Shoulder pain is quite common and can be triggered by a number of problems, including a muscle tear, ligament sprain, dislocation, spinal dysfunction (in the neck or mid-back) and even heart disease. The most common cause of this pain, however, is a slight stretching of the muscles and / or ligaments caused by excessive stress at work or during training. In most cases, this is a self-limiting disorder that clears up in about a week and sometimes even sooner if you put some helpful home remedies into practice. For more serious injuries you need to see an orthopedist, as surgery may even be needed (although this is rare).
Steps
Part 1 of 2: Home Remedies
Step 1. Rest your shoulder and be patient
In most cases, the pain is generated by fatigue or by excessive stress, in other words by repetitive movements or by too heavy loads. If you believe this is the most plausible reason for your suffering, then stop any activity that aggravates the situation for a few days. If the injury is related to the work you do, then ask your supervisor to temporarily entrust you with different tasks (less repetitive or heavy) or change your workplace. If the pain is caused by physical training, then you may have lifted excessive weights or performed exercises incorrectly; consult your personal trainer for advice.
- Rest is certainly a good idea, but in the case of minor injuries you shouldn't immobilize your shoulder with a shoulder strap, as this could cause adhesive capsulitis. At least gentle movements are needed to promote blood circulation and stimulate the healing process.
- A feeling of stiffness is usually a symptom of a muscle strain, while a sharp pain with every attempt to move is related to damage to the joint or ligament. Suffering is worse at night when you go to bed.
Step 2. Apply an ice pack
If your shoulder feels swollen as well as painful, then you should apply an ice pack (or a cold pack) to the area that hurts the most to reduce inflammation and numb sensitivity. Cold therapy is perfect for acute injuries that have triggered an inflammatory response. Ice should be kept in place for 15 minutes or so every two hours, until symptoms go away or subside.
- Compress the ice pack using an elastic bandage to increase its effectiveness against inflammation.
- Always wrap the ice pack in a thin cloth before placing it on the injury site, to prevent skin irritation and chilblains.
- If you don't have ice cubes, then you can use a packet of frozen vegetables or a cold gel pack.
Step 3. Try moist heat
If you are suffering from chronic (long-term) pain and feel that the joint is very stiff in the morning when you get up or before doing some exercise, then you should use moist heat therapy instead of cold therapy. In this way you warm the soft tissues (muscles, tendons and ligaments) and increase the blood flow to the area; all this is very useful in cases of shoulder pain caused by osteoarthritis (wear of the joint) or old sports injuries. For moist heat, you can heat a bag full of cereals (rice or wheat), herbs and / or essential oils in the microwave. Apply the compress for 15-20 minutes first thing in the morning or before working out.
- A hot bath also performs the same function. Add Epsom salts to the water to relax the muscles even more and increase the effectiveness of the treatment.
- Avoid the dry heat emitted by electric warmers, as it further dehydrates the tissues and increases the risk of injury.
Step 4. Take over-the-counter medications
If the pain is too severe to bear and unresponsive to treatment with cold or hot packs, then you need to consider drug therapy with non-steroidal anti-inflammatories or pain relievers. The former are more suitable when the shoulder is very swollen (as in cases of tendonitis and bursitis); you can take aspirin, ibuprofen (Brufen, Moment) and naproxen (Aleve). Painkillers (analgesics), on the other hand, prove effective for indeterminate pain not generated by inflammation; among these we remember the paracetamol (Tachipirina). Keep in mind that these are short-term solutions, which you do not have to resort to daily for more than a few weeks, as they have negative side effects on the liver, kidneys and stomach.
- Alternatively, you can try muscle relaxants (such as cyclobenzaprine), but never take them in combination with other medicines.
- Ibuprofen is not suitable for very young children, while aspirin is not recommended for patients under 18 because its use is associated with Reye's syndrome.
Step 5. Do some simple shoulder stretches
The pain could be caused by stiff and contracted muscles due to poor posture or a sedentary lifestyle. As long as you don't feel stabbing, piercing, or "electric" pain when you move your shoulder, stretching exercises can give you some relief. Sore and contracted muscles respond well to stretching because they become less tense, more flexible, and are supplied with more blood. Shoulder flexibility is key, because it is the joint that has the widest range of motion in the entire body. Hold each stretch for about 30 seconds as you breathe deeply and repeat them 3-5 times a day daily until the pain subsides.
- Stand or sit with your back straight. Bring one arm in front of your torso and grab the elbow with the opposite hand. Pull the back of the bent elbow towards your torso until you feel a gentle stretch in the corresponding shoulder.
- Also for this exercise you can stand or sit; bring your arms behind your back and towards your shoulder blades where you will cross your fingers. Bring the hand corresponding to the sore shoulder down until you feel a little stretch.
Step 6. Consider changing your workplace
The pain could be caused by a poorly ergonomic workplace. If your computer, desk, or chair are not positioned correctly for your height and build, then you may be in positions that stress your shoulders, neck, and mid-back. When you sit at your desk and look straight ahead, your gaze should be on the top third of your computer monitor; the forearms should be parallel to the floor, with the elbows a few inches from the hips, while the feet should be firmly on the ground.
