Shoulder & Elbow Pain

Frozen shoulder, shoulder and elbow pain and tennis elbow are all among the conditions osteopaths commonly help with. They have one thing in common: the arm is used constantly, so a painful shoulder or elbow is hard to rest and quick to become a daily nuisance.

What causes shoulder pain?

The shoulder is the most mobile joint in the body, and its stability depends on the muscles and tendons around it as much as the joint itself. The NHS lists the usual causes of shoulder pain as frozen shoulder, tendon inflammation (tendonitis), bursitis, impingement, where a tendon is pinched as the arm lifts, and arthritis. The pattern helps tell them apart: stiffness that has built up over months points to frozen shoulder, while a sharp catch when you lift or reach is more often a tendon or bursa problem.

Frozen shoulder deserves a mention on its own. It causes pain, often worse at night, followed by stiffness that makes it difficult to move the arm. It is more common in people with diabetes and after an injury or surgery that keeps the arm still. It does get better, but the NHS is honest that this can take months or years, so good management along the way matters.

What causes elbow pain and tennis elbow?

Tennis elbow is pain on the outside of the elbow where the forearm tendons attach. It comes from repetitive gripping and wrist movements, which is why it is common in people who use a keyboard and mouse all day, do manual work or gardening, or play racket sports. It is most common between the ages of 35 and 54. The NHS says it usually gets better with rest, though it can last for over a year in some cases. Golfer's elbow is the equivalent on the inside of the elbow.

How can osteopathy help with shoulder and elbow pain?

Abdul assesses the whole chain: the neck and upper back, the shoulder blade, the shoulder joint itself and, for elbow pain, the wrist and grip. Shoulder problems often involve the neck or a shoulder blade that is not moving well, and treating only the painful spot misses that. Treatment may include mobilisation of the shoulder and upper back, soft tissue work on the muscles and tendons involved, and a graded exercise plan to restore movement and strength, which the NHS suggests continuing for six to eight weeks to stop the pain returning. For some long-standing tendon problems shock wave therapy is available at the clinic.

What can I do while I wait for an appointment?

The NHS advises:

• staying active and gently moving the shoulder rather than keeping it still
• for tennis elbow, reducing the activity that causes the pain, and a forearm strap or brace if it helps
• heat or cold, wrapped in a towel, for up to 20 minutes at a time
• paracetamol or ibuprofen gel if they suit you
• simple arm and shoulder exercises, within comfort

When should I see a GP or get urgent help?

See a GP if shoulder pain is getting worse or has not improved after two weeks of self-care, if you still have elbow pain after resting it for at least two weeks, or if movement is severely restricted. Get urgent help for sudden, severe shoulder pain, a shoulder that looks out of shape or cannot be moved, pain after an injury or fall, persistent pins and needles or numbness, or a hot, swollen joint with a high temperature.

Sources

• NHS: Shoulder pain
• NHS: Frozen shoulder
• NHS: Tennis elbow
• Institute of Osteopathy: Muscle and joint conditions