Shoulder pain, a common affliction that strikes countless individuals across all walks of life, can significantly hinder daily activities and diminish quality of life. This complex issue stems from a variety of causes, ranging from acute injuries such as rotator cuff tears and dislocations to chronic conditions like arthritis and bursitis.
Danielle Valentino, orthopedic nurse practitioner at the Riverside Orthopedic and Spine Center, shares helpful information about shoulder pain, including causes, symptoms, and solutions.
Identifying the Root of the Pain
Shoulder pain can be non-specific, so it’s important to perform a full assessment in order to get to the root of the problem. Valentino and her colleagues often start with looking for symptoms of rotator cuff disease, which can range from a partial rotator cuff tear to a full thickness tear. Another issue might be cuff tendinitis or a condition called calcific tendinitis, where calcium deposits form on the rotator cuff.
“There are actually four muscles that make up the rotator cuff. There's the subscapularis, the teres minor, the supraspinatus, and the infraspinatus. These muscles are important for stabilizing the shoulder and providing certain shoulder movements,” she explains. “Rotator cuff tears are a very common source of shoulder pain. And that usually manifest as pain in the shoulder or decreased motion. A patient might come in and say, ‘You know, I used to be able to reach my top cabinet. And now, I can only reach to the sink to fill up water. What's going on?’”
Treatment Options: Conservative Methods to Surgical Intervention
One of the first recommendations for finding pain relief is a home-stretching program, particularly if the patient is unable to fully refrain from the aggravating factors contributing to pain. Valentino also suggests rest, ice, over-the-counter anti-inflammatories or lidocaine-containing patches or gels. Sometimes, physical therapy can be helpful as well.
“We don't really like doing this in younger athletes, but sometimes we'll consider a shoulder injection with an interarticular steroid.”
If a patient is a surgical candidate, treatment varies depending on the type of shoulder issue. For example, partial rotator cuff tear versus full tear. “If it's a bad enough tear and they have terrible arthritis, those are fixed with a reverse total shoulder replacement. It's really not a straightforward answer for anybody out there who has shoulder pain,” adds Valentino.
The recovery timeline from surgery also varies, depending on the approach. If a tear can be repaired arthroscopically, many patients can start to resume shoulder movement quite quickly. Alternatively, any repair of ligamentous structure inside the joint of the shoulder requires longer downtime—up to 12 weeks of being in a sling.
You Don’t Have to Live with the Pain
The most important takeaway Valentino wants people to remember is that there are effective ways to address shoulder pain, many times without surgery. She encourages individuals to schedule a visit with an orthopedic specialist if they have tried conservative home treatments and nothing is providing relief.
“If anyone has any questions or concerns about one of their joints, come in sooner rather than later. If there is something underlying that is a simple fix, then we can evaluate them and hopefully successfully treat them and get them moving right away versus if there is some kind of underlying tear and they wait it out. They then go from something that could be very simple to something that progresses to surgical treatment. It's always better to avoid surgery if you can at all costs.”