What can I do about

my shoulder pain?

By ShareMD Connect

Shoulder pain can be quite severe, and it often lasts for months or even years if it’s not treated. There are many potential treatments for shoulder pain and working with an orthopedic shoulder specialist is the first step you can take to fast track yourself to a pain-free future. 

Here are some of the most common treatments for shoulder pain:

Physical Therapy. Exercises may help, and therefore your orthopedist may prescribe physical therapy for your specific condition. Benefits from a physical therapy program include being shown safe movements and activities that can be done with your shoulder and this may include changing up some of your current activities. The other main benefit of physical therapy is being taught exercises to strengthen the shoulder joint as well as stretches to restore movement and flexibility.

Medication. Ibuprofen for inflammation or acetaminophen for pain can often help. Your orthopedist may also prescribe other medications such as NSAIDs (nonsteroidal anti-inflammatory drugs) that are very helpful in reducing pain and swelling in certain shoulder conditions. It is important to discuss which over the counter or prescription medications may be best for you with your orthopedic doctor. 

Steroid Injections. If the above treatments do not work or the problem gets worse, your orthopedist may consider steroid injections. Generally, injections are considered in patients whose pain prevents them from participating in physical therapy, or whose symptoms do not improve after several weeks of conservative management detailed above. Although clinical studies of steroid injections show that the injection may not help all patients with certain shoulder conditions, there are a lot of people who do get relief from them. The injection benefit is usually temporary (weeks to months), which may be helpful to facilitate therapy efforts during that time. In these individuals, pain and inflammation may improve quickly usually within a few days.

Surgery. Fortunately, most shoulder pain can be resolved through one or more of the above mentioned approaches, but if pain persists beyond three to six months, surgical repair may be considered. If you have a tear in your rotator cuff or a separated shoulder, surgery might be necessary. Additionally, if your shoulder has repeatedly become dislocated, certain exercises and movements might be off the table. If that’s the case, then your orthopedic doctor might suggest surgery at a much earlier stage.

Many different types of surgeries are available for shoulder conditions, including:
  • Arthroscopic tendon repair. In this procedure, surgeons insert a tiny camera (arthroscope) and tools through two to three small incisions to reattach the torn tendon to the bone. A partial tear may need only debridement where the surfaces are trimmed and smoothed. Because of the tiny incisions, patients experience less postoperative pain, quicker return to work and sports, usually no stitches to remove, and less wound issues. However, it is more technically demanding to perform arthroscopically.
  • Open tendon repair. In some situations, such as in large tears or severe injuries, an open tendon repair may be a better option. In these types of surgeries, your surgeon works through a larger incision to reattach the damaged tendon to the bone. Because of the larger incision, there is typically a longer recovery period as well as a greater risk for infection afterwards.
  • Tendon transfer. If the torn tendon is too damaged to be reattached to the arm bone, surgeons may decide to use a nearby tendon as a replacement. The tendon most commonly transferred is the latissimus dorsi tendon in the back. For a latissimus dorsi transfer, the surgeon makes two incisions: one in the back and one in the front of the shoulder. Tendon transfer surgery is a more extensive undertaking than direct rotator cuff repairs. Tendon transfers are less commonly performed and are generally done by more specialized surgeons
  • Shoulder replacement. Massive rotator cuff injuries may require shoulder replacement surgery. To improve the artificial joint's stability, an innovative procedure (reverse shoulder arthroplasty) installs the ball part of the artificial joint onto the shoulder blade and the socket part onto the arm bone.