Rotator Cuff Related Shoulder Pain

What is rotator cuff related pain?

Rotator cuff related pain is very common condition that causes pain at the top and outside of the shoulder, which may spread into the arm, towards the neck and shoulder blade. There are many different muscles, tendons and bursae (fluid filled sacks) around the shoulder which help to support and move the arm. In the past this condition has been known by many names including rotator cuff tendonitis, bursitis or shoulder impingement. However, changes in how we understand this condition are now leading us to the use the term rotator cuff related shoulder pain.

What are the symptoms?

The main symptom is pain felt in and around the shoulder and arm, which is made worse when the arm is moved away from the body, such as reaching up or when placing the hand behind the back. The pain can be described as a dull ache or a sharp pain. The pain may have come on slowly over time or quite quickly if the shoulder has been used for an activity that is much more demanding than it is used to doing each day. The symptoms can last anywhere between 6-24 months.

What are the causes?

The exact cause is not always known, but there are several factors that can contribute towards it:

  • Sudden increase in load and demand placed on the tissues that is different to your normal activity, such as decorating a room.
  • Inactive lifestyles, causing deconditioning of the muscles and tendons.
  • Repetitive activities that continually overload the tissues.
  • Smoking.
  • Being over weight.
  • Diabetes.
  • Depression and anxiety.
  • Rheumatoid Arthritis.

What can I do to help myself?

  • Reduce any specific activities that aggravate your symptoms, but don’t stop using the arm completely.
  • Use pain relief. They will reduce your pain allowing you to the muscles of the shoulder normally. It is recommended to try regular paracetamol in the first instance and then ibuprofen if paracetamol is not effective. If you are not sure if these are safe for you to use or they are not effective speak to your GP or pharmacist.
  • Try to avoid lying on that arm in bed.
  • Try placing a small rolled up towel/pillow between the arm and the body whilst sitting or lying in bed.
  • Self-refer yourself to see a physiotherapist or try our recommended exercises (see below).

What will physiotherapy do?

A physiotherapist with take a thorough history of your symptoms and will conduct a physical examination of the area to confirm the diagnosis.

The main aim of physiotherapy is to restore strength and function to the shoulder and surrounding muscles. Treatment will be based on active rehabilitation, focusing on strength and flexibility.

Your physiotherapist will create an individual and progressive exercise programme to address your individual needs. We have provided some exercises on our resources page for you to try if you want to.

Acupuncture, electrotherapy and massage have not been shown to be helpful for subacromial pain and therefore not offered.

The use and risks and benefits of steroid injections can be discussed with your Physiotherapist or GP. Due to the current coronavirus pandemic we will not be offering injections until further notice.

Symptoms to check

Click the plus sign to see a list of problems that could be a sign you may need to be checked urgently

Get advice from 111 now if:

  • the pain is sudden or very bad
  • you cannot move your arm
  • your arm or shoulder has changed shape or is badly swollen
  • you have pins and needles that do not go away
  • your arm or shoulder is hot or cold to touch
  • the pain is severe and started after an injury or accident, like a fall
  • hurts when you exercise but goes away when your rest
  • you are experiencing chest pain/tightness with your shoulder pain

111 will tell you what to do. They can tell you the right place to get help if you need to see someone.

Go to 111.nhs.uk or call 111.

Immediate medical advice is available by contacting NHS 111

Exercises & Resources area

If you have already received a diagnosis from a medical professional you may find some the following links helpful:

5 star service. An outstanding service by all staff. They have identified my symptoms with great professionalism & empathy. Best health care and results I have ever had.

Excellent, supportive and professional approach. Could not achieve these results on my own! Thank you.

Everyone was so friendly and helpful. Wonderful experience.

Having formerly been a rugby player needed physiotherapy on a number of occasions I have never has as comprehensive a diagnosis and treatment as I have had from Alison Starkey. She was excellent.

Shafeeq Younus was very knowledgeable and courteous. Made me feel so much better mentally. Nothing could be improved.

Very helpful. Exercises really seemed to work for me.

Yohann & Diane are brilliant. Yohann was the only one who realised I had, had a mini stroke, if it hadn't been for him I don't know where I would be today. Diane was brilliant today, she really helped me and calmed me down.

Bart (Klimek) was great, feel like the exercises he gives are helping loads and I'm getting sorted.

Excellent service. Good follow up each time with the care given. All instructions for therapy were very clear.

Within days of attending I was doing exercises, more movement and less pain and everything was explained to me in great detail.

Referral information

If your shoulder pain persists then you can self-refer to see a physiotherapist who can help diagnose your problem and guide you on how best to help recovery.

Refer