Shoulder Pain Treatments
If you are feeling a lot of shoulder pain, it is necessary to know the reason why. Whether you feel acute pain or chronic pain due to rotator cuff conditions: tears, tendonitis, bursitis, Dr. Sherif Algendy, pain management doctor who can diagnose and cure your shoulder problem.
You never realize how much you use your shoulders every day until one of them starts hurting, it is necessary to know the reason why. Shoulder pain can surface because of issues with the shoulder joint or from muscles, ligaments, and tendons surrounding it. As the shoulder joint is built to rotate in several directions, it is prone to injuries that can trigger pain. It is also one of those joints that are affected by osteoarthritis–a degenerative joint disease. Some of the most common conditions connected to shoulder pain include: a dislocation, Rheumatoid Arthritis, tendonitis, Fibromyalgia, instability or a rotator cuff condition: tears, bursitis.
Shoulder pain might get worse as you move your arm or shoulder, like lifting a box, doing yard work, or even swinging a tennis racket.
At Bay State Pain Associates, Dr Sherif Algendy, Pain Management Specialist, will thoroughly examine patients experiencing Shoulder pain and assess all symptoms before offering several forms of non-surgical treatment.
Shoulder Joint Anatomy
As your knee joint, your shoulder boasts a ball-socket joint that enables your arm to roll in all directions. This joint consists of just two bones. First is the humeral head, the top part of the upper arm bone. It fits into the other bone called shoulder blade (glenoid fossa of the scapula). The joint capsule and labrum of the shoulder joint protects and holds the humeral head in place via thick layers of cartilage. There are also the rotator cuff muscles (supraspinatus, subscapularis, infraspinatus and tere minor) that allow the shoulder joint to move energetically and stay stable.
Attached to the scapula, the rotator cuff muscles tend to be affected by the changes in the movement of the scapula in response to the shoulder range of motion. As a result, the muscles themselves can develop a tear and hurt when you try to use your shoulder joint. Along with other muscles (pectoralis major, teres major, coracobrachialis, latissimus dorsi and deltoid), the rotator cuff muscles stabilize and move your shoulder joints.
Due to the structure of your shoulders, they are prone to certain disorders and injuries. These include the following:
- Rotator Cuff Tear
- Shoulder Impingement Syndrome
- Rotator Cuff Tendonitis
Just like back pain, shoulder pain can be acute or chronic. As it involves your hands, the pain can interfere with your ability to do your daily chores. When shoulders are aching, you cannot move your hands up or away from the side of your body without panting in pain. If you decide to live with your shoulder discomfort, it will turn from acute to chronic and you will hate the aftermath. Hence, we would advise you to seek medical help at once to prevent a future shoulder problem that will be hard to treat. And as you meet one of our top orthopedics, answer his or her questions clearly to improve your diagnosis and the selection of a great treatment plan.
How can a doctor diagnose Shoulder Pain?
If you are feeling a lot of shoulder pain, it is necessary to know the reason why. Whether you feel acute pain or chronic pain due to rotator cuff conditions: tears, tendonitis, bursitis, there is a pain management doctor who can diagnose and cure your shoulder problem. The important thing is look for this particular doctor and set your first appointment with him or her. It is important to be able to describe the history of your pain and to honestly answer your doctor’s questions. If your work entails the use of hands above your shoulders, let your doctor know.
Further, tell your doctor whether you recently fell on your shoulder or are involved in strenuous sports activities. If you are a senior person, your shoulder specialist will want to carry out clinical tests that will reveal whether you have an inflammatory joint disease like osteoarthritis. During the test, your physician will find out whether your shoulder is fractured, dislocated, frozen or just unstable. The causes of your shoulder ache will be discovered and solved immediately.
Meanwhile, make sure that your health insurance company can cover your shoulder pain treatment costs. If you need assistance with this, ask one of our shoulder specialists to confirm your insurance coverage on your behalf.
- torn cartilage.
- torn rotator cuff.
