Understanding your shoulder pain together

We want to know when your symptoms began and what has changed since then. Was there a fall, unfamiliar overhead work or a return to training? Did your range of movement gradually decrease? Please also tell us if you cannot identify a trigger. You do not need to remember precisely when it started for a useful assessment. A concrete example often describes the restriction better than a single numerical score: you can no longer reach a shelf, wake when you turn over, or find your arm harder to use after sport. Treatments you have already tried and what happened afterwards are equally important. Did an exercise change your symptoms? Did a medicine help but cause stomach problems? Details like these affect which options we then consider together.

During the physical examination, we assess factors such as range of movement, strength and your response to selected movements. Depending on the symptoms, we also examine neighbouring areas. Taken together, the findings indicate which cause is likely and which questions remain open. Ultrasound can help answer questions about tendons and other soft tissues. X-rays mainly show the bony structures and any calcifications. If a further question requires an MRI or CT scan, we arrange it for you with an external provider. The choice depends on the information needed for your treatment. Imaging changes and pain need to be considered together: particularly around the area beneath the shoulder’s bony roof, abnormal-looking images can occur without corresponding symptoms. We therefore discuss what a finding explains and what remains uncertain. Bring existing reports and images; changing practice alone does not require repeat imaging. A new medical question may make additional images necessary.

First, we agree which problem should take priority. For you, it may be interrupted sleep; for someone else, a lack of strength at work. A clear goal also makes it easier to assess later whether the treatment is making a difference. For suitable shoulder conditions, adapted movement and physiotherapy can help improve function and tolerance of activity. A targeted exercise programme is an important non-surgical option, particularly for symptoms beneath the shoulder’s bony roof. The appropriate movements, amount of exercise and progression depend on the diagnosis and how irritated the shoulder currently is. An exercise video chosen at random cannot replace this assessment. If pain medication or an injection is being considered, we discuss its purpose, limitations and risks. For medication, this also includes your other conditions and any medicines you already take. Pain relief can make movement easier; it does not prove that the shoulder can tolerate every activity again. For additional treatments such as shockwave therapy or ACP/PRP, we assess the specific diagnosis and the relevant evidence. These are not a general answer to every shoulder symptom. If a finding requires a surgical assessment, we explain why. Non-surgical treatment is appropriate when it fits the situation. It must not delay further care that is needed.

If symptoms have developed gradually and there are no acute warning signs, you can initially reduce activities that are particularly painful. Keeping the shoulder completely still for a long period is not automatically helpful, however. Notice which movements remain possible within a tolerable range. Do not force movement through severe pain or begin a heavy strength-training programme while the cause is unclear. For the appointment, note two or three situations that particularly limit you. Bring existing reports, access details for scans and an up-to-date medication list. If the list has a 2D barcode, please bring the complete document; a medication list without a code is also helpful.