Treatments for Severe Shoulder Pain
Treatments for severe shoulder pain typically start with determining the cause of the pain. Shoulder pain is often caused by chronic wear and tear from sports or work-related activities, especially with physically demanding professions, instability when the upper arm bone is dislodged from the socket, or conditions such as arthritis. Shoulder surgery or a fracture can also cause severe shoulder pain, often limited to the healing period. Regardless of whether or not shoulder pain is temporary, selecting the right treatment can bring welcome relief.
Treatments for severe shoulder pain often involve altering your activities, usually temporarily, until the pain eases or goes away completely. This often includes altering your exercise routines by switching to low-impact workouts or modifying the types of exercises you do until the strength in your shoulder returns. If your shoulder pain is directly related to your workout routine, however, you’ll likely need to reduce the intensity of your workouts. Common sense activity changes include:
• Taking a break from physically demanding activities
• Getting more rest between activities to promote healing
• Bracing or immobilizing the shoulder area before any activities
Severe shoulder pain is sometimes related to a lack of shoulder flexibility and strength. Physical therapy treatments for severe shoulder pain are based on the nature of the pain and the physical abilities of each patient. As the shoulder pain eases, therapy sessions are altered to further improve mobility and strength to reduce or eliminate shoulder pain. Physical therapy is sometimes followed by surgical procedures to alleviate the cause of the pain or extreme discomfort. Physical therapy is a common follow-up for shoulder fractures after the bones have been repositioned. Once the bones within the shoulder area heal, exercises strengthen and restore normal movement and often alleviate any discomfort. A similar procedure is used to treat shoulder separation, sometimes proceeded by surgery for severe tears.
If other treatments for severe shoulder pain aren’t effective, surgery may be required to provide relief. Shoulder-related conditions such as rotator cuff tears may not respond physical therapy or medication. Sometimes surgery is required to repair torn issues or remove scar tissue. In some cases, a previous surgery may not have been successful, requiring additional surgery to correct the issue. In extreme cases, shoulder reconstruction or replacement may be necessary. Fortunately, about 90 percent of patients dealing with severe shoulder pain respond to non-surgical treatments.
Prescription medications may reduce pain and inflammation related to your shoulder pain. In some cases, injections are given to numb the shoulder area to eliminate pain during the healing process. Steroids may also be prescribed to relieve severe pain. It’s important to take all medications as prescribed to avoid dependence issues. Medications tend to work best for severe shoulder pain related to conditions such as osteoarthritis, caused by wear and tear of cartilage, and rheumatoid arthritis, an autoimmune disease causing inflammation of shoulder joints. Additionally, medications are often prescribed for severe shoulder pain caused by:
• Frozen shoulder (to reduce swelling)
• Rotator cuff tear (to minimize pain and discomfort)
• Rotator cuff disease (usually aspirin and ibuprofen to reduce swelling)
Heat and Ice
While certainly not a new innovation, heat or ice applied to the sore area can help reduce the intensity of shoulder pain. When shoulder pain is severe, however, the application of heat or ice is usually coupled with other treatment options. Heat can sooth inflamed joints and provide short-term relief, even for more severe bouts of shoulder pain. Keep in mind that heat or ice should only be applied in 15-20 minute intervals to prevent skin damage.
Longer lasting heat or ice therapies for moderate to severe shoulder pain include:
• Low-level heat (in the form of a heat wrap, can be worn up to 8 hours)*
• Hydrotherapy (may include a warm shower or bath or a prolonged stay in the hot tub)
• Cool baths or showers*Some patients report relief extending to approximately 48 hours or more.
*Some patients report relief extending to approximately 48 hours or more.
Contrast baths require the use of 2 containers or tubs large enough to soak the affected shoulder. The idea is to soak in the warm water (or at least keep your shoulder area submerged) for about 5 minutes before alternating to the cold water bath for a minute or so.
Prescription Topical Pain Cream
While over-the-counter topical pain cream often works for mild shoulder pain, more severe shoulder pain usually responds before to prescription topical pain creams. Also referred to as topical non-steroidal anti-inflammatory drugs, prescription creams work to relieve shoulder pain by soothing deeper muscles and tendons within the shoulder area. Prescription topical pain creams and ointments should be selected based on the origin of the shoulder pain. Some pain creams, for instance, are better at treating shoulder pain related to sprains or strains while other creams ease general muscle pain.