How to Relieve Shoulder Pain Without Surgery
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While shoulder pain may share symptoms with shoulder blade pain, the term “shoulder pain” generally refers to any pain or discomfort in or around the shoulder joints. There may be various causal factors that reduce your shoulder’s flexibility or cause pain and discomfort when moving it. Conservative management of symptoms is typically the first-line treatment for most cases of shoulder pain.
Common Causes of Shoulder Pain
Shoulder pain varies based on the root cause and where it occurs. The most common causes typically include:
Injury/Trauma
Any damage to the shoulder joint or its surrounding structures (such as a fracture or pulled muscle) can lead to pain, discomfort, and reduced range of motion in the shoulder. This can occur due to a sporting injury or poor posture when lifting heavy objects.
Overuse Injury
Overuse of the shoulder joint, which may stem from repetitive motions without adequate rest between activities, can also cause shoulder pain.
Frozen Shoulder
Medically known as adhesive capsulitis, a frozen shoulder involves thickening of the shoulder joint capsule (the strong connective tissue surrounding the joint), causing pain, discomfort, and stiffness. The pain may start near the shoulder joint and radiate into the upper arm.
Rotator Cuff Injuries
The rotator cuff comprises muscles that stabilise the shoulder joint and support various shoulder movements. An injury, repetitive strain, or age-related wear and tear may lead to a partial or complete rotator cuff tear, resulting in symptoms such as shoulder pain, especially when you attempt to use the affected arm.
Nerve Impingement
If something compresses a nerve connected to the shoulder joint, it can also cause pain, stiffness, and discomfort in your shoulder.
Shoulder Bursitis
This condition is characterised by inflammation of the bursae, which cushion the spaces around bones and other tissues. Injuries or overuse can gradually irritate or damage the bursae, causing inflammation that leads to pain, swelling, stiffness, and other symptoms.
Shoulder Arthritis
This condition is characterised by inflammation or degeneration of the shoulder joint, which gradually leads to cartilage loss as the bones rub against each other. The friction can cause substantial pain, as cartilage helps reduce friction between the bones of the shoulder joint as they move in the ball-and-socket joint. It may also cause bone spurs to form, further reducing the shoulder’s range of motion, and spurs may break off, forming loose bodies that can cause further damage to the joint.
Nonsurgical Medical Treatments for Shoulder Pain
Mild to moderate shoulder pain is primarily treated with conservative, nonsurgical medical treatments that help restore overall shoulder flexibility while relieving pain and other symptoms.
Medications
Medications may help provide temporary relief of symptoms for mild or moderate shoulder pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are commonly used to manage pain and inflammation, while other pain relief medications may be prescribed for longer-term symptom management.
Physical Therapy
Physical therapy typically involves working with a qualified physical therapist to craft a treatment regimen for treating your shoulder pain. They may recommend various exercises that strengthen the shoulder muscles, support the joint, and improve its overall strength and flexibility. The therapist will identify clear goals that you can slowly achieve, ranging from improving shoulder range of motion to strengthening overall muscle strength. The plan can be fine-tuned to help support your rehabilitation and address any difficulties along the way.
Here are a few exercises you can try doing at home. Consider speaking to your physical therapist for further advice and support for your rehabilitation.
Free-Hanging Arm Swings
A simple starter is this arm-swing exercise. First, place a table or chair close to you and use your unaffected arm to support yourself. Bend over at a 45-degree angle and let the arm requiring rehabilitation hang loosely straight down. Gently sway the arm back and forth, and gradually increase the length of the swing, but do not put too much force into the swings. Repeat this several times per exercise.
Across-the-Chest Stretches
This exercise helps to slowly increase the shoulder joint’s flexibility and range of motion. It also supports the surrounding muscles and other structures.
To start, first bring the affected arm across your chest. Place it in the crease of the other arm’s elbow, or use your hand to support the arm. Maintain this position for up to 1 minute, then repeat on the opposite side. You can deepen each stretch by lifting your arm to shoulder height, but make sure you are comfortable when doing so. Do this at least 3 to 5 times, or as recommended by your physical therapist.
