Stop Shoulder Pains

Shoulder pain is relatively common and has a variety of causes, ranging from a simple muscle pull to a dislocated joint. The reason why the shoulder is so susceptible to injury is that it has the most range of motion of any joint in the body. Furthermore, shoulder pain sometimes originates from other areas of the body such as the neck, mid back or even the heart. In most cases, using common sense and following some simple home remedies will be enough to stop your shoulder pain, but in some cases, treatment from a health professional is necessary.

Steps

Using Home Treatments

1. Rest your shoulder. Often, but not always, the root cause of shoulder pain is simple overexertion — lifting things that are too heavy or lifting lighter loads too often. Stop the aggravating activity for at least a few days. If your problem is work related, then if possible, talk to your boss about switching to a different activity. If the shoulder pain is exercise related, then you may be working out too aggressively or with bad form — consult with a personal trainer.
   • Excessive bed rest is not a good idea for any type of musculoskeletal injury because some movement is needed to stimulate blood flow and healing. As such, some rest is good, but complete inactivity is counterproductive.
   • Reconsider your sleeping environment. Mattresses that are too soft or pillows that are too thick may contribute to shoulder pain. Sleeping on your back for a few days or weeks may be needed so as to not aggravate your shoulder.
   • Shoulder joint pain (as opposed to muscle pain) frequently worsens at night while in bed.
2. Ice your shoulder. The application of ice is an effective treatment for essentially all acute injuries — including shoulder strains and sprains — because it constricts blood vessels (reducing blood flow) and numbs nerve fibers. Cold therapy should be applied to the most tender part of your shoulder in order to reduce the swelling and pain. Apply ice for 10-15 minutes every hour, then reduce the frequency as the pain and swelling subside in your shoulder.
   • Compressing the ice against your shoulder with a bandage or elastic support will also help control the inflammation.
   • Always wrap ice or frozen gel packs in a thin towel in order to prevent frostbite on your skin.
3. Take over-the-counter drugs. Non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen, naproxen or aspirin can be short-term solutions to help you deal with pain or inflammation in your shoulder — they can be found in every pharmacy and grocery store. Keep in mind that these medications can be hard on your stomach, kidneys and liver, so it's best not to use them for more than 2 weeks at a stretch and to take them with food.
   • Talk to your doctor about your medical problems you have and any medications that you take before taking these medications.
   • Follow the instructions on the package or your doctor's instructions on dosing.
   • Alternatively, you can try over-the-counter analgesics such as acetaminophen (Tylenol and Paracetamol) or muscle relaxants (such as cyclobenzaprine) for your shoulder pain, but never take them concurrently with NSAIDs.
4. Do some light shoulder stretches. If your shoulder pain is primarily achy in nature and doesn't involve sharp, stabbing or shooting pain with movement or a dislocation, then likely you're experiencing a muscle strain. Mild muscle strains respond well to some light stretching because it relieves muscle tension, promotes blood flow and improves flexibility. In general, hold stretches (without bouncing) for about 30 seconds and do them 3x daily until the discomfort fades away.
   • Trying to protect your sore shoulder by not moving it or putting it in a sling may increase the risk of adhesive capsulitis or "frozen shoulder," which is characterized by scar tissue, chronic stiffness and reduced range of motion.
   • While standing or sitting, reach around the front of your body and grab the opposite elbow. Gently pull on the back of the elbow until you feel a stretch in the corresponding shoulder.
   • While standing or sitting, reach behind your back towards your shoulder blade and interlock with your other hand (diagram above). Slowly pull on the hand with the sore shoulder until you feel a good stretch.
5. Build shoulder strength. If your shoulder pain is caused by overexertion (especially while on the job), you may benefit from strength-building exercises, assuming you perform them safely and correctly. When your initial pain subsides, try to introduce low-intensity, low-impact shoulder strengthening exercises to your routine. Stronger muscles such as the deltoids and rotator cuff are more able to handle the strain and exertion that can lead to shoulder pain, decreasing the likelihood that it will return.
   • Work with a personal trainer or physical therapist to make sure you are doing the exercises correctly.
   • Make sure your shoulder muscles are warmed up before exercising them. Taking a warm shower or applying moist heat or doing simple calisthenics before weight training is recommended because your shoulder muscles will be more pliable.
6. Distinguish between acute and chronic conditions. Although rest, ice and over-the-counter drugs are certainly helpful for acute (sudden) shoulder injuries, chronic (long-term) shoulder pain caused by arthritis or other degenerative conditions requires a little different approach. For example, for non-inflammatory osteoarthritis of the shoulder (the wear and tear type), applying some moist heat first thing in the morning may provide pain relief, reduce stiffness and increase your mobility.
   • As a source of moist heat, microwaved herbal bags work well and are often infused with aromatherapy (such as lavender) that has relaxing properties.
   • Supplements such as glucosamine, chondroitin, MSM and various fish oils may help lubricate and cushion arthritic joints.

