Shoulder Pain

Shoulder Pain2019-08-28T14:24:50+00:00

When we think about joint pain, knees and elbows tend to receive the most attention. Yet Shoulder Pain can occur just as frequently and also vary considerably in regards to intensity, cause, and long term prognosis. In most cases, shoulder pain tends to be caused by light strains inflicted during our day to day activities. Just a quick visit to the physical therapist and a little rest ought to see the discomfort completely disappear. However, as we age, shoulder discomfort can become more intense and caused by underlying conditions that may prove much trickier to address.

The Essential ‘Do’s’ & ‘Don’ts’ Of Treating Shoulder Pain

As with any form of physical discomfort, shoulder pain can be a frustrating experience as it will take an indefinite length of time to disappear. Sprains can heal within one/two weeks but sometimes may take three or four times as long depending on the severity of the injury. A quick visit to a medical doctor is advisable, especially with an injury that was inflicted by serious bodily trauma or appears alongside other worrying symptoms such as chest pains, loss of balance or spine/hip/leg pain.

To help your shoulder heal you should:

  • Keep generally active and gently move your shoulder as frequently as you can. Doing so will prevent stiffness and reduce pain

  • Be sure to stand up straight and maintain a good posture when walking

  • Perform routine shoulder exercises several times a day to help reduce inflammation around the joint

  • Sit with a large cushion supporting the back and place a similar sized one on your lap to rest your arm weight

Try to avoid the following even if it seems to reduce pain in the short term:

  • Do not resume regular intensive exercise or put excessive weight on a damaged shoulder

  • Avoid any weight or impact training

  • Medications that aren’t prescribed by a physical therapist or medical doctor

  • Keep using your shoulder but stick to ‘light’ activities

  • Keep your back as straight as possible especially when sitting for longer periods

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Rotator Cuff Shoulder Injuries

Should your pain not heal up despite following appropriate care, then it could be time to pay a visit to the doctor. When shoulder pain refuses to simply go away there is a high probability that the damage is due to a problem with the rotator cuff tendons and/or muscles. These are what allow us to rotate our arms, and if you experience sharper pain when pushing your shoulder in a particular direction then there is a high chance this is the source of the problem. On the plus side, these injuries are very common (approximately 2 million cases per year in the U.S) and there are plenty of well-established and effective routes to recovery.

Tears & Impingement

Despite tears and impingement sounding very similar, they project pain in quite different ways. Impingement is the less serious shoulder injury and will exhibit signs of inflammation and irritation. Usually, this is due to the swelling of the muscle and nerves between the bones, and while commonly associated with impact injury (sports, tripping over, etc) it can come around simply because of general wear. In most cases, just taking it easy – but keeping mobile – alongside light painkillers should result in a full recovery.

If the pain is also partnered with an overall lack of strength in the shoulder then there is a possibility that it could be either a partial or full tear. These can be longer-lasting and it is a good idea to consult a doctor immediately if you suspect it could be a full tear as surgery may be required. 

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Adhesive Capsulitis (Frozen Shoulder)

Despite being a relatively well-known health issue, little is understood about why some people develop adhesive capsulitis. What we do know for sure is that it can develop after an impingement injury or tear, and seems to be caused by a thickening of the muscles within the shoulder joint. It creates a kind of tightness that leads to long term throbbing pain with any movement and is more common in men and women aged over 40. Often these people also have high cholesterol, thyroid problems, and diabetic issues.

The term ‘frozen shoulder’ is quite appropriate because when the condition hits its peak shoulder movement may be near to impossible. While the condition can be quite debilitating and there can be some success found via corticosteroid injections, anti-inflammatory drugs (non-steroid), and even surgery the condition tends to disappear after 3/4 years anyway. Plenty of people find that physiotherapy and muscle stimulation can help them through episodes of frozen shoulder without needing to undergo invasive surgery.

Calcific Tendinitis

This is another condition still not entirely understood. In this case, the shoulder tendons become extremely stiff due to excessive calcium deposits – possibly delivered by the body in a failed attempt to assist with the healing process. Most people who suffer this condition experience the worst pain when they wake up in the morning, with the pain slowly reducing after the shoulder has been exercised.

For this reason, physical therapy is often the best way of addressing the problem alongside anti-inflammatories and possibly even stem cell treatments. In extreme cases surgery can be used to manually remove the calcium, however, we recommend stem cell treatment.

Osteoarthritis

Despite osteoarthritis most commonly afflicting hips and knees, sometimes it can appear in shoulder joints. The cartilage between the bones gradually erodes and causes the bones to painfully rub together. Despite being a relatively severe form of arthritis which may cause long term discomfort there are a wide variety of treatment and management options.

As the intensity of the pain can vary (sometimes by weeks or even months) medicating for osteoarthritis can be difficult. Most patients diagnosed with the condition will start on lower strength general painkillers and ‘work up’ to stronger, script-only, alternatives should the condition drastically worsen. The most effective method for treating osteoarthritis in the shoulder over the long term is to protect and strengthen the muscles and tendons as much as possible through regular/suitable exercise and physiotherapy. Stem cell therapy is a better alternative to  surgery that can help alleviate the pain.

 

Light shoulder injuries such as strains and even light tears should usually heal without the need for any specialist treatment. Yet recovery can be considerably quicker – and similar injuries far less likely to recur – when the painful shoulder is kept moving and performing some regular light exercise. More serious conditions such as those listed above can all be medically treated, but doing so effectively may take time and be a frustrating process.

Anyone suffering from persistent shoulder pain should consider their treatment as comprising three complementary parts. First, make use of medical expertise by following scheduled exercise programs and sticking to the recommended medications. Second, if the issue is long term and degenerative it is essential to undertake physical therapy treatments – a quality physiotherapist will not just perform treatments but also structure a recovery plan to follow at home. Third, consider how cognitive behavioral therapy and mindfulness techniques can help cope with the pain. 

When combined together there is no reason why even the most severe shoulder pain cannot be effectively managed even if a full recovery is only a distant possibility.

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