People of all ages suffer from shoulder pain. The causes
are many and can range from an unknown onset to a traumatic
event. Many people develop shoulder pain from performing
repetitive type activities for prolonged times. Others
will experience pain in the shoulder following a fall onto
the shoulder or on the outstretched arm. Sometimes the
reason for pain is not as obvious. I see many cases where
a person cannot identify what caused the pain in the
shoulder. Often times this pain for unknown reasons can
occur when someone bumps their shoulder against the door
jam in the middle of the night when going to the bathroom.
This rather benign action sets off a chemical process in
the shoulder that will build up over several days.
Eventually this will cause pain in the shoulder. Since the
injury occurred several days earlier the person cannot
recall any event that started the process. Regardless of
the cause of the pain in the shoulder the treatment is
often similar from case to case.
Treatment of the shoulder can encompass several different
areas. Conservative measures include medication such as
anti-inflammatories or pain medications, rest, cortisone
injections, and or physical therapy. All of these methods
can be effective in helping relieve a painful shoulder
especially when they are performed in combination with each
other.
Often times when you present to your medical doctor with
complaints of shoulder pain they will prescribe some
medication as described above. Rest will also be advocated
although this is not always easy for people to follow
depending on their activity levels or their occupations.
Injections for the painful shoulder are sometimes given
right away depending on your medical doctor's philosophy.
Some MD's would rather you attend physical therapy before
considering injecting the painful shoulder. Injections are
not the end all beat all and they do not offer relief to
all patients that receive them. Often times a well rounded
physical therapy program can alleviate shoulder pain and
you won't have to consider having an injection.
Physical therapy treatment can consist of the following
interventions:
1. Therapeutic exercises: this will consist of range of
motion, conditioning, and strengthening exercises. The
goal here is to maximize and restore any loss of range of
motion, improve the overall endurance of the shoulder blade
and shoulder muscles and to improve the strength of these
same muscles. The muscles surrounding the shoulder blade
must be conditioned and strengthened just as the main
shoulder muscles would be because the shoulder blade
muscles have to work in conjunction with the shoulder
muscles in order to restore normal motion and to prevent
recurrence of pain.
2. Manual therapy: this will consist of hands on treatment
that the physical therapist would perform on you. This
might consist of joint mobilization (i.e. techniques
designed to improve joint motion and relieve pain), or soft
tissue massage (i.e. techniques designed to improve muscle
and connective tissue flexibility and to relieve pain).
3. Modalities: this consists of machines that the physical
therapist may apply to your painful shoulder to assist in
pain relief and healing along with the other treatments
mentioned above. Some of these machines are ultrasound,
electrical stimulation, TENS, or iontophoresis.
All of these interventions can be used in the treatment of
a painful shoulder. It is common in clinical practice to
use a combination of these interventions. It has been my
experience in treating hundreds of shoulder patients over
the years that therapeutic exercise is an absolute in the
treatment of the painful shoulder. Well rounded exercises
that target the shoulder blade and shoulder muscles are the
mainstay of any good physical therapy regimen for the
treatment of shoulder pain. A painful shoulder can persist
for years. With the right education you won't have to
suffer any longer!
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Peter Harris is a licensed Physical Therapist with 17 years
experience in the profession treating patients with
shoulder pathology. Learn how I have helped hundreds of
patients with shoulder problems overcome their pain and get
their life back!
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