- If you work standing up, make sure your torso is not constantly rotated or twisted, your goal is to maintain a symmetrical and balanced posture.
- To prevent shoulder injuries, minimize jobs that involve lifting your arms above your head and use a higher ladder to reach objects or perform your tasks.
Part 2 of 2: Professional Treatments
Step 1. Get a deep massage
If the pain lasts longer than you thought, then you should consider a deep tissue massage performed by a qualified therapist. This type of manipulation acts on chronically contracted or tense deep muscles that restrict movement, reduce flexibility, block circulation, and trigger an inflammatory response. Massage is very useful for light to moderate stretches, but it is not recommended for more severe joint injuries.
- Start with a 30-minute session that focuses on the aching shoulder, but also on the lower neck and middle back, the one between the shoulder blades.
- Allow the massage therapist to apply as much pressure as you can handle without flinching, because there are many layers of muscle tissue in the shoulders and the therapist has to manipulate them.
Step 2. Ask for the name of a physiotherapist
If the pain is caused by overexertion or repetitive motion, then you should strengthen your shoulder to allow it to carry greater workloads. In this case you must undergo strength exercises under the guidance of a physiotherapist who will teach you which ones to perform and how, based on your specific condition. He may recommend the use of machines, free weights, elastic bands or medicine balls that will make your shoulders stronger, so that you can manage your work environment or play your favorite sport. Additionally, the physical therapist might also treat the painful muscles with therapeutic ultrasound or electro stimulators, if needed.
- You typically need to undergo physical therapy 2-3 times a week for 4-6 weeks to achieve good results.
- If the shoulder pain is caused by a sprain, then the physical therapist will help you by applying medical tape.
- Activities that strengthen the shoulders are rowing, swimming, archery, and bowling.
Step 3. Go to a chiropractor or osteopath
If the pain is related in any way to the shoulder joint or spine, then go to one of these professionals for a consultation. Both are joint specialists and their goal is to restore normal range of motion and function in the spine and peripheral joints, just like the shoulders. Shoulder pain can obviously be caused by the joints that compose it (the scapulohumeral and / or acromioclavicular), but the sensation could also be generated by a dysfunction or injury in the cervical (neck) or thoracic (central) area of the spine. If necessary, the therapist unlocks or repositions the joints by manipulating them and you may hear "pops" or "creaks" coming from the area.
- Although a single manipulation of the joint can, at times, significantly improve the problem with the musculoskeletal system, in general some treatments are necessary to stabilize the area.
- Osteopaths and chiropractors can manipulate joints, but only an orthopedic doctor can reduce a dislocation.
Step 4. Evaluate acupuncture
It is a therapy that developed in China hundreds of years ago with the aim of reducing pain and stimulating healing. The therapist inserts some fine needles into the skin, in specific points (sometimes close to the suffering area, but in some cases also very distant), for 20-60 minutes at a time, triggering the production of pain-relieving compounds in the body. It is not yet certain how acupuncture is effective in reducing pain, because there are not enough scientific studies on it; however, there are testimonials from people who have benefited greatly from it. As this is an extremely safe practice, it's worth a shot if you can afford the cost.
- Acupuncture is practiced by many health professionals such as doctors, chiropractors and physiotherapists. Always make sure that the person you trust is enabled.
- A single acupuncture session may not be enough and you may not even feel any benefit, for this reason consider undergoing at least three treatments before considering it ineffective for your case.
Step 5. Discuss more invasive solutions with the orthopedist
If the pain does not respond to home treatments or other conservative therapies, then you should discuss other more aggressive treatments, such as cortisone injections or surgery, with your doctor. Injections of corticosteroids (such as prednisolone) are given directly into the swollen shoulder and quickly reduce inflammation and pain by allowing you to move the joint normally. These are indicated in severe cases of tendonitis and bursitis. Surgery, on the other hand, is reserved for those patients who need to reconstruct their tendons, who have suffered fractures, suffer from severe arthritis, thrombosis or when it is necessary to drain fluids. Your orthopedist may recommend that you see a shoulder surgeon who will have an X-ray, MRI, bone scan, or test to study nerve conductivity. All this to establish with certainty the condition of your shoulder.
- Possible complications of cortisone injections are atrophy and weakening of the tendon or muscle, nerve damage and decreased immune function.
- Risks associated with surgery are localized infections, bleeding, allergic reaction to the anesthetic, nerve damage, paralysis, reduced movement due to scar tissue, and chronic pain or swelling.
Advice
- To reduce shoulder pain, you should sleep on your back. In general, resting on your stomach irritates the shoulder and neck joints.
- To avoid shoulder problems, do not use bags that distribute weight unevenly. Instead, opt for a classic backpack with well-padded shoulder straps.
- If your shoulder pain is very severe or disabling and you feel it is getting worse, make an appointment with your orthopedist as soon as possible.
- Do not sleep on the side with the shoulder facing forward, as this position causes severe pain in the area throughout the night.
- Sleep on your back and lift your shoulder by adding an extra pillow on which you will rest your entire affected arm, from the hand to the shoulder itself. Apply ice and rest until the pain is completely gone so that the muscle doesn't inflame again.
