Shoulder Pain and Conditions in Durban

Expert care for shoulder pain, injury and surgery in Durban.

Shoulder problems make everyday things hard: reaching for a shelf, sleeping on your side, lifting your arm above your head.

Dr Paul Ryan is a Durban orthopaedic surgeon with fellowship training in shoulder surgery. He sees patients with shoulder pain from injury, overuse and wear.

The rotator cuff (the group of muscles and tendons that hold your shoulder in place) can tear from a single injury, like a fall onto an outstretched arm, or from years of gradual wear. This causes pain, weakness and trouble lifting your arm, especially overhead or behind your back. Night pain that disturbs sleep is common. Smaller tears often respond well to physiotherapy that strengthens the surrounding muscles. Larger or full-thickness tears, especially in an active patient, may need surgical repair to restore proper function. An ultrasound or MRI usually confirms the size and location of the tear before deciding on the best path forward.

Tendons in the shoulder get pinched between bones during certain movements, especially reaching overhead or behind your back. It causes pain that builds up gradually over weeks or months rather than starting suddenly, often worse at night or after repetitive overhead activity like swimming, painting or manual work. Left untreated, ongoing impingement can eventually wear down the rotator cuff tendons themselves. Most cases settle with physiotherapy focused on shoulder-blade positioning and posture, combined with activity changes. An anti-inflammatory injection sometimes helps break a stubborn pain cycle. Surgery to create more space for the tendons is only considered when conservative treatment hasn't worked after several months.

The shoulder joint moves more than it should, or slips fully out of its socket. This is common after a sports injury, a fall, or a sudden wrench of the arm, and it can also develop gradually in people with naturally loose joints. A first-time dislocation needs prompt reduction and is treated differently to a shoulder that keeps slipping out repeatedly, since recurrent instability often means the supporting ligaments have been damaged. Physiotherapy to strengthen the muscles around the joint is the usual starting point. If the shoulder keeps dislocating despite this, surgery to repair or tighten the stretched ligaments is often the more reliable long-term fix, particularly in younger, active patients.

The shoulder capsule, the tissue surrounding the joint, thickens and tightens, and movement becomes painful and steadily more limited. It often develops slowly over weeks, without any specific injury, and can take many months, sometimes over a year, to resolve on its own. It's more common in people with diabetes and tends to follow a pattern: a painful freezing stage, a stiffer frozen stage, and a gradual thawing stage as movement returns. Physiotherapy and stretching help maintain as much movement as possible through the process, and a cortisone injection can ease pain in the early, most painful stage. Surgery is rarely needed and reserved for cases that don't improve with time and physiotherapy.

Wear in the joint's cartilage causes pain and stiffness that gets worse over time, especially with activity, and can eventually affect sleep and everyday tasks like reaching or dressing. It's less common in the shoulder than in the hip or knee, but it does happen, particularly after a previous fracture, a rotator cuff tear that's gone untreated for years, or simply from age-related wear. Early on, activity changes, physiotherapy and anti-inflammatory medication usually keep symptoms manageable. When arthritis is advanced and significantly limiting daily life, a shoulder replacement can relieve pain and restore movement, and Dr Ryan will explain exactly what that involves before any decision is made.