Shoulder pain: What happens when it persists?
Shoulder pain is the third most common musculoskeletal complaint, with studies indicating that the prevalence of shoulder pain in the general population may be up to 67%.1 Shoulder pain has been reported to persist beyond a year in up to 40% of patients, following an acute attack.2 As chronic pain is defined as such when it persists beyond three months, the rates of people experiencing chronic shoulder pain are high. The prevalence of chronic shoulder pain makes this not only a problem for the individual, but for society more generally, due to the burdens of revenue loss and increased reliance on healthcare.
Chronic shoulder pain can originate due to injury or a number of other factors, however, the nature of the pain changes once it has persisted beyond the expected period of healing. Where there is not a precipitating injury or underlying disease process, it is thought that postural and and psychological stressors are a likely cause. Degenerative disc disease and the phenomenon of central sensitisation may also be contributing or causal factors. Furthermore, shoulder pain could be nociplastic in nature, meaning its biological cause is due to rewiring in the pain system itself and not caused by a precipitating event.
In treating chronic shoulder pain, the aim of treatment is to reduce the pain, increasing function and improve quality of life. The most common treatments for chronic neck pain are rehabilitation programs, physical therapy, epidural steroid injections and suprascapular nerve blocks. Anti-inflammatory medications may also play a role in managing chronic shoulder pain depending on its underlying mechanisms. However, in discussing treatment options we must remember that a one-size-fits-all approach does not work for chronic pain as each individual’s biopsychosocial factors mediate the effectiveness and appropriateness of treatments.
For this reason, developing an individualised, multi-faceted management plan in conjunction with a pain physician can maximise treatment outcomes and help you Live Better. If you would like your current pain management plan reviewed, or for more information, please fill out the form below:
1 Luime, J. J., Koes, B. W., Hendriksen, I. J. M., Burdorf, A., Verhagen, A. P., Miedema, H. S., & Verhaar, J. A. N. (2004). Prevalence and incidence of shoulder pain in the general population; a systematic review. Scandinavian journal of rheumatology, 33(2), 73-81.
2 Kuppens, K., Hans, G., Roussel, N., Struyf, F., Fransen, E., Cras, P. & Nijs, J. (2018). Sensory processing and central pain modulation in patients with chronic shoulder pain: A case‐control study. Scandinavian journal of medicine & science in sports, 28(3), 1183-1192.