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dimanche 28 février 2016

How to Get Rid of Shoulder Ache

An achy shoulder is pretty common and can be triggered by numerous issues, including muscle strain, ligament sprain, joint dislocation, dysfunction in the spine (neck or mid-back), or even heart disease. However, the most common cause of shoulder ache is mildly pulled muscles and/or ligaments, usually from over-use at work or overdoing it with exercise.[1] Most achy shoulders are self-limiting and resolve within a week — sometimes even quicker if you use helpful home remedies. For more severe shoulder injuries, professional help may be needed, including (in rare instances) surgery.

EditSteps

EditTreating Your Shoulder at Home

  1. Rest your shoulder and be patient. In most cases, the cause of an achy shoulder is overuse or overexertion — in other words, repetitive shoulder motions or lifting things that are too heavy. If this sounds like the cause of your shoulder problem, then stop the irritating activity for a few days or so. If your shoulder injury is work related, then ask your boss if you can temporarily switch activities (to something less repetitive or demanding) or change work stations. If your shoulder injury is related to working out, then you may be lifting weights that are too heavy or training with bad form — talk to a personal trainer for advice.
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    • Resting your shoulder is a good idea, but completely immobilizing it in a sling is not recommended for minor shoulder injuries — it can promote the development of "frozen" shoulder. At least some gentle shoulder movement is needed to encourage blood flow and stimulate healing.[2]
    • Achy pain is usually indicative of a muscle pull, whereas sharp pain with movement is often caused by joint / ligament injuries.
    • Bursitis and tendon pain in the shoulder is usually worse at night while in bed.
  2. Apply an icepack to your shoulder. If your achy shoulder looks or feels swollen, then apply an icepack (or something cold) to the most tender area in order to reduce the inflammation and numb the pain.[3] Ice therapy is best for acute injuries that involve inflammation. Apply the icepack for about 15 minutes every couple of hours until the symptoms in your shoulder subside or go away.
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    • Compressing the icepack against your shoulder with a Tensor or Ace bandage is even more effective at reducing inflammation.
    • Always wrap ice in a thin towel before you apply it to any injury — it prevents skin irritation and frostbite.
    • If you don't have ice cubes, then consider using a frozen gel pack or bag of veggies from the freezer.
  3. Try applying moist heat instead. If your achy shoulder is chronic (long term) and feels particularly stiff first thing in the morning or prior to exercise, then apply moist heat to it instead of ice. Moist heat warms up the soft tissues (muscles, tendons and ligaments) and increases blood flow to the area, which can be helpful for achiness caused by osteoarthritis (the wear and tear type) or old sports injuries.[4] Good sources of moist heat are microwavable bags filled with grains (usually wheