Shoulder Pain
Shoulder pain is one of the most common orthopaedic reasons for a patient to see a GP or physio, and only 50% of new shoulder pain episodes recover within 6 months*.
This makes shoulder pain often a chronic and long-term condition, especially if not assessed thoroughly and treated promptly.
Here are patients’ most asked questions on shoulder pain.

What are the causes of shoulder pain?

Shoulder pain can be caused by:

Injury or trauma – Strains, sprains, sport throwing injuries, shoulder fractures, shoulder dislocations or tears in the muscles, tendons or ligaments.

Overuse or repetitive motion – heavy lifting, or repetitive work tasks such as baggage handling or trades work that is physically demanding.

SLAP Tears – Competitive sports can also cause shoulder pain such as rugby, tennis, weightlifting and martial arts.
One injury common in athletes is a SLAP tear, a painful overuse throwing injury that affects the labrum, a ring of cartilage around the shoulder socket.

Poor posture – Hunching or slouching can put strain on the muscles in the tendon and neck area (think of your head as a 5kg weight).

Arthritis – Both osteoarthritis and rheumatoid arthritis can cause pain, stiffness, swelling and inflammation in the joint.

Bursitis – This is inflammation of the bursae sacs in the shoulder that can lead to pain and a limited range of motion.

Frozen shoulder – A common condition for both sexes, for women typically occurs around perimenopause and menopause and is often called “fifties shoulder”. The cause is often idiopathic, however frozen shoulder can be an early sign of diabetes, while people who have other autoimmune diseases are also at greater risk of frozen shoulder. Someone who has had one frozen shoulder is at greater risk of the other shoulder freezing as well. Symptoms typically include night pain especially when sleeping on affected shoulder, loss or range of motion (especially putting on a coat or doing up a bra), as well as a persistent dull ache in the shoulder.There may also be severe pain with sudden movement.

Rotator Cuff tendonitis – Inflammation or tears of the rotator cuff can cause pain and discomfort. Rotator cuff tears commonly cause shoulder pain and weakness in the shoulder. This could be either right shoulder pain or left shoulder pain.

Tumours – Very rarely, shoulder pain that is sudden and acute can be a sign of a tumour of the shoulder or the lung.

Nerve compression – Conditions like a pinched nerve or cervical radiculopathy can cause pain that radiates down the shoulder area.

Referred pain – Quite often pain in the shoulder is referred from other areas such as the chest, neck and abdomen.

Shoulder impingement – This can also cause shoulder pain and occurs when the rotator cuff muscles become pinched or compressed between the bones of the shoulder joint.

Bicep Tendonitis – This condition causes inflammation and irritation of the biceps tendon that connects the biceps muscle to the shoulder and typically causes pain in the shoulder or upper arm especially with lifting or overhead activities. It can also cause weakness, tenderness and painful snapping or tearing.

Acromioclavicular Joint Sprain – This is where the collarbone meets the highest point of the shoulder blade. Sprains or separation of the joint can cause swelling, pain and tenderness at the very top of the shoulder.

What are the symptoms of shoulder pain?
  • Pain or tenderness in the shoulder when reaching overhead or behind the back
  • Pain when sleeping
  • Shoulder blade pain
  • Shoulder pain at night
  • Frozen shoulder pain
  • Pain that worsens with movement or pressure
  • Warmth or redness
  • Weakness in the affected arm
  • Inability to lift shopping or grandchildren
  • Dull ache in the shoulder that worsens with activity
  • Sharp or shooting pain especially with specific movement
  • Limited range of movement (cannot do bra up or put on a coat)
  • Swelling or inflammation
  • Pain that radiates from neck to shoulder to hand
  • Bulge of the shoulder
  • Stiffness, often worse in the morning if arthritis
  • Pain that worsens with the weather
  • Tenderness of sensitivity to points on the shoulder
  • Audible sounds of popping or clicking
What specific factors are known to cause shoulder pain?
  • Working above shoulder height
  • Low frequency vibration
  • Repetitive tasks
  • Improper lifting at gym
  • Shift work
  • Sleep disturbance
  • Driving
  • Lifting
  • Smoking
  • Depression
  • Job dissatisfaction
  • Immigrant status
What specific factors are known to cause shoulder pain?

At Replay health we see everyone from elite athletes to weekend warriors. Common conditions we see include

  • Swimmer’s Shoulder
  • Golfer’s Elbow
  • Frozen shoulder (adhesive capsulitis)
  • Shoulder Impingement Syndrome
  • Partial rotator cuff tears (and we will refer suspected full tears to a surgeon promptly)
  • Inflammation of the bursae
  • Shoulder tendonitis
  • Shoulder arthritis
  • Osteoarthritis of the shoulder
  • Rheumatoid arthritis
  • Post-traumatic arthritis
  • Labral tears
  • Biceps tendon rupture (Popeye Deformity)
  • Shoulder Dislocation
  • Shoulder Instability
  • Acromioclavicular Joint Sprain (clavicle/shoulder blade injury)
What treatments for shoulder pain does Replay Health offer?

At Replay Health we offer onsite physio, as well as affordable take- home cryotherapy – CRYO IPC.
CRYO IPC is a two-in-one device that provides hospital grade compression therapy as well as cryotherapy (cold therapy) at the same time.
Popular with elite athletes looking to expedite recovery, we now offer a practical, portable pump and compression sleeve that you can use from the comfort of home – perfect for after injury or post-op.
The pump, which comes with customisable sleeves helps reduce swelling and pain.
And you can buy a sleeve for any body part from shoulder, to ankle, knee, hip and elbow.
CRYO IPC also offers a personalised fit, no risk of ice burn, a short 30 minute treatment time and there is a safety setting which means you can never apply TOO much pressure.

Cryo IPC is useful for

  • Post workout pain
  • Post orthopaedic surgery
  • Post acute injury
  • During arthritis flare up
What are important tips for managing shoulder pain conservatively?
More than 50% of shoulder conditions do not recover within 6 months*, which is why prompt attention is important in maximising the chance of a long term shoulder image.
Try these conservative therapies and book in today for an assessment of your shoulder condition.
  • Try over the counter medicines such as paracetamol. Follow dosage directions strictly.
  • Rest. Don’t use your shoulder in ways that cause or worsen pain.
  • Ice. Put an IPC CRyo pack on your painful shoulder for 15 to 20 minutes a few times each day.
  • Corticosteroid injections can also help relieve frozen shoulder pain. We can refer you to a doctor’s office and this will add cushioning to the joint which will reduce the friction and allow the bones to move more freely. However, frequent cortisone injections can be harmful and best avoided if possible.
  • PRP can be used intra-operatively or in our Pyrmont rooms during a Saturday PRP clinic. Ask us today.
  • Peripheral nerve ablations or stimulation can be very effective for complex pain conditions that involve the shoulder. As experienced worker injury providers we can refer to pain physicians, occupational physicians and shoulder surgeons.
  • Surgery such as an arthroscopy (key-hole surgery) is typically a last resort option to explore if the pain experienced is severe and unbearable. This is considered a minimally invasive procedure which makes it a fairly low risk operation.
  • Shoulder replacement may be an option if symptoms persist for more than six months despite dedicated physiotherapy and other treatments..
  • Urgent shoulder injuries such as dislocation, severe trauma, acute painful sporting injury or broken bone, or require urgent ER care.
  • TOP TIP: In the case where your shoulder is dislocated do not try to put the shoulder back in place – this can damage the joint and nerves