- swollen bursa sacs or tendons.
- bone spurs (bony projections that develop along the edges of bones)
- pinched nerve in the neck or shoulder.
- broken shoulder or arm bone.
- frozen shoulder.
- dislocated shoulder
injury due to overuse or repetitive use
spinal cord injury
Here are the treatments for treating Shoulder Pain:
Rotator cuff tears
Rotator cuff tears are prevalent when people start aging, although it can affect younger people who participate in heavy lifting and sports. If these tears are either misdiagnosed or ignored, you can feel a lot of pain when you try to use your arm.
While physical therapy can improve the rotator cuff tears and help you resume your daily activities, it cannot be enough to treat chronic pain. When a tear only develops in just a part of your rotator cuff muscle or tendon, it is known as a partial thickness tear.
These are prevalent when people start aging, although it can affect younger people who participate in heavy lifting and sports. If these tears are either misdiagnosed or ignored, you can feel a lot of pain when you try to use your arm. While physical therapy can improve the rotator cuff tears and help you resume your daily activities, it cannot be enough to treat chronic pain. When a tear only develops in just a part of your rotator cuff muscle or tendon, it is known as a partial thickness tear.
On the other hand, a tear that affects the entire rotator cuff muscle or tendon is called a full-thickness tear. Rotator cuff tears can also be grouped based on the severity of pain. Hence, an acute rotator cuff tear normally happens abruptly because of falls, lifting injuries or sport-related injuries. Symptoms of acute tears include the following:
– Abrupt tearing sensation that triggers a lot of pain that tends to travel from the upper shoulder to the arm and elbow. It might as well reduce your joint’s range of motion.
– A lot of pain and loss of muscle power, resulting to a difficulty when trying to raise your arm.
– Bleeding and/or muscle spasms that may disappear in a couple of days.
Chronic rotator cuff tear
The next kind is the chronic rotator cuff tear. It is triggered by strenuous activities like professional sports and jobs that require making continuous overhead movements. Chronic shoulder injuries can also result from a past acute injury that altered the structure of the rotator cuff and how it functions.
Pain that worsens during sleep
– Gradual weakness and reduced shoulder motion when the pain gets so severe.
– It becomes harder to move your arm out to the side.
The very first symptom felt when there is a problem with the shoulder is pain. It is felt inside and around the joint, especially, when trying to move the shoulder.
Doctors describe this pain as a dull ache that tends to come from deep within the shoulder. It is often enough to interrupt your sleep as you cannot lie on the injured shoulder joint.
Signs of cuff tears:
– When lifting your shoulder, you feel too weak and it might produce a clicking sound.
– Decreased shoulder motion or having a stiff shoulder.
– Inability to touch behind your back or lift a hand above your shoulders.
– Pain on the side of the injured arm that leads to disturbed sleep.
– Pain that seems to travel down the outer arm from the top of the shoulder.
Besides the below-mentioned treatments, your shoulder physician can use physical therapy and strength workouts along with home remedies like rest and reduction of activities that lead to the shoulder problem you are having.
These are anti-inflammatory medicines and their work is to decrease pain, swelling and inflammation. They provide relief by blocking the production of given body chemicals that trigger inflammation. Once you control pain, you can continue functioning normally until your rotator tears heal.
Simply called a PRP therapy, this method entails a treatment where a patient is injected with their own blood platelets and growth factors. These platelets and growth factors are known to start a repair process where stem cells are aroused to initiate natural healing.
If your doctor notices that conservative care treatments are not good at treating your rotator cuff tear, they might administer steroid-based cortisone injections in the shoulder bursa area–just above the tendon. These injections are able to reduce discomfort, break continuous bursal irritation, and get rid of swelling. At the same time, cortisone injections enable people to do strengthening exercises. Normally, victims receive 3 shots per shoulder every six months. These are often combined with physical therapy.
Shoulder Impingement Treatment
PRP (Platelet Rich Plasma) injections
These can be used to treat this shoulder problem as well. As the injections use platelets and growth factors removed from your own blood, they are safe and good at arousing body tissues repair. According to research findings, PRP injections are better than other types of injections used to cure osteoarthritis and chronic tendonitis. The best candidate is determined via a Magnetic Resonance (MRI) scan. This test will help the doctor discover arthritis in your shoulder joint or another cause of pain.
A PRP injection therapy takes less than five minutes at the doctor’s office and it feels just like any other injection you have done before. Two to four treatments are needed for full results to be noted. Fifty to seventy-five percent cases show improvement after their PRP injection therapy. The treatment causes no down time and can be combined with physical therapy to promote muscles and joint performance. While shoulder pain will not go away in the first 24 hours after treatment, it will reduce in due course.
As with the rotator cuff tears, the shoulder impingement problem is treated with cortisone injections. These reduce inflammation, pain and swelling. Two to three cortisone injections given once in every six months are enough to stop shoulder impingement symptoms. The shots entail steroid medicines and are given to four areas of your shoulder: biceps tendon, acromioclavicular joint, intra-articular and subacromial.
Hyaluronic Acid Injections
These can also be used to treat a shoulder impingement problem. These injections allow joint lubrication and reduce joint inflammation and pain. They are mainly used to improve the shoulder gliding process and minimize pain and inflammation. As hyaluronic acid injection involves the use of a natural joint lubricant, it acts as a great replacement for the natural synovial fluid which is lost due to a degenerative joint disease.
Rotator Cuff Tendonitis
Rotator Cuff Tendonitis is closely related to the shoulder impingement problem. However, it worsens gradually and its initial symptoms are easily manageable.
This is a condition that is closely related to the shoulder impingement problem. However, it worsens gradually and its initial symptoms are easily manageable. If nothing is done to eliminate the shoulder tendonitis problem, symptoms can worsen and extend beyond the elbow. If you have tendonitis of the shoulder, the following symptoms can be expected:
– Shoulder stiffness and pain that causes the victims to wake up from their night’s sleep.
– Feeling pain when trying to touch the behind of your back or wearing clothes.
– Pain when raising or lowering your hand.
– Clicking sound when lifting the arm.
– Weakness in the sick arm and stiffness, affecting its ability to rotate.
– The side of your arm or the front of your shoulder might swell.
Doctors use specialized injections to treat severe degenerative joint disease, arthritis and rotator cuff disease. One of these is called Scapular Nerve Block that entails a shot with a local anesthetic drug near the suprascapular nerve. This nerve is near the shoulder blade. People who can receive the Scapular Nerve Block injection are those who are enduring milder shoulder injuries and pain and those who are recovering from postoperative pain.
This injection also works for people who haven’t received any relief from steroid injections as it blocks the nerves’ output signals that provokes pain. Done under the guidance of ultrasound, this Scapular Nerve Block procedure does not hurt because the area is numbed with local anesthetic. It does provide relief after 3 months, 6 months or one year and might call for more than one session. Another great thing is that this specialized injection does not affect your ability to resume your duties immediately.
How can I prevent shoulder pain?
Simple shoulder exercises can help stretch and strengthen muscles and rotator cuff tendons. A physical therapist or occupational therapist can show you how to do them properly.
If you’ve had previous shoulder issues, use ice for 15 minutes after exercising to prevent future injuries.
After having bursitis or tendinitis, performing simple range-of-motion exercises every day can keep you from getting frozen shoulder.
Why is a pain management doctor a good choice to be treated for back pain?
Pain management doctors are specialists who have training in the evaluation, diagnosis, and treatment of different kinds of pain, which may be the symptom of a variety of conditions – both acute or chronic, or a combination of causes. Pain management specialists are trained to evaluate patients with complicated medical issues and have a deep understanding and knowledge of the specialized tests designed for the diagnosis of conditions which can cause pain. They are also incredible knowledgeable when it comes to the treatment of pain and are often on the cutting edge of new technologies and techniques used in its treatment.