How to deal with shoulder pain in France

Up to 20% of the general population claim to suffer from shoulder pain on any given day, according to SFRE (the French Society for Shoulder Rehabilitation), a condition that can severely restrict your everyday life. 

One particular condition is ‘frozen shoulder’, whose official name in French is capsulite rétractile de l'épaule, affecting up to 10% of adults in France, with increased numbers for those aged 40 to 60, and women in particular.

Symptoms

The first signs are pain in the shoulder, often radiating into the arm, but this type of pain could be due to muscle strain, arthritis or tendonitis. 

However, the second stage (frozen) is when the joint gradually stiffens, causing you to lose your range of motion and general mobility; it becomes difficult to get dressed, and normal everyday movements become challenging or painful, restricting your daily activity. 

Causes

Given how much we rely on our shoulder joints, they are particularly susceptible to injury and trauma, even more so if your job involves repetitive shoulder movements, such as working at a till or overhead lifting, or if you have suffered an injury such as in a car accident.

In many cases, frozen shoulder seems to be inexplicable but can actually result from a non-physical trauma, such as an emotional or psychological shock, bereavement or a period of intense stress. 

Specialists say that when frozen shoulder has no clear physical cause, it is often the body’s response to dealing with these life events; the fact that there is no visible injury does nothing to alleviate the pain, which must still be treated.

Read more: What is being proposed to help people in areas that lack doctors in France

Diagnosis

Frozen shoulder is notoriously hard to diagnose, but the order in which you lose movement is one of the keys to identifying the problem, as patients typically lose their range of motion in a particular order (1. external rotation; 2. abduction; 3. flexion), and this helps your GP to diagnose the condition. 

Before your appointment, it will help your GP if you identify which movements cause you the most pain or are no longer possible; for example, lifting your arm to the side, brushing your hair or scratching your back.

Treatments

According to the Haute Autorité de Santé, an initial X-ray can be used to check there are no physical injuries, and if necessary an ultrasound or MRI might also be requested. 

Analgesics and anti-inflammatories can help to manage the pain, and in some cases you might be prescribed a cortisone injection (often referred to as une infiltration).

Frozen shoulder can be a complicated condition to treat, so you will probably be referred to a shoulder specialist: either an experienced physiotherapist, a rheumatologist or a rehabilitation expert. 

They will be able to recommend the right exercises to ease the pain, improve your range of movement and strengthen your shoulder.

Can I treat it myself?

If you feel you might simply have pulled a muscle in your shoulder – perhaps while gardening or decorating – you can take over-the-counter painkillers and rest the shoulder for a few days until the pain eases. 

If, however, it continues to hurt and the joint starts to stiffen up, you should go and see your GP, who can check whether your shoulder pain is being caused by another underlying condition such as rotator cuff injury or arthritis in the joint. 

In any event, you must not try to make up your own exercise regime for a painful shoulder, as you could end up doing more harm than good.

For more information

The Ameli website has comprehensive information about chronic shoulder pain (see épaule douloureuse chronique), its diagnosis and treatment.