Minimally Invasive Treatments for Shoulder Pain
Minimally invasive procedures are generally considered in cases where conservative treatments cannot provide effective symptom relief or address the root cause of your shoulder pain.
Steroid Injections
Also known as corticosteroid or cortisone injections, these injections deliver a medication (along with a local anaesthetic for your comfort) into the shoulder joint or a nearby area. The medication provides targeted relief from inflammation, pain, and other symptoms. It is usually performed under X-ray fluoroscopy or ultrasound guidance to ensure safe, accurate delivery of medication to the injection site.
Platelet-Rich Plasma (PRP) Injections
PRP injections use platelets, a component of blood that contains growth factors, to treat symptoms of mild to moderate shoulder pain. An injection requires drawing blood from your body and separating it into its individual components using a centrifuge. PRP injections may be performed alongside other treatments to support your recovery, and may require follow-up injections for your ongoing recovery. Further studies are establishing the role of PRP injections in supporting one’s recovery from shoulder pain and other related conditions.
Hyaluronic Injections
Hyaluronic acid is a naturally occurring substance found in the joints that helps lubricate them and supports smooth joint function. Along with an anaesthetic, it is injected directly into the shoulder joint to increase synovial fluid viscosity (to improve joint lubrication) and enhance joint gliding motion, thereby reducing friction. This treatment is generally administered to relieve mild to moderate shoulder pain and alleviate the symptoms of shoulder arthritis.
Home Remedies to Relieve Shoulder Pain
Proper Rest
Getting proper rest is necessary to support your shoulder joint’s overall recovery, as it may reduce inflammation and prevent the pain and discomfort from worsening. Ideally, make sure you get at least 8 hours of sleep between work and other daily activities. It may also help to adjust your sleeping position to minimise tension on your shoulder joint.
Gentle Stretches & Exercise
It helps to continue moving and exercising within your comfort level to prevent your muscles and other structures from weakening over time, especially after long periods of rest. Gentle stretching and exercise can gradually alleviate your shoulder pain, especially with the support of a physical therapist to fine-tune your daily routine. Take things slow to avoid injuring yourself, then gradually build up the intensity and duration of exercises as your shoulder’s condition slowly improves.
Hot and Cold Packs
You may use hot and cold packs to relieve shoulder pain. Using cold packs may alleviate pain, swelling, and inflammation in your shoulder joint. As the inflammation subsides, hot packs are applied to relax tight, achy muscles, promote blood circulation, and support your shoulder’s recovery.
When using a hot or cold pack, always wrap it with a protective barrier, such as a clean towel, to prevent direct heat or cold from reaching your skin. Gently apply the pack to your shoulder area for 15 minutes, then repeat every 2 hours. If necessary, speak to your doctor for additional advice.
Good Posture
Maintaining good posture during activities can help keep your shoulders back and relaxed, while your head stays aligned with your spine. Doing so reduces the stress on the shoulder joint and the surrounding muscles and connective tissues. It may also benefit you to keep your elbows bent down and back, with your chin tucked as well, to reduce further shoulder tension that results in lasting pain and discomfort. You should also avoid slouching, as this can gradually introduce stress and pressure on your shoulders.
When Should You See a Shoulder Pain Specialist?
An orthopaedic doctor can examine your shoulder joint during a medical consultation. They will review your medical history while diagnosing your shoulder’s condition to determine the root cause and suggest a suitable treatment plan. They will brief you on your condition, available nonsurgical and surgical treatments, and how you can support your recovery.
Contact Avant Orthopaedic today to learn more about our chronic pain management and treatment options.
Dr. Hope Ang
MBBS (NUS) | MMed (Anaes) | FAMS
Dr Hope Ang is a Consultant Anaesthesiologist with extensive expertise in acute and chronic pain management, dedicated to helping patients regain function, reduce suffering, and improve quality of life through evidence-based, personalised care.
With more than 18 years of clinical experience, Dr Ang specialises in the assessment and treatment of complex chronic pain conditions, including musculoskeletal pain, neuropathic pain, cancer-related pain, and persistent postoperative pain. His approach integrates interventional pain procedures, ultrasound-guided regional techniques, multimodal pharmacological strategies, and close collaboration with multidisciplinary care teams to address both the physical and functional impact of chronic pain.
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