In previous posts we have talked about how a incorrectly functioning shoulder can cause impingement and pain.

While thinking it is essential to have a good understanding of what is occurring in your shoulder and why you are getting pain. I also understand that when you are in pain all you want to do is get out of it.

Today’s post is reviewing some of the common ways medical professionals help relief shoulder pain.

Keep in mind, the way to long term relief is correcting the dysfunction in the shoulder by use of shoulder impingement exercises. But when it is 3am and you can’t sleep because your shoulder is aching it is crucial to have some options to give you temporary relief.

Pain Medication
With shoulder impingement it is common to also have a tendonitis or bursitis. Basically that means an irritated or inflamed tendon or bursa. For more information on these terms click here to read the Shoulder Joint post.

For this reason the anti-inflammatory group of medications often give the best relief from shoulder pain. These are commonly referred to as NSAIDs (Non-Steriodal Anti-Inflammatory Drugs). Common over the counter examples are Advil and Aleve. Click here to visit WebMD for more information about NSAIDs

You should always check with your doctor before starting a medication to ensure it is the correct medication for you. Prolonged use of NSAIDs can harm your kidneys.

If your pain is severe you may need a prescription anti-inflammatory from your doctor.

Thermal Relief
Thermal Relief refers to the use of Hot or Cold Packs. Both of these can help with inflammation and pain relief.

Typically cold packs are best in the first 3 weeks after an injury or recent aggravation.

Apply a cold pack directly to the shoulder for 15-20 minutes. Repeat every few hours if pain persists.

Common cold pack options include: wrapping ice in a towel or plastic bag, a frozen bag of vegetables e.g. peas, or a store bought cold pack.

Heat is usually more effective relaxing tight muscles and reducing pain but only if the pain has been present for more than 3 weeks.

Even though it is called a Heat Pack, it is not meant to cook you. The heat should only be a mild comfortable warmth.

Once again 15-20 minutes is ideal.

Common heat pack options are a heating pad, store bought microwavable heat pack, or a hot water bottle wrapped in towels.

Electrical Stimulation
Electrical stimulation is a very effective modality commonly used in Physical Therapy clinics to help relieve shoulder pain.

Here’s how it works. Basically your nerves are like a series of electrical wires. Pain is sent to the brain via the nerves as a series of electrical impulses.

The electrical stimulation sends a current through your shoulder at the same frequency that pain is carried at in the nerves. It interferes with the pain signal and thus the brain doesn’t register the pain.

The electrical stimulation also helps increase localized circulation thus facilitating healing.

When applied properly all you should feel is a pleasant pins & needles, tingly sensation. It should not be painful or too strong.

Ultrasound
Ultrasound is another modality commonly used in Physical Therapy to decrease inflammation, pain and facilitate healing.

Ultrasound is a certain frequency sound wave.

Basically the ultrasound helps increase localized circulation, flushing out the inflammation and bring new nutrients to the area to help with healing.

What you feel with ultrasound is the transmission head moving around on your shoulder and the coldness of the gel. The gel is required to aid penetration of the sound wave into your skin. Sometimes you will feel some warmth from ultrasound but it should never be painful or too hot.

I hope these have provided you with some shoulder pain relief ideas for when you shoulder next plays up.

The next post will review the diagnostic tests to confirm if your shoulder pain is really due to a shoulder impingement.

Now it is time to start putting the pieces together.

One of the common misconceptions that I come across in the clinic in regards to shoulder impingement pain is the concept that “this is where I feel the pain, this must be the problem”.

This introduces the concept of Shoulder Pain Site Vs Shoulder Pain Cause.

Pain Site refers to the structure that has become irritated to cause the pain, e.g. bursa, tendon or ligament.

Pain Cause refers to why has that structure become irritated, e.g. a tight posterior Deltoids may not be letting the arm bone rotate precisely within the shoulder joint and thus impinging the Supraspinatus muscle.

The Supraspinatus tendon may be the site of the pain but it is the tight deltoids that is the cause of the problem.

This may be a subtle but important difference. If we just focus on the pain site, we will be able to reduce the pain and inflammation but we haven’t addressed the root cause, thus there is a very high likelihood that the shoulder pain will return sometime in the future.

To illustrate this more clearly let’s think about the car analogy used in other posts.

Imagine your wheels are out of alignment (this would be the pain cause). As you drive this is going to cause uneven wear and tear on your tires.

At some point down the road it will become necessary to replace your tires due to the abnormal wear (this is the pain site).

Now if you just replace the tires and continue driving you are very likely to have the same problem again and again.

In order to correct the problem properly you not only need a new set of tires but you also need to get a wheel alignment to spread the wear more evenly over the entire tire (treating the pain cause).

That is why when it comes to shoulder pain, for best results it is important to address both the pain site and the pain cause.