the change.
The message here is not that you should panic about shoulder pain.
Quite the opposite.
It is that you should do something about it.
Shoulder Pain Often Responds Extremely Well to Physiotherapy
The good news is that the majority of shoulder problems we see respond extremely well to the right treatment and rehabilitation.
The first step is a proper assessment.
We want to understand when the problem started, how it has changed, where the pain is coming from, which movements are restricted and what activities you are struggling with.
From there, we can assess your movement, strength and shoulder function to build a picture of what is happening.
Once we know what we are dealing with, treatment becomes much more specific.
Physiotherapy for shoulder pain may include hands on treatment to improve movement and reduce pain alongside specific exercises designed to restore mobility, strength and confidence in the shoulder.
For some people, the initial goal is simply getting them sleeping again.
For someone else, it might be getting enough movement back to put a coat on comfortably.
For another person, success might mean getting them back into the gym, onto the golf course or playing with their grandchildren without thinking about their shoulder.
The treatment should always be built around what you need your shoulder to do.
With frozen shoulder specifically, understanding what stage the condition is in is also important. Treatment needs to be appropriate for how irritable and restricted the shoulder is rather than simply forcing it through painful exercises.
In some cases, physiotherapy may also work alongside other treatments. If we believe further investigation or another intervention would be useful, we can help make sure you are pointed in the right direction rather than spending months trying things that are unlikely to help.
You Don’t Have to Accept Shoulder Pain as Part of Getting Older
Being over 50 does not mean you should expect to be in pain.
And it certainly does not mean you should accept gradually losing the ability to use your shoulder.
If you have started noticing that you cannot lie on your shoulder at night, you are losing movement, everyday activities are becoming more difficult or you are increasingly relying on painkillers to get through the day, get it checked.
The earlier we can understand what is causing your symptoms, the sooner we can put a plan in place to do something about them.
You might have a frozen shoulder. You might have a rotator cuff problem. You might have another common shoulder condition that responds extremely well to physiotherapy.
But you will not know until somebody properly assesses it.
Our goal is not simply to make your shoulder feel better for a few hours.
It is to work out what is causing the problem, restore as much movement and strength as possible and ultimately get you back to doing the things you want to do without constantly thinking about your shoulder.
Because staying active, independent and doing the things you enjoy should not stop just because you have turned 50.
