Continuing on the same theme of “pain” from my last post, I felt it timely to highlight an excellent review on pain and the shoulder published in the British Journal of Sports Medicine from December 2013 (Dean, B; Gwilym, S and Carr,A: Br J Sports Med 2013;47:1095-1104)
As a Sports Physiotherapist treating shoulder injuries, one of the most common questions I am asked is “why does my shoulder hurt?”. The patient, in most cases, is hoping for a simple answer with a simple model of tissue damage = pain ; with the belief that correction of “what is broken will fix the pain”. Unfortunately research increasingly shows us that such a simplistic approach is… well-honestly- considerably too simplistic. I strongly urge the clinician with an interest in the sporting shoulder to read this excellent review which considers the role of 1) peripheral receptors, 2) nociception or peripheral pain processing , 3) the spinal cord , 4) the brain , 5) the location of receptors in the shoulder and 6) the neural anatomy of the shoulder. It is only when considering the complex nature of shoulder pain can one truly consider appropriately the variability in the clinical presentation, treatment and diagnosis of shoulder pain. For those of you interested in reading a guest post on this subject from one of the articles authors, this link from British based Sports Physiotherapist Adam Meakins makes excellent reading.