Seeking Alternative Treatments

1. Get a shoulder massage. A strained muscle occurs when individual muscle fibers are taken beyond their limits and tear, which leads to pain, inflammation and some degree of guarding (muscle spasm in attempts to prevent further damage). A deep tissue massage is helpful for mild-to-moderate strains because it reduces muscle spasm, combats inflammation and promotes relaxation. Start with a 30 minute massage, focusing on your shoulder, lower neck and mid back areas. Allow the therapist to go as deep as you can tolerate without wincing.
   • Always drink lots of water immediately following a massage in order to flush out inflammatory by-products and lactic acid from your body. Failure to do so might cause a headache or mild nausea.
   • Your therapist may do trigger point therapy that focuses on areas of tight muscle fibers that can form in your shoulder after injuries or overuse.
2. Consider acupuncture. Acupuncture is an ancient art and involves sticking very thin needles into specific energy points within the skin / muscle in efforts to reduce pain and inflammation. Acupuncture for shoulder pain (caused by an injury or arthritis) can be effective, especially if it's done when the symptoms first occur. Based on the principles of traditional Chinese medicine, acupuncture works by releasing a variety of substances including endorphins and serotonin, which act to reduce pain.
   • Acupuncture is practiced by a variety of health professionals including some physicians, chiropractors, naturopaths, physical therapists and massage therapists — whoever you choose should be certified by NCCAOM.
   • Acupuncture points that may provide relief to your shoulder pain are not all located near where you feel the pain — some can be in distant areas of the body.
3. See a chiropractor. Chiropractors are joint specialists who focus on establishing normal motion and function of the spine and peripheral joints such as the shoulder. Shoulder pain is not only caused by the underlying glenohumeral and acromioclavicular joints, but also from joint issues in the neck and mid back. Your chiropractor is trained to diagnose joint problems and treat them (if appropriate) with manual joint manipulation, also called adjustments — they often illicit a "popping" or "cracking" sound.
   • Although one joint adjustment can sometimes completely relieve your shoulder pain, more than likely it will take 3-5 treatments to notice significant results.
   • Manual joint manipulation is not a good idea for inflammatory arthritis.
   • Other professions that use manual joint manipulation include osteopaths and some physicians and physiotherapists.

Seeking Medical Treatments

1. See your doctor. If your shoulder pain is especially severe, long-lasting (more than a few weeks) or debilitating, and home remedies are not particularly helpful, then make an appointment with your doctor. Your shoulder pain may be caused by something serious such as a torn tendon, damaged cartilage, dislocated joint, fracture or inflammatory arthritis. Your doctor may refer you to a specialist such as an orthopedist, neurologist or rheumatologist in order to better diagnose and treat your shoulder issue.
   • X-rays, bone scans, MRI, CT scan and nerve conduction studies are tools that specialists may use to help diagnose your shoulder pain.
   • Depending on your diagnosis, you may be given stronger prescription medications (especially if your pain is caused by arthritis) and/or asked to wear a shoulder sling short-term, which is common with severe joint sprains and dislocations. Your doctor will discuss a treatment plan tailored to your diagnosis with you.
2. See a physical therapist. If your shoulder problem is recurring (chronic) and not alleviated by your own exercise routine, then you need to consider some form of rehabilitation guided by a professional. Your doctor can refer you to a physical therapist, who can show you specific and tailored stretches and strengthening exercises to rehabilitate your shoulder. Physiotherapy is usually required 2-3x per week for 4-8 weeks to positively impact chronic shoulder problems.
   • If need be, a physical therapist can treat your sore shoulder muscles with modalities such as therapeutic ultrasound or electronic muscle stimulation.
   • Good strengthening exercises for your shoulder include pushups, pullups, swimming and rowing, but make sure your injury is resolved first.
3. Get a cortisone injection. Cortisone is a hormone that is sometimes administered medically to treat injuries and various forms of arthritis such as rheumatoid arthritis and osteoarthritis. An injection of steroid medication near or into a muscle, tendon or ligament can quickly reduce inflammation and allow normal, unrestricted movement of your shoulder again. Cortisone, compared to NSAIDs, has a longer duration of action and a stronger effect. The most common preparations used are prednisolone, dexamethasone and triamcinolone.
   • Potential complications of corticosteroid injections include infection, bleeding, tendon weakening, local muscle atrophy, nerve irritation / damage and decreased immune function.
   • If corticosteroid injections fail to provide adequate resolution for your shoulder problem, then surgery should be considered and discussed with your doctor.
4. Consider surgery as a last resort. Surgery for chronic shoulder pain is often the last resort (after more conservative approaches have been tried), although it may be warranted immediately if your shoulder is dislocated or fractured due to serious trauma suffered from a car accident or sports injury, for examples.
   • Osteoarthritis of the shoulder may lead to the formation of bone spurs or disintegrating cartilage, which can be remedied with arthroscopic surgery.
   • Rotator cuff tears — a group of four muscles surrounding the ball and socket shoulder joint — is a common cause of pain and disability that often needs surgery to remedy.
   • Shoulder surgery may involve the use of metal rods, pins or other devices for structural support.
   • Possible complications from shoulder surgery include local infection, allergic reaction to anesthesia, nerve damage and chronic swelling/pain.
   • Be prepared for needing some time after the surgery to recover. You will most likely need to do stretching, exercises, or physical therapy during the recovery period.

Tips

• Soaking your body in a warm Epsom salt bath can significantly reduce pain and swelling in your shoulder, especially if the pain is caused by muscle strain or osteoarthritis. The magnesium in the salt helps the muscles relax.
• An alternative to ice or frozen gel packs is a frozen bag of veggies, such as peas or corn.
• Avoid carrying bags that distribute weight unevenly across your shoulders like single-strap messenger bags or purses. Instead, use a bag with wheels or a two-shoulder backpack with padded straps.
• Exercise regularly.

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Sources and Citations

See also

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• Treat Muscle Spasms
• Get Rid of Leg Cramps
• Tolerate Getting Wisdom Teeth Pulled

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