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Shoulder Pain Cure
Despite the fact that one-fifth of adults will suffer from shoulder pain at some point in their lives, the clinical trials on treatment have failed to show a single shoulder pain cure. In reality, the treatment of shoulder pain requires several different types of interventions. We do know that identifying the source of shoulder pain and then optimizing management to address the cause gives shoulder pain treatment a chance to become a shoulder pain cure. With that in mind, it is helpful to be aware of the conditions and techniques that physicians and physical therapists use to treat this common musculoskeletal problem.
The shoulder joint is complex
The shoulder is made up of the four large muscles collectively called the rotator cuff (supraspinatus, infraspinatus, teres minor, and subscapularis muscles) plus two additional muscles, teres major and deltoid. These muscles move the upper arm bone (humerus) about the torso, which includes a number of bones including the collarbone (clavicle) and scapula. The shoulder "joint" actually has a number of joints between bones plus tendons and ligaments. What does this all mean for you? The shoulder is very complex and has plenty of structures that can be the source of pain.
Common causes of shoulder pain
Tendonitis is perhaps the most common cause of shoulder pain. This is an inflammation (-itis) of the tendons in the shoulder. Tendons are the structure that connects muscle to bone. Another common cause of shoulder pain is adhesive capsulitis or "frozen shoulder." Not only does this disorder cause pain, but it severely limits the shoulder's range of motion. Shoulder bursitis can cause a painful shoulder, as well. The bursa is a fluid-filled, shock absorber found in certain joints of the body, including the shoulder. When these cushions become inflamed (which is the definition of bursitis) the resulting shoulder pain limits joint function. Finally muscle tears or bone fractures in the shoulder can cause pain and dysfunction.
The first step to a shoulder pain cure is diagnosis
It cannot be overemphasized how important diagnosis is to shoulder pain. This diagnosis serves as the basis for tailored shoulder pain treatments, especially physical therapy. Understand that the person that performs the diagnosis will also prescribe the treatment. Arguably, internists will mostly rely on NSAIDs and anti-inflammatory drugs, surgeons will mostly use surgical interventions, and physical medicine and rehabilitation physicians will usually prescribe exercises and refer to physical therapists.
Medications and injections as shoulder pain cure
There may be a place for medications and injections in the treatment of shoulder pain. They can be added to a comprehensive shoulder pain treatment regimen when inflammation is a key component of the pain. Oral NSAIDs, such as naproxen and ibuprofen, can take the edge off of shoulder pain and work to reduce inflammation in the joint. For short periods of time, up to nine months, corticosteroid injection into the shoulder joint will reduce inflammation and pain. This is especially true if local anesthetic (e.g. lidocaine) is included in the injection. The information available on this form of treatment is limited, however. Therefore a real shoulder pain cure cannot rely solely on oral or injected anti-inflammatory drugs. The side effects and complications of such drugs can be quite serious and the overall benefit diminishes with time.
Physical therapy as shoulder pain cure
Physical therapy is the cornerstone of any shoulder pain cure, but, just like medications it should not be the only treatment. In order to be maximally effective, physical therapy should be combined with other treatment modalities such as relative rest/activity modification. The goal of physical therapy in shoulder pain is to restore and improve the function of the shoulder joint by focusing on strength, range of motion, and proprioception. Specific shoulder pain exercises will be tailored to the specific diagnosis. Whatever regimen is prescribed needs to be followed closely and faithfully, even if it is uncomfortable.
When to call a surgeon
It is occasionally necessary to consult with an orthopedic surgeon to affect a shoulder pain cure. Contrary to what many believe, surgery alone is never the answer. In fact, any shoulder surgery will include physical therapy and medical interventions sometimes before and certainly afterwards. With the exception of a large rotator cuff tear, an unstable fracture of one of the shoulder bones, or severe osteoarthritis of one of more joints, surgery should be considered a last resort in shoulder pain treatment. It certainly should only be considered as part of a larger, more comprehensive shoulder rehabilitation program.
shoulder pain cure references
Arroll B, Goodyear-Smith F. Corticosteroid injections for painful shoulder: a meta-analysis. Br J Gen Pract 2005;55:224-228.
Burbank KM, Stevenson JH, Czarnecki GR, Dorfman J. Chronic shoulder pain: part II. Treatment. Am FamPhysician 2008;77:493-497.
Green S, Buchbinder R, Hetrick S. Physiotherapy interventions for shoulder pain. Cochrane Database Syst Rev. 2003;(2):CD004258.
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