Is rotator cuff pain the same as shoulder impingement?

They overlap. Impingement describes a symptom — pain as the arm is lifted, as though something is being pinched under the bony point of the shoulder. Irritation of a rotator cuff tendon is the most common reason for that symptom. Because the two are so closely linked, many clinicians now use a broader term such as rotator cuff related shoulder pain, and treat both in much the same way.

Will massage alone fix my shoulder?

Usually not on its own. Massage and medical acupuncture reliably help a guarded, aching shoulder feel looser and move more comfortably, which matters. But the treatment that changes how much your shoulder can tolerate is progressive strengthening. Most people do best with both: hands-on work to make movement bearable, and a loading programme they keep up between appointments over a couple of months.

Why does my shoulder hurt so much more at night?

Lying down changes the position of the shoulder and removes the small movements that keep a sore tendon comfortable during the day, so the ache builds. Night pain is very common with rotator cuff problems and is often the first symptom to improve with treatment. Sleeping on the other side with a pillow hugged under the sore arm helps many people while the tendon settles.

Where can I get shoulder pain treatment in Bromley?

SMSM Therapy is at Carlton Chambers, 5 Station Road, Bromley BR2 0EY. The entrance is the red side gate to the right of the building, a three-minute walk from Shortlands station. We also see people from Beckenham, Shortlands, Hayes, West Wickham, Chislehurst, Petts Wood and Orpington. Call 07896 257328 to arrange an assessment or to talk through whether treatment is likely to suit you.

Shoulder Pain Treatment in Bromley

The rotator cuff is a set of four small muscles running from the shoulder blade around the top of the arm bone. They hold the ball steady in its socket while the bigger muscles lift. When one of those tendons becomes irritable you get a catching pain partway through raising the arm sideways, an ache down the outside of the upper arm, and a throb at night. Impingement is the older name for that pinching feeling, but it is a symptom rather than a cause.

Most people who come to our Bromley clinic with this have not injured themselves. They painted a ceiling, went back to swimming, or added overhead pressing at the gym. The other large group is the over-forties, whose tendons have changed quietly over years and then tip over the line after an ordinary weekend. Almost everyone mentions the same two things: sleep, and getting a coat on.

How to tell if that is what you have

Pain arriving partway through lifting the arm sideways, often easing as it goes higher.
An ache on the outside of the upper arm, not on the point of the shoulder.
Trouble reaching behind you: seatbelt, back pocket, bra strap.
Night pain lying on that side, which is usually what prompts the call.
Weakness, or a sense the arm might give way holding something in front of you.

Neck problems refer into the shoulder blade and towards the elbow, change with neck movement and often bring pins and needles. Frozen shoulder is stiff in every direction, including when someone else moves your arm. Pain on the very top of the shoulder points to the joint at the end of the collarbone.

What actually causes it

Tendons adapt to what you ask of them, and they adapt slowly. Ask for more than the tendon can tolerate — more weight, more repetitions, more hours overhead — and the tissue turns irritable before it turns stronger. This is a problem of load rather than simple inflammation, and that changes what helps. Rest and anti-inflammatories take the edge off, but the pain returns when you go back, because capacity has not changed.

There is a second ingredient at the shoulder. If the cuff is not controlling the ball, or the shoulder blade is not gliding underneath it, the space the tendon passes through tightens under load. Scans muddy things further: tendon wear and partial tears are common in people over fifty with no pain at all.

How we treat it at the clinic

We assess what the shoulder can do under resistance, and whether the neck is contributing.

The part with the strongest evidence is an exercise programme: progressive loading of the cuff and the muscles around the shoulder blade. That is what shifts a tendon problem, over weeks and months rather than sessions.

Sports massage around the shoulder blade, upper back and chest buys more comfortable movement, which matters in a shoulder guarded for months. Medical acupuncture — fine needles into muscle and trigger points for anatomical reasons, the same technique often called dry needling — often helps the ache down the outside of the arm. Both are adjuncts that make the loading tolerable, not replacements for it.

What you can do yourself

Keep using the arm. Turn down the overhead work for a few weeks rather than protecting the shoulder completely, because a shoulder that stops moving stiffens quickly.
Sort out the night. Lie on the good side with a pillow hugged under the sore arm.
Try isometric holds: press the arm into a wall at about a third of your effort for thirty seconds, a few times over, which often quietens the pain for an hour or two.
Carry on training everything else.

How long it takes

Think in weeks and months. Night pain usually eases first, often within two to four weeks of sensible loading. Real gains in strength take eight to twelve weeks of work two or three times a week, and a stubborn cuff can take four to six months.

Progress is rarely a straight line. If nothing has changed after around three months, a GP review may lead to imaging, an NHS physiotherapy referral, an injection or an orthopaedic opinion.

When to see a doctor instead

Call 999 if shoulder or arm pain, particularly on the left, comes with chest tightness, breathlessness, sweating, nausea, or pain spreading into the jaw or neck. That needs emergency care, not a therapy appointment.

See a doctor the same day if any of these apply.

You cannot lift the arm at all after a fall or a heavy pull, or the shoulder looks the wrong shape — that can mean a large tear, a fracture or a dislocation.
Unexplained weakness, a limp arm, or visible wasting of muscle.
A hot, red, swollen joint with fever, which can indicate infection.
Pain at rest unrelated to position, unexplained weight loss, or a history of cancer.

Book shoulder pain treatment in Bromley

The clinic is at Carlton Chambers, 5 Station Road, Bromley BR2 0EY, and the way in is the red side gate to the right of the building. We are a three-minute walk from Shortlands station and treat people from Beckenham, Shortlands, Hayes, West Wickham, Chislehurst, Petts Wood and Orpington as well as Bromley itself.

Call 07896 257328 to talk it through, or book an appointment online. See our prices, or the location page for directions.

Written by Dharam Vyas, sports therapist and clinic director at SMSM Therapy, Bromley.