Shoulder pain | Sunday Observer

Shoulder pain

14 February, 2021

In my stint in Sri Lanka I have seen many patients with pain issues around the shoulder. This prompted me to write about shoulder pain. Shoulder pain is one of the commonest pain issues one can experience. The shoulder has a wide and versatile range of movement. It is the most mobile joint in the body. When someone develops shoulder pain it can hamper one’s lifestyle due to impaired movement of the joint. The day to day activities can be challenging and painful.

The shoulder is a ball and socket joint. It is made of three bones:

Humerus - Long bone in the arm

Clavicle - Collar bone

Scapula - Shoulder blade

The movement of the shoulder is aided by the rotator cuff.

Rotator cuff is made of four tendons arising from four muscles:



Teres minor


Tendons are the tissues that connect the muscle to the bone.

There are two main joints in the shoulder:

Acromioclavicular joint

Glenohumeral joint

(Shoulder joint)

Movement of the shoulder joint is by the rotator cuff which is made up of four tendons. When the rotator cuff or the bones are inflamed or damaged lifting of the arm above the head is difficult.

The shoulder can be injured in accidents, sport or manual labour

Causes of shoulder pain

Arthritis – Osteoarthritis

Osteoarthritis can affect the shoulder. Movements can be

limited, e.g. combing the hair can be challenging.

Frozen shoulder – Short period of pain in the shoulder.

Shoulder movements are limited and painful.

Torn Cartilage

Torn rotator cuff

Swollen tendons

Bone spurs

Broken bone


Pressure on nerves in the neck

Heart disease

Disease of gall bladder

Referred pain from other areas


Thorough examination of the shoulder by the doctor

X- rays of the shoulder can show wear and tear

MRI scanning


Excluding arthritic conditions

Treat arthritic conditions if any

Application of a shoulder sling and rest


Simple analgesics

Opiates – Fentanyl patch

Shoulder injection with a steroid

PRP (Platelet rich plasma) injection

Surgery - Referral to a shoulder surgeon which can result in


Rotator cuff repair carried out through keyhole surgery

(Arthroscopic repair)

Shoulder replacement (Extreme cases)

Treating shoulder pain can be challenging due to its functions

and the increased range of mobility. It can be frustrating to the

patient as well as the doctor.

Dr Namal Senasinghe MBBS, Dip in Pain Med, FFARCS, FFPMCA, CCST(U.K) is a Consultant in pain medicine at the London Pain Management Centre, No. 31, Horton Place, Colombo 7, Sri Lanka. Hotline 0767155716