Can stress cause shoulder pain?

We all know that when we get stressed, we tend to tense up - this is part of the body’s natural ‘fight or flight’ reaction to stress. Normally this settles down once the stress is over and we have begun to relax again, but if this happens repeatedly then it can lead to muscle tension building up in our neck and shoulders. This can cause stiffness, muscle tightness and pain.

There are also things that can make stress-related shoulder pain worse. These include poor posture, sleeping badly, long periods spent sitting down (especially if using a computer) and repeatedly doing the same shoulder movements such as can happen in certain jobs.

What other conditions could cause shoulder pain?

It can be quite common to get shoulder discomfort, usually because of a mild shoulder sprain or inflammation of the shoulder tendons that often subsides by itself after a few days. Other possible causes include:

• Adhesive capsulitis (often called a ‘frozen shoulder’). This causes stiffness, reduced movement and chronic pain in the shoulder joint.
• Arthritis. Often due to ‘wear and tear’, osteoarthritis causes stiffness and shoulder pain. Other joints in the body can also be affected at the same time.
• A torn shoulder tendon. Typically linked to a sporting injury, trauma or accident this causes pain and sometimes very reduced shoulder movement.
• A torn rotator cuff. This is a tear in the ‘cuff’ of tissues that help to connect muscles to bones and tendons around the shoulder joint.
• Tendonitis of the shoulder (inflammation of a flexible band of fibrous shoulder tissue that connects muscle to bone). This is often caused by injury but can also happen if you carry out the same shoulder movement repeatedly. This means people such as athletes, gardeners and musicians have a higher chance of developing tendonitis. Tendons become less flexible as you age, so you are more likely to get tendonitis as you get older too.

Exercises to help with stress shoulder pain

Stretching is one of the best ways to ease away shoulder pain caused by tightness or tension due to stress. At Healthwords we recommend three exercises that we find helpful for this:

1. Sit in a chair with your back straight and your fingers touching your shoulders. Roll your shoulders as if you are drawing circles with your elbows for 10 seconds. Reverse the circle and repeat in the opposite direction. Do this 10 times, breathing deeply as you do so.

2. Sit in a chair with your back straight and let your arms hang by your sides. Breathe in and pull your shoulders towards your ears. Breathe out fast and drop your shoulders back down to their normal position. Repeat 10 times.

3. The cross arm stretch exercise. Stand up, take your right arm and place it across your chest. Using your other hand, grab the outer forearm of the arm that’s across your body and push that arm into your body to feel more of a stretch. Hold this stretch for 30 seconds then repeat this using your left arm. Make sure that your elbow remains at shoulder height during the stretch. Repeat 10 times.

See your doctor if:

• you have joint pain with redness, swelling and warmth around the painful joint
• you've had a significant injury, particularly if your joint looks abnormal or you are unable to use it
• you're in severe pain
• the pain has lasted more than two weeks
• painkillers do not ease the pain
• you feel generally unwell and/or have a high temperature
• you have symptoms of weight loss or night sweats

If you have multiple joints that are painful, stiff and swollen, and any other symptoms like feeling very tired or low in energy, you should book an appointment with your doctor, so they can diagnose you properly and suggest the appropriate treatment that is needed. Depending on how bad your shoulder pain is you are usually fit for work, but if you feel you are unable to work then see your doctor about this too.

Self care tips

If you have shoulder pain due to stress and you do not feel you need to see your doctor about it, then our neck and shoulder exercises should help. Remember too, you can treat yourself with simple painkillers such as acetaminophen or nonsteroidal anti-inflammatory tablets or gels (check with your doctor first that you are able to use these). Using ice or heat packs can also help with shoulder pain. Ice is best if your shoulder problem is related to an injury, or you can try a heat pack to help your pain levels if there's no swelling and your symptoms are not related to a recent injury. Never place ice or heat directly on your skin; always use a towel to protect it. In general, apply heat or ice for no longer than 15 minutes and always leave a few hours between treatments.

There are a number of easy ways to help manage stress in your life including:

Taking a nap – if possible, getting 30 to 40 minutes of sleep in the day helps you recharge and re-energize yourself.

Getting a massage - ask your partner to massage your neck and shoulders. This is where stress often causes muscle tension.

Try doing something creative rather than competitive, such as acting, playing an instrument, photography, writing poetry or singing and set time aside for it each day. Deliberately cultivate the habit of listening to relaxing music, too.

Allow at least 30 minutes for each meal, eating slowly and making sure that your diet is balanced and providing you with plenty of energy.

Practice meditation, contemplation and relaxation techniques. For some people, daily sessions practicing yoga/meditation or listening to relaxation tapes, may be very helpful.

Learn to manage your time - this is very important. Understand where you spend your time - think about how you could best prioritize and itemize the many pressures in your life.

Organize your week - plan the week ahead using a week-at-a-glance diary or drawing up your own chart. If something prevents you from completing an activity, don't worry. Just try to fit it in elsewhere or make it the first thing you plan for next week.

At the end of the first week, take a look at how it went. What were the big successes? Which scheduling details were less successful? Identify turning points - those times when you consciously decided to prioritize one activity over another. Re-evaluate your goals and roles each week, so you can close the gap between what's most important to you and how you spend your time.

Here are our Healthwords ten top tips to help you get your work-life balance right and keep your stress levels low at work:

1. Work no more than eight hours daily.
2. Always set realistic targets for each work period.
3. Work methodically. Always finish one task before starting another.
4. Don’t accept, or set yourself, unrealistic deadlines. Unfulfilled resolutions will only make you feel guilty and inadequate.
5. If you're unhappy in your work, stand back. Take a fresh look at your options and your goals.
6. If you can, always try to have one and a half days each week completely free from work.
7. Take as much care in planning your leisure as you do in your work.
8. In your leisure time, make sure that all reminders of work are out of sight.
9. Try to walk, talk and move at a slower pace and take at least 30 minutes daily for physical exercise, preferably outdoors, so that you get the added benefit of fresh air and full-spectrum light.
10. Good relaxation always starts with focusing on your breathing. The way to do it is to breathe in and out slowly and in a regular rhythm as this will help you to calm down. Fill up the whole of your lungs with air, without forcing. Breathe in through your nose and out through your mouth. Breathe in slowly and regularly, counting from one to five (don’t worry if you can’t reach five at first), then let the breath escape slowly, counting from one to five. Keep doing this until you feel calm. Breathe without pausing or holding your breath. Practice this relaxed breathing for three to five minutes, two to three times a day.

Shoulder pain can be really uncomfortable and limiting but if you’re under a lot of stress, consider whether this might be the cause. With simple exercises, stress-busting tips and self-care treatments you may find you become pain free very quickly!