Self-Treatment Strategies for Shoulder Pain: Debunking Myths and Embracing Evidence-Based Solutions

Shoulder pain is a prevalent issue that affects people of all ages and backgrounds, impacting daily activities and quality of life. While seeking professional medical advice can be important, individuals can also implement various self-treatment strategies to alleviate pain and improve shoulder function. In this comprehensive guide, we'll explore evidence-based best practices for shoulder pain, discuss self-treating shoulder pain, debunk common myths surrounding imaging and medication, and discuss the importance of exercise and additional therapeutic options.

Myth:

Imaging is Necessary for Diagnosis

Fact:

Research indicates otherwise. Despite the common belief that imaging such as MRI is necessary for diagnosing shoulder pain, studies have shown that it can be unreliable and often leads to incidental findings that may not be relevant to the patient's symptoms. A systematic review published in the Journal of Shoulder and Elbow Surgery highlighted the high prevalence of asymptomatic findings on shoulder MRIs, suggesting that they may not always correlate with clinical symptoms. Instead of relying solely on imaging, healthcare providers should prioritize a thorough clinical evaluation to guide diagnosis and treatment. Too many times providers are rushed to see patients in a large hospital setting. If you feel the pain generator is being decided on imaging alone we generally recommend seeking a second opinion. Partial rotator cuff tears, labral tears, and bursitis diagnoses are too often not the pain generating issue in the absence of trauma.

Myth:

Medication Should Be A First Line of Treatment

Fact:

While medications like non-steroidal anti-inflammatory drugs (NSAIDs) and opioids (less common now due to addictive characteristics) are commonly prescribed for shoulder pain, they come with risks such as gastrointestinal complications and dependency. Furthermore, a study published in JAMA Surgery found that opioids were frequently prescribed following shoulder surgery, contributing to the opioid epidemic. Instead of relying solely on medication, individuals should explore safer and more effective alternatives for pain management and/or relief.

Myth:

Surgery is Necessary To Fix The Problem

Fact:

Surgery should be considered later on in the absence of traumatic injury. While surgical interventions like arthroscopic shoulder surgery and rotator cuff repairs are viable options for certain conditions, they are not always necessary and may not provide better outcomes. A study published in the BMJ Open Sport & Exercise Medicine journal found that many shoulder surgeries were performed for conditions that could potentially be managed conservatively. Emphasizing conservative management before considering surgery is essential for optimizing outcomes and minimizing risks. Worst case, considering conservative care (seek a skilled chiropractor or physical therapist) before and after surgery is considered to provide better outcomes long term when having surgery.

Best Practices for Self-Treatment:

1. Exercise Therapy:

• Shoulder-strengthening exercises, such as rotator cuff exercises and stabilization exercises can improve shoulder function and reduce pain

• Range of motion exercises, including shoulder stretches and pendulum exercises can help maintain flexibility and mobility in the shoulder joint

• Posture correction exercises can address muscular issues and reduce strain on the shoulder joint

1. Additional Therapies:

• Manual therapy modalities like massage therapy and joint manipulation can help alleviate muscle tension and improve joint mobility in the shoulder

  • It is often underappreciated how valuable neck and upper back mobility through the spine can be for shoulder function

• Dry needling has been shown to be effective in reducing shoulder pain and improving shoulder function

• Class IV Laser Therapy can provide relief from shoulder pain by reducing inflammation and helping with mobility

1. Lifestyle Modifications:

• Proper ergonomics and workstation setup can prevent shoulder pain associated with prolonged sitting and computer use

• Adequate rest and sleep are essential for promoting tissue healing and reducing inflammation in the shoulder

• Stress management techniques, such as mindfulness meditation and deep breathing exercises, can help alleviate tension in the shoulder muscles

  • Proper breathing/diaphragm function is an underappreciated concept for whole body stability that we address regularly in our office

Empower yourself with knowledge and take proactive steps to manage shoulder pain effectively. Prioritize conservative treatments (a skilled chiropractor or physical therapist), including exercise, additional therapies as mentioned above, and lifestyle modifications, before considering invasive interventions like surgery. Consult with healthcare professionals for personalized guidance and explore evidence-based approaches for long-term relief and improved shoulder function. Every case of shoulder pain is unique and in many cases can be difficult to treat. By adopting evidence-based self-treatment strategies and advocating for conservative approaches, individuals can effectively manage shoulder pain, improve function, and enhance their quality of life. Take charge of your shoulder health and of course reach out if you need assistance with shoulder pain or finding a skilled provider near you!