Shoulder Pain and Elbow Problems – frozen shoulder and tennis elbow.






Is it a shoulder OR a neck problem?

A lot of shoulder pain, especially if full mobility is retained, is referred down from the neck especially when the pain is vague ( hard to describe ) and unpredictable. Stabbing pains that feel deep and under the shoulder blades are often from problems at the lower part of the neck. Usually a proper examination will be able to sort this out THO’ there are times when there is a problem in both areas and each one tends to make the other worse.

If you have shoulder and arm ( usually upper ) pain, feelings of “tight bands” around the biceps and tingling sensations ( usually lower arm ) then this could well be what I call “heavy head syndrome”. Please look this up on the Neck Problems page. In the last few years I have seen 8-10 people who have been diagnosed with fibromyalgia, have been suffering all types of shoulder and arm discomfort and in fact they just had a lower neck problem. Two to three treatments can cause a very positive change in these cases.

True shoulder pain can be from the following:

1/ Rotator cuff strains

These are frequently from sports injuries. Pain can vary in intensity and position and is usually made worse by movement. Soft tissue treatment, mobilisation, acupuncture and hot and/or cold treatments can be very helpful. There is usually a significant amount of strengthening exercises that must be done by the patient over a long period of time.

2/ Impingement problems

These can be very debilitating usually shown by pain being caused if the arm cannot be lifted in the front or/and to the side more than 70-90 degrees ( pain or inability to comb hair is often the first way it is noticed ).  The pain is generally right on top of the shoulder joint plus a little towards the neck. There are a few causes, the least serious ( mild to medium tendonitis ) can be treated by soft tissue work and acupuncture. More serious problems need surgery. Luckily the surgery is usually keyhole and success rates are very good.

3/ Frozen shoulder  ( capsulitis )

GPs have a tendency to over diagnose frozen shoulder frequently confusing it with impingement and/or a bad tendonitis. True frozen shoulder can last for up to 18 months if not helped out – a very rough description would be

a/ 6 months of discomfort/pain and slow reduction in movement until the upper arm can hardly be moved.

b/ 6 months of pain ( decreasing slowly ) with the arm not being able to move very much without causing severe pain.

c/ 6 months of pain reducing and movement returning.

Osteopathy, using soft tissue techniques, mobilisation, perhaps acupuncture can make the journey through these phases much more rapid and reduce the pain levels at each stage.

4/ Tendonitis ( bicipital )

Ow! This problem ( in my experience ) is much more common than frozen shoulder. Pain is usually on and around the top of the bicep muscle and moving over the shoulder itself. This problem can last from a few weeks to over a year – I should know as I have had these problems on both of my shoulders. 

Treatment is a mixture of soft tissue techniques, anti inflammatories – tablet AND gel, REST and cold/ice packing. IF all of these are done at the very start of the problem, recovery can be with weeks.

5/ Calcific tendonitis

This is ( usually ) where very small calcite crystals are deposited in the supra spinatus tendon – right on the top lateral edge of your shoulder. Movement can be severely limited associated with a lot of pain. Surgery was regularly used in severe cases but now, the treatment of choice is shockwave therapy. The percussive sound waves can break up the crystals so that they disappear entirely. Before and after X Rays show this to be the case.

6/ Osteoarthritis

OA to the shoulder, compared to in the neck, back, hips and knees, is not common. When it does occur ( and is causing significant problems / pain ) it needs to be diagnosed by X-ray or scan and then usually surgery is required.

Tennis and golfer’s elbow -tendonitis

If you put your arms by your sides and turn your palms to the front of you, tennis elbow is on the side of the elbow AWAY from your waist, golfers elbow is on the side NEXT to your waist. They are both very common. They are usually caused by repetitive movement whether from using machinery, sports activities or even from using a mouse for hours every day.  A group of small forearm muscles coalesce to form a common tendon at the elbow and it is when this tendon becomes inflamed      ( tendonitis ) the pain starts.

If caught early a mixture of soft tissue techniques, anti-inflammatory gel, REST and cold/ice packing ( plus acupuncture ) can sort the problem out within weeks. If, however, the problem is chronic and is continually aggravated ( at work or play ) the problem can take months to resolve.


This is usually a more chronic condition of the tendon. Instead of the area just being inflamed – tendonITIS, there is specific damage to the collagen fibres in the tissue structure. The only practical way of repairing this tissue is to do ECCENTRIC STRETCHES. This is where the tendon is stretched WHILST being contracted. These exercises would need to be done twice a day for weeks up to months. Best / quickest results would doing this be alongside shockwave therapy. See below.


Bad or chronic tendinopathies are best treated by Shockwave treatment. Please go to the Shockwave page on the menu.





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