Tips for Shoulder Pain Relief

You reach into the backseat of your car and suddenly your shoulder twinges. Or maybe your it starts clicking during your weekly tennis game. Whatever the cause, you want pain relief. Our sports medicine experts share the common causes of shoulder pain and which treatments work best…

Being flexible is terrific in yoga class, on the dance floor and when playing Nintendo Wii with your kids. But it’s a drawback when it comes to your shoulder.

That’s because having very flexible joints, known as hypermobility, cause instability in the shoulder and increases risk of injury and pain, says Ralph Gambardella, M.D., orthopedic surgeon and sports medicine specialist at Kerlan-Jobe Orthopaedic Clinic in Los Angeles.

You’re also at risk if you sit behind a desk all day.

“Women in traditional administrative roles – who spend hours hunched over a desk – often develop shoulder pain because of poor posture,” Dr. Gambardella says.

Simply being born a woman may also cause chronic shoulder pain. Some studies show that hormonal changes during pregnancy – particularly the release of relaxin, a hormone that relaxes joint muscles in preparation for childbirth – may make the shoulder joint more elastic and less stable, he says.

So how do you find shoulder pain relief? Read on for the most common causes of shoulder pain in women and doctor-recommended treatments.

Frozen Shoulder

Do you feel a sharp pain when lifting your arm, making it hard to reach into a cabinet, comb your hair or hook your bra? That’s a sign of frozen shoulder, or adhesive capsulitis. The condition causes a thickening and stiffening of the ring of soft tissue surrounding the joint, called the capsule, which then becomes inflamed.

A frozen shoulder may occur for no reason, from an injury that puts your arm in a sling or because you restrict motion due to pain, Gambardella says.

Women age 45-55 are most at risk for the condition, but experts don’t know why.

Diabetics also face a higher risk, possibly because of abnormally high deposits of collagen, a protein that’s the basic building block of connective tissue in the shoulder, according to the American Diabetes Association.

Shoulder Pain Relief:Don’t delay treatment. Treated early, a frozen shoulder may heal in 4-6 weeks. Wait a few months, and recovery may take up to a year.

“It takes longer to heal when it has been progressing for a few months,” Dr. Gambardella explains.

Treatment may include anti-inflammatory medications, such as Celebrex and Anaprox and/or cortisone injections to relieve inflammation. Physical therapy is another option.

“A physical therapist will manually move the joint to stretch it and get [synovial] fluids moving in the joint,” says Renee Garrison, a physical therapist with the Medical University of South Carolina.

Synovial fluids nourish your shoulder and help it heal.

Rotator Cuff Strains and Tears

Unlike a frozen shoulder, rotator cuff strains cause pain but don’t limit your range of motion.

“You can move your arm overhead or out to the side, but it hurts when you do,” Dr. Gambardella explains.

Typical signs of problems with rotator cuff muscles, which stabilize the shoulder joint, include pain at night, pain while reaching into the backseat of your car or pain while tucking shirts into the back of your pants.

Strains and injuries often occur during sports that require overhand motions, such as tennis or volleyball.

They also can result from poor posture, for example, such as hunching over a computer keyboard for long periods.

But just getting older can trigger them too.

“Rotator cuff injuries can also be due to the wear and tear of age,” Dr. Gambardella says.

In fact, people over the age of 60 get rotator cuff injuries more often than other age groups, according to the Mayo Clinic.

Shoulder Pain Relief:The remedy depends on the extent of the injury. For example, a strain would need rest, ice and anti-inflammatories such as acetaminophen, but a total tear of the muscle requires surgery to repair, Dr. Garrison says.

Regardless of severity, doctors usually advise taking a break from painful activities and several months of physical therapy before resorting to surgery.

Impingement Syndrome

This condition is also called swimmer’s (or thrower’s) shoulder because “reaching away from the body causes pain,” says C. David Geier, M.D., director of sports medicine at the Medical University of South Carolina in Charleston.

It’s one of the most common causes of shoulder pain, triggered when the front of the shoulder blade rubs, or impinges, on the rotator cuff.

