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Writer's picturePiotr Karcinski

Understanding and Managing Shoulder Pain



Many people commonly experience shoulder pain, particularly those who engage in repetitive movements such as athletes, manual laborers, or individuals who spend long hours working at a desk. A common cause of this discomfort is rotator cuff-related pain, also known as subacromial syndrome (SAS). This condition may hinder your ability to move your shoulder easily and carry out daily activities.


What Is Rotator Cuff-Related Pain/Subacromial Syndrome?

Subacromial syndrome is a common shoulder condition that affects the rotator cuff muscles and the surrounding structures in the shoulder joint. These structures are located beneath a bony section of the shoulder blade called “the acromion”. The irritation or inflammation of these muscles or tendons can cause pain and discomfort - especially with lifting the arm or rotating the shoulder.

Subacromial syndrome, also known as shoulder impingement, occurs when the tendons are compressed between the acromion and the upper arm bones. This condition can lead to intense pain and discomfort, hindering daily tasks and limiting an active lifestyle. Gaining insight into the various causes, symptoms, and treatment options for subacromial syndrome is essential for effectively managing the condition and getting relief.


Common Causes of Rotator Cuff Pain

Subacromial syndrome usually develops from a mix of factors that result in the compression or irritation of the rotator cuff tendons and nearby structures within the shoulder. It is often triggered by several common factors, including:


  1. Repetitive Overhead Movements: Engaging in activities with frequent overhead motions, like weightlifting, swimming, baseball, or tennis can overstrain the rotator cuff, resulting in inflammation and impingement.

  2. Bone Spurs: Bony growths, known as bone spurs, can form beneath the acromion (the bony projection of the shoulder blade) and lead to impingement of the rotator cuff tendons as they move through the subacromial space.

  3. Shoulder Instability: Shoulder joint weakness or instability can disrupt normal movement and place extra pressure on the rotator cuff, playing a role in the onset of subacromial syndrome.

  4. Aging and Wear and Tear: With age, the rotator cuff tendons may degrade and tear more easily, raising the likelihood of developing subacromial syndrome.

  5. Injury or Trauma: Acute injuries, like a fall or a direct impact to the shoulder (e.g., a blunt trauma), can trigger subacromial syndrome by inducing inflammation, swelling, and changes in shoulder mechanics.


Symptoms

The symptoms of subacromial syndrome vary with intensity and the type of injury involved. Key symptoms include;


●     Shoulder Pain: Pain is the most prevalent symptom, typically felt during overhead movements, at night while lying on the affected shoulder, or when reaching behind the back.

●     Reduced Range of Motion: Individuals with subacromial syndrome might notice reduced shoulder mobility, which can hinder their ability to carry out everyday tasks or engage in sports and activities.

●     Weakness: Impingement due to an injury or age can weaken the rotator cuff muscles, resulting in diminished strength and stability in the shoulder joint.

●     Clicking or Popping Sounds: Some individuals might experience grinding, clicking, or popping sensations in the shoulder during movement.


Treatment Options

The first line of treatment for subacromial syndrome generally emphasizes non-surgical methods to alleviate pain, enhance shoulder function, and address the root causes of the condition. These may include;


  1. Rest and Activity Modification

Adjusting or avoiding activities that worsen your shoulder pain can play a crucial role in minimizing inflammation and facilitating the healing process. By giving your shoulder a break from movements that exacerbate discomfort, you create an opportunity for the affected area to recover and regain strength. This approach not only helps reduce inflammation but also promotes a more effective healing environment, allowing your shoulder to gradually return to its optimal function.


  1. Anti-inflammatory Medications

Using over-the-counter or prescription anti-inflammatory medications can significantly ease shoulder pain and reduce swelling. These medications work by targeting the inflammation that's contributing to your discomfort, providing relief and helping to restore normal function.


  1. Physiotherapy

Physiotherapy often serves as the initial treatment approach. A physiotherapist will evaluate your shoulder and create a personalized rehabilitation plan to address your specific needs. This program typically involves:


●     Stretching and Strengthening Exercises: To improve flexibility and stability of the shoulder joint and surrounding muscles, which can reduce pain and prevent further injury.

●     Postural Training: Modifying your posture to alleviate strain on your shoulders can make a significant difference in managing shoulder discomfort and pain.

●     Manual Therapy: Techniques such as soft tissue therapy and joint mobilizations aim to enhance shoulder mobility.


4.    Shockwave Therapy

For individuals suffering from chronic or severe rotator cuff pain, shockwave therapy offers a cutting-edge treatment solution. This innovative therapy utilizes sound waves to accelerate the healing process in damaged tendons. It helps to:


●     Increase blood flow to the injured area.

●     Stimulate tissue repair.

●     Reduce pain over time by desensitizing nerves.


Shockwave therapy is a non-invasive procedure, which means there are no needles or surgical interventions involved. Depending on the severity of your condition, multiple sessions may be necessary to achieve optimal results. This therapy provides an excellent alternative for those who prefer to avoid injections or surgical options, offering a promising path to relief and improved shoulder function.


Treatment is available at our practice visit: https://www.physio4quality.com/shockwave-therapy


3. Guided Injections

If pain continues despite physiotherapy and other treatments, corticosteroid or hyaluronic acid injections might be the next step. These injections, often administered with the precision of ultrasound guidance, deliver medication directly to the inflamed area for maximum effectiveness. This approach ensures that the medication reaches the exact spot where it’s needed most, providing targeted relief and improving the chances of alleviating persistent discomfort.


●     Corticosteroids: These injections help to lessen inflammation and relieve pain, but they are usually administered cautiously since frequent use can weaken the tendons over time.

●     Hyaluronic Acid: This substance functions as a lubricant and shock absorber within the joint, alleviating discomfort and enhancing movement.

●     Platelet-Rich Plasma (PRP) Injections: This therapy harnesses your own blood platelets, packed with growth factors, to promote the healing of injured tissues in the shoulder.


Treatment available at our practice visit: https://www.physio4quality.com/injections


4. Surgery

When conservative treatments are unable to offer relief, surgery might become necessary. Surgical options may involve:


●     Rotator Cuff Repair: This surgical procedure is designed to repair torn tendons in the rotator cuff. During the operation, the surgeon reattaches the torn tendons to the bone, restoring their normal function. This repair aims to alleviate pain, improve shoulder strength, and restore the range of motion.

●     Subacromial Decompression: This surgical procedure involves removing a portion of the acromion, the bony projection on the shoulder blade, to relieve pressure on the rotator cuff tendons. By creating more space in the subacromial area, the surgery aims to reduce compression and friction on the tendons, which can alleviate pain and improve shoulder mobility.


Prevention of Rotator Cuff Injuries

Preventing rotator cuff injuries is essential, especially if you’re prone to shoulder pain or have a job that places significant strain on your shoulders. Here are some strategies to help you avoid rotator cuff-related discomfort:


  1. Strengthen Your Shoulder Muscles: Regular exercise plan that focuses on the stability of the rotator cuff and neighboring muscles can enhance shoulder stability and help prevent injuries.

  2. Improve Your Posture: Maintaining good posture while sitting, standing, and moving can help minimize unnecessary strain on your shoulders.

  3. Warm-Up Before Activity: Before participating in sports or activities that involve heavy lifting or overhead movements, be sure to stretch and warm up your shoulders.

  4. Avoid Repetitive Strain: If you’re engaged in activities that involve repetitive shoulder motions, make sure to take regular breaks. Rest is crucial for preventing overuse injuries.

  5. Use Proper Techniques: Proper techniques, whether you're lifting weights or participating in sports, can help lower your risk of injury.


Conclusion

Rotator cuff pain and sub acromial syndrome are frequent sources of shoulder discomfort that can disrupt daily life. Although managing this condition can be challenging, numerous effective treatments are available, including physiotherapy, shockwave therapy, guided injections, and, when necessary, surgery. Preventing these issues is crucial - strengthening shoulder muscles and maintaining good posture can significantly reduce the risk of pain. If you have ongoing shoulder pain, it's essential to see a healthcare professional to create a customized treatment plan tailored to your needs.

 

Book your appointment now for an assessment and treatment plan to get you back on track.




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