Treating and managing shoulder pain

Depending on the cause and severity of your shoulder pain, there are a variety of options to manage and treat the issue with your joint. For some, lifestyle changes will be enough to reduce and manage shoulder pain. There are also a variety of treatments available, both non-invasive and surgical, for people with more advanced or painful joint conditions.

With specialist advice from Mr Adel tavakkolizadeh, Consultant Orthopaedic & Upper Limb Surgeon at BMI The Sloane and BMI The Blackheath hospitals.

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If you have shoulder pain or can’t move your shoulder as usual, and find that this lasts for more than two weeks and doesn’t improve with adequate rest, you should speak to your GP or a specialist consultant to seek a diagnosis for your shoulder problem.

Common causes of shoulder pain include injury, overuse, and osteoarthritis. These conditions can also cause stiffness, swelling and reduced flexibility in the shoulder joint.

One you have a diagnosis, your specialist will work with you to decide on the best course of treatment to improve your range of motion and reduce your joint pain.

Mild cases will first be recommended lifestyle changes. There are also a variety of non-surgical treatments that can significantly improve your symptoms. If your condition is more advanced, or if you have an injury that needs to be fixed, you may be recommended for shoulder surgery.

Managing shoulder pain with lifestyle changes

Many people worry that if they have chronic joint pain, in particular arthritis, that their consultant will immediately recommend surgery. This is not true.

Most doctors would much rather you got your pain and stiffness under control by making healthy lifestyle changes. Surgery is a last resort when other methods have failed.

There are a number of things you can do to reduce or even relieve pain in your shoulder – or any other joint. Some of the most effective things you can do are:

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Stay active

If you have pain in your shoulder or other joints, don’t be tempted to stay away from exercise. Unless you’re advised otherwise, it’s almost always best to increase your activity levels.

Exercise can reduce pain and swelling as well as improving flexibility. It also builds the muscles around your joints, meaning they’re better supported.

Sleep well

This is a really important tip for anyone. Good sleep benefits your health in so many ways. If you have a bad shoulder, a good night’s sleep could reduce your symptoms, while a bad night’s sleep could make them worse.

Eat well

Foods including fruits and vegetables, nuts, olive oil and fatty fish have anti-inflammatory properties, which may help to ease arthritic symptoms such as joint swelling and pain.



Maintain a healthy weight

Being overweight by even a small amount can affect your joint health. Staying within a healthy weight range could significantly improve swelling and pain in your shoulder.

Speak to your GP to find out what’s a healthy weight for you.

Look after your mental health

Studies have found that stress and other mental health problems can actually exacerbate joint problems.

So, while your shoulder pain may be a physical issue, it’s important to consider your mental wellbeing too.



Non-surgical treatments for shoulder pain

There are various non-invasive medical treatments for joint pain that you will be recommended before resorting to surgery.

These include long-established methods such as physiotherapy, as well as newer treatments including PRP injections.

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Some of the most common include:

Painkillers and anti-inflammatories

Many people will be prescribed painkillers and anti-inflammatories for shoulder pain, some short-term and others long-term.

Some people find that pain is the worst symptom of their joint damage, so may benefit more from painkillers.

Others will suffer more with inflammation. Rheumatoid arthritis, for example, can cause severe inflammation in the shoulder.

Joint injections

Injection therapy is the injection of steroid (corticosteroid) medications into painful joints or soft tissues to reduce pain and inflammation in that area.

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This may be recommended if you are unable to tolerate oral anti-inflammatories, if your condition is too painful for you to manage with physiotherapy exercises, or if your progress has slowed down.

Occasionally, injections may be used to confirm a diagnosis if it is not clear where your symptoms originate from.

Physiotherapy

Also known as physical therapy or rehabilitation, physiotherapy can be a fantastic tool when it comes to reducing muscle pain and improving mobility in your shoulder.

You can book directly with a specialist physiotherapist, who will put together a bespoke programme of movements, stretches and exercises that could significantly improve your symptoms.

Physiotherapy can help people with all stages of joint pain, from mild to very severe.

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Surgery for shoulder pain

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There are various surgical procedures available that can help reduce or even cure shoulder pain. These won’t be recommended until other, less invasive options have been exhausted.

If you are recommended shoulder surgery, the type of operation you have will depend on the cause and severity of your pain as well as your individual circumstances. Common procedures include:

Shoulder arthroscopy

A shoulder arthroscopy, which is a kind of keyhole surgery, allows your surgeon to see inside your shoulder joint. This allows for diagnosis and sometimes even treatment.

You might be recommended this procedure if your consultant needs to diagnose the cause of your shoulder pain. In some cases, it can be used as a means of delaying the need for shoulder replacement surgery.

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Rotator cuff surgery

The rotator cuff is a collection of muscles and tendons attaching your arm to your shoulder blade. It’s a very important part of your shoulder, so if it becomes seriously damaged you may need surgery.

Common causes of damage to the rotator cuff tendons and muscles are accidents, sports injuries and, often in older patients, wear and tear.

During the surgery, your surgeon may use instruments to remove any thickened tissue, release any tight tissue and to shave off some bone. If you have a large tear, your surgeon will repair the rotator cuff using stitches that anchor into the bone.

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Shoulder replacement surgery

Shoulder replacement surgery involves removing all or part of a damaged shoulder joint and replacing it with a prosthetic joint. You’ll only be recommended this surgery if all other treatments have failed to improve your mobility and reduce your pain.

This procedure is only recommended to patients whose lives are being significantly impacted by shoulder pain. Most people see a real improvement after surgery.

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