Typically, your shoulder hurts and movement is limited, but it isn’t weak or unstable, says Dr. Geier.Pain might get worse at night as the impingement gets more severe. Untreated, impingement syndrome can progress to frozen shoulder.

Shoulder Pain Relief:Initial treatment involves ice therapy: ice packs, ice massage and/or commercial gel ice packs, rest and avoiding reaching or overhead movements.

A doctor might also prescribe anti-inflammatory medication or cortisone injections, as well as physical therapy with exercises tailored to address the cause, Dr. Garrison says.

“Impingement caused by [hyper-flexible] shoulders, for example, requires stabilization exercises to keep the shoulder joint in place,” she explains.

Biceps Tendonitis

The hallmark symptom of biceps tendonitis is pain and tenderness in front of the shoulder, which worsens with overhead-lifting activities, Dr. Geier says. Pain may also radiate down the upper arm bone, and you may feel occasional snapping or a “clicking” in the shoulder.

Biceps tendonitis is caused by an inflammation of the tendon that attaches your upper bicep muscle to the shoulder bones. It’s often triggered by repetitive overhead motions, for example, when swimming or playing tennis.

You might also have other shoulder problems at the same time, such as impingement and rotator cuff damage, Dr. Geier says.

Shoulder Pain Relief:As with most shoulder injuries, the most common prescription includes ice, rest and anti-inflammatory medications. More severe injuries may need physical therapy and cortisone shots, Dr. Geier adds.

Shoulder Osteoarthritis

A degenerative joint disease, osteoarthritis of the shoulder causes cartilage – the cushioning layer between bones – to wear away.

Age, a prior injury and genetics may trigger the condition.

“It’s not nearly as common as hip and knee arthritis, because the shoulder isn’t a weight-bearing joint,” Dr. Geier explains.

You’re most likely to feel pain during or after moving the shoulder.

It can be triggered while combing hair and reaching for overhead objects.

Other signs include stiffness after long periods of inactivity, such as sleeping, and clicking noises when moving the shoulder.

Shoulder Pain Relief: First, you’ll need to see a doctor for diagnostic screenings, including blood and synovial fluid tests.

Physical therapy (which includes exercises to keep joints flexible and/or heat and ice therapy) increases range of motion, Dr. Geier says.

Your physician may also consider hyaluronic acid injections to cushion the bones. A thick liquid that naturally occurs in synovial fluid, hyaluron helps lubricate joints and acts as a shock absorber between bones.

“Anti-inflammatory medications and cortisone injections may help with pain,” he adds.

While no cure exists, proper treatment can reduce the pain and slow the progression of osteoarthritis.

Serious joint deterioration and extreme pain may require surgery.

How to Prevent Shoulder Pain

Good posture is one of the best ways to ward off shoulder pain.

“To improve your posture, you must first become aware of it,” says Judy Seto, physical therapist with the Kerlan-Jobe Orthopaedic Clinic in Los Angeles.

Have a friend take a picture of you at your desk. Your ear should line up with your shoulder and your shoulder with your hips, Seto says.

Set a timer to go off every 30-60 minutes (or make a pact with a co-worker to remind you) to check your posture.

More Posture Exercises
Do a quick set of shoulder blade retraction exercises: Sit with your hands on your lap, set your shoulders as wide as possible, and imagine your shoulder blades lying flat against your back; hold and repeat 5-10 times.

Also add seated rows to workouts 2-3 times a week, doing 12-15 reps with medium-resistance exercise tubing.

Here’s how:

• Attach tubing to a door hinge.
• Sit tall on a bench or exercise ball, grasping the handles in each hand.
• Keep your chest high and shoulders down (avoid shrugging) as you pull the handles toward you (tubing should be at chest height) and imagine flattening your shoulder blades against your back.
• Pause when your hands reach the sides of your chest and slowly return to starting position.

Linda Melone, a Certified Strength and Conditioning Specialist, writes frequently about fitness for Lifescript.