Shoulder Pain Treatments

Pain Conditions

At Bay State Pain Management, Our Expert Pain Management Specialists Provide Effective Treatments for 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.

If your shoulder is hurting, chances are that you have a fracture, instability, a dislocation, arthritis, tendonitis, or a rotator cuff problem. 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. If your shoulder has been hurting for some time, get it examined and treated by a reputable specialist. We have this shoulder specialist and all you have to do is to get in touch with us as soon as possible.

  • What Is it?
  • Diagnosis
  • Causes
  • Common Symptoms
  • Treatment Guidelines

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:

  1. Rotator Cuff Tear
  2. Shoulder Impingement Syndrome
  3. 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.

 

What causes shoulder pain?
  • arthritis.
  • 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
    heart attack

Treatments

Here are the treatments for treating Shoulder Pain:

shoulder pain treatments in NY, NJ

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.

Symptoms:

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.

Acute tears

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.

Common causes

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.

Treatment:

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.

NSAIDs

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.

Platelet Rich Plasma Therapy

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.

Cortisone injections

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.

Cortisone injections

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.

Treatment

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.

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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.

Shoulder Exercises to Ease Arthritis Pain: 6 Daily Exercises to Try

No matter which type of shoulder arthritis you have, your doctor will recommend shoulder exercises as an important part of your shoulder arthritis treatment plan.

 
Exercises for Shoulder ArthritisLift your arms to grab something off a shelf and your shoulder stiffens, grinds, and cracks. No part of that feeling makes you want to move your shoulder more. But that’s exactly what has to happen to help your shoulder function better and hurt less. There are many different forms of shoulder arthritis — from osteoarthritis to rheumatoid arthritis and others. No matter which type of shoulder arthritis you have, your doctor will recommend shoulder exercises as an important part of your shoulder arthritis treatment plan.

Here’s what’s happening in your shoulder when you have arthritis, and why exercising helps relieve pain and stiffness.

How Arthritis Affects Your Shoulders

Your shoulder is made up of three bones: the upper arm bone, shoulder blade and collarbone. The ends of those bones — where they meet in a joint — are covered with articular cartilage, a slippery substance that cushions and protects the bones as you move around.

Your shoulder has two separate joints: a bigger ball-and-socket called the glenohumeral joint, where the top of the upper arm bone is the “ball” that moves against a rounded “socket” in your shoulder blade. The other — called the acromioclavicular (AC) joint — is located where the collarbone meets the shoulder blade. Both can be affected by arthritis.

Different Types of Shoulder Arthritis

Osteoarthritis 
In OA, the cartilage in the shoulder joint gradually wears down, and the protective space between the bones decreases. Bone on bone rubbing and friction in the joint leads to pain, stiffness, and limited range of motion. Everyday tasks like combing your hair or carrying a bag become more challenging and painful, says Lauren Shroyer, MS, director of product development at the American Council on Exercise. “Loss of range of motion in the shoulder can also lead to muscle spasms throughout the shoulder and the neck, which can cause headaches,” she adds.

Osteoarthritis usually affects people over 50 years of age and is more common in the AC joint than in the glenohumeral shoulder joint.

Rheumatoid arthritis 
With RA, the immune system mistakenly attacks a protective lining in your joint called the synovium, and destroys cartilage. Though RA tends to affect smaller joints first (such as those in your hands and feet), symptoms can spread to both shoulders as the disease progresses.

Post-traumatic arthritis 
A shoulder injury — like a fracture or dislocation — can damage the cartilage or cause additional wear, which can result in arthritis.

Rotator cuff tear arthropathy 
The rotator cuff is comprised of tendons and muscles that wrap around the ball portion of your upper arm bone, keeping it centered in the shoulder socket. If one or more of these tendons is heavily torn, it may cause the head of the upper arm to rub against other bones, damaging the surfaces and leading to arthritis.

Avascular necrosis 
This is when bone tissue dies due to a lack of blood supply. In the shoulder, blood flow may be disrupted to the head of the upper bone due to disease, injury, or other causes. Without blood supply, the bone will slowly collapse, becoming uneven and causing arthritis.

How Exercise Helps Shoulder Arthritis

Your shoulder is made to move; in fact, it has the most motion of any joint in the body. “What’s common to all types of shoulder arthritis is the potential of losing range of motion,” says Nancy Yen Shipley, MD, board-certified orthopedic surgeon in Portland, Oregon.

And that is reason number one to exercise. The shoulder joint can get stiff and weak. If you keep it still, it stiffens more, she explains. Gentle stretching exercises can help maintain range of motion in your shoulder.

Strengthening exercises are important as well: “Keeping the muscles in and around the shoulder strong can give the joint more stability,” adds Dr. Yen Shipley, who is a member of the American Academy of Orthopaedic Surgeons.

Precautions Before Exercising with Shoulder Arthritis

If you’re new to exercise, it’s always smart to first talk to your doctor. Your doctor or physical therapist can make sure the exercises are safe and help you gain mobility and strength without exacerbating inflammation or aggravating joint pain. If you’ve had surgery on your shoulder, get guidance from your doctor or physical therapist on which shoulder exercises are safe for you. More tips to help protect your joints:

Start slowly
Ease your joints into exercise if you haven’t been active for a while, say experts. Push too hard too fast, and you can overwork your muscles and worsen joint pain. Go easy at first, then increase the length and intensity of your workout as you progress.

Move gently
Always warm up or stretch at the start of every exercise activity and do it again at the end. Don’t force any stretches. Don’t have someone else push on your shoulder to help you stretch more because that can set off a flare up, advises Dr. Yen Shipley. Instead, keep your movements slow and easy. Push to the point of feeling a good stretch without pain. With strength training, begin with fewer reps (or lower weight), and build up gradually.

Do a little every day
If you have a flare of RA or an increase in OA pain, you should still stay active. Some simple stretching may diminish some of the pain. Do short stretching sessions more often, instead of skipping a few days and then doing a longer workout, recommends Dr. Yen Shipley: “Frequency is important is maintaining range of motion around the shoulder joint.”

Stop if your shoulder (or anything else) hurts
“Listen to the pain,” says Shroyer. Take a break when your joint starts to ache. If you feel any new joint pain, it’s time to stop. Talk to your doctor about what pain is normal and when it’s a sign of something more serious.

Exercises to Help Relieve Shoulder Arthritis Pain

The following shoulder exercises were recommended by Shroyer at ACE and Dr. Yen Shipley from the AAOS:

Arthritis Shoulder Exercise Pendulum

1. Shoulder Exercise: Pendulum

Stretches your outer shoulder and rotator cuff

  • Stand next to a table or counter.
  • Lean forward and place one hand on the table for support. Let your other arm hang freely at your side.
  • Gently swing your arm forward and back 10 times.
  • Gently swing your arm side to side 10 times. Gently swing your arm in a circle 10 times.
  • Repeat with the other arm. Repeat the entire sequence one more time.

 

Tip: Don’t round your back or lock your knees.

Arthritis Shoulder Exercise Crossover Arm Stretch

2. Shoulder Exercise: Crossover Arm Stretch

Stretches the back of your shoulder

  • Stand straight, with your shoulders relaxed.
  • Gently pull one arm across your chest as far as comfortable, holding at your upper arm.
  • Hold the stretch for 30 seconds, and then relax for 30 seconds. Repeat with the other arm.
  • Repeat the sequence three more times.

 

Tip: Don’t pull or put pressure on your elbow.

Arthritis Shoulder Exercise Passive Internal Rotation

3. Shoulder Exercise:  Passive Internal Rotation

Stretches the front of your shoulder

  • Get a lightweight stick, such as a yardstick, wooden dowel, or cane.
  • Hold the stick behind your back with one hand, and lightly grasp the other end of the stick with your other hand.
  • Pull the stick horizontally so that you feel a pull in the front of your shoulder without pain.
  • Hold for 30 seconds, and then relax for 30 seconds. Repeat on the other side.
  • Repeat the sequence three more times.

Tip: Don’t lean over or twist to side while pulling the stick.

Arthritis Shoulder Passive External Rotation

4. Shoulder Exercise: Passive External Rotation

Stretches the back of your shoulder

  • Get a lightweight stick, such as a yardstick, wooden dowel, or cane.
  • Grasp the stick with one hand and cup the other end of the stick with your other hand (so the stick is horizontal in front of you).
  • Keep the elbow of the shoulder you are stretching against the side of your body and push the stick horizontally so you feel a pull at the back of your shoulder without pain.
  • Hold for 30 seconds, and then relax for 30 seconds.
  • Repeat on other side.
  • Repeat the sequence three more times.

Tip: Keep your hips facing forward and do not twist.

Arthritis Shoulder Exercise Wall Crawl

5. Shoulder Exercise: Wall Crawl

Improves range of motion and strengthens shoulder muscles 

  • Stand in front of a wall, about an arms’ reach away, so your fingers can just touch it.
  • Using your affected arm, slowly crawl your fingers up the wall as high you can comfortably go. (Keep your shoulder down, without shrugging up toward your ear.)
  • Hold for 15 to 30 seconds; then crawl back down.
  • Repeat one or two more times, trying to reach higher each time.

Tip: If you feel a twinge of pain or your shoulder tightens as you crawl your fingers up, pause for a second and focus on relaxing the shoulder muscle, advises Shroyer. You may be able to go a little higher once your shoulder is relaxed. If you feel a twinge again, you’ve reached your max range of motion.

Arthritis Shoulder Exercise Wall Push-Up

6. Shoulder Exercise: Wall Push Up

Strengthens shoulder, arm, and chest muscles

  • Stand in front of wall, with your arms straight and hands flat against it.
  • Place your feet slightly wider than shoulder-width apart, and tighten your stomach muscles.
  • Keeping your feet flat on the floor, bend your elbows and open your chest toward the wall.
  • Lower your upper body toward the wall in a slow, controlled motion. Your shoulder blades will come together a bit in the back. Hold for one second.
  • Keeping your hands flat against the wall, slowly push yourself back until your arms are straight.
  • Repeat 8 times; and gradually build up to more reps.

Tip: Make sure your fingers aren’t bent on the wall, says Shroyer. Keeping them flat and pushing hard against the wall fully engages the muscles in your shoulder, arm, and chest.

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