Treatment Options for Shoulder Pain

There are several options available for treatment of your shoulder along with exercises that can help. Conservative options are a great choice prior to jumping into surgery. The rehab following surgery is not a quick process nor a fun one so finding the right combination for you is key.

Natural Treatment Options

Physical Therapy

Evaluation

• Similar to other diagnosis, the first session will be a one on one session with your physical therapist. The therapist gather a history of your pain or injury and make a plan of care. They will take measurements to determine your baseline range of motion and limitations.

Return Visit

• Return visits can consists of:

  • Manual therapy

    • Hands on approach to loosen musculature, decrease trigger points, improve tissue extensibility

• Joint mobilizations

  • Hands on approach to improve joint mobility within the range of motion

• Strengthening exercises

  • Very Important

  • Strengthen the musculature in the new range of motion in order to maintain that range of motion

  • Helps improve musculature endurance

  • Helps improve stability of the shoulder joint

  • Decreases the chances or prolongs the need for surgery

Conservative Treatment Options

Over-the-counter Medications

• Usually the first step everyone takes before seeking professional help

• Over-the-counter pain relievers to prescription-strength anti-inflammatory medications, oral steroids, and non-narcotic pain relievers

  • Topical ointments, or oral medications

Cortisone Injections

• Steroid medication is injected directly into the affected joint space, bursa, or inflamed tendon

• The goal is to reduce inflammation and pain

• Some may be ultrasound guided to ensure proper location of the needle

Platelet-Rich-Plasma (PRP), Stem-Cell Therapy

• Involves harvesting specific types of cells from your body, concentrating them, and injecting them directly into your shoulder joint, bursa, or tendon sheath

• Emerging treatment option

• Insurance generally does not cover

Surgical Treatment Options

Arthroscopy

• Trimming damaged cartilage

• Removing loose debris within the shoulder (debridement)

• Irrigating the inside of the shoulder (lavage)

Rotator Cuff Surgery

• Involves re-attaching the tendon to the head of the humerus (upper arm bone)

• Partial tear, may only need a trimming or smoothing (debridement)

• Complete tear is repaired by stitching the tendon back to its original site

• Open Repair

  • Incision over the shoulder and pulls back the deltoid (outside shoulder muscle) for better visual

  • Typically bone spurs are removed

  • Good option if the tear is large or complex

• Arm will be in a sling for 4 to 6 weeks following surgery, with minimal movement

• Most patients have functional range of motion and adequate strength by 4 to 6 months

• Slow progress. Your commitment to rehabilitation is key to a successful outcome

Partial Shoulder Replacement

• Removes and replaces the damaged bone surfaces and cartilage

• Only one side of your joint is replaced, leaving the healthy portion untouched

• Successful partial shoulder replacement can relieve pain and preserve more of your natural anatomy

• May delay or prevent a total shoulder replacement

Total Shoulder Replacement

• Both the ball and socket have been damaged by arthritis

• Both are removed and replaced with artificial parts made of metal and durable plastic material implants

• Implants are shaped so that your shoulder joint will move in a way that is very similar to the way the joint moved while healthy

Reverse Shoulder Replacement

• When your rotator cuff is so damaged that it would not be able to support a traditional joint replacement

• Both parts are replaced

• The “ball” is attached to your shoulder blade and the “socket” is attached to your upper arm

• Allowing your deltoid (outside shoulder muscle) to compensate for your damaged rotator cuff, resulting in increased stability, strength, and range of motion

Here are a few exercises that you can perform at home. These are good to do to strengthen the surrounding musculature and maintain stability in your shoulder. If you are currently having pain in your shoulder, seek the advice of a medical professional before performing.

Exercises

Slide and Lift – 2 sets of 10

Stand with your chest against a wall. Slide your hand up the wall as far as you can go, then lift your hand off the wall. Place your hand back on the wall and slide back down.

Scaption – 2 sets of 10

While standing, place your arms at your side. Lift your arms at a 45 degree angle. Remember to keep your shoulders down and back.

Y’s, T’s, I’s – 2 sets of 10 each

Lay on your stomach either on the corner of your bed or on an exercise ball. Y’s – same motion you are doing for scaption, except you will be on your stomach. T’s – arms will come out to your side to form a T. I’s – arms will come back towards your hips. With all three motions, you should be squeezing your shoulder blades together.

Remember you don’t have to live with pain, but you do need to put in the time and effort to decrease the pain. Give these exercises a try and see how your shoulders feel.

Disclaimer: I am in no way diagnosing anyone, if you have persistent pain you need to call your local physical therapist and schedule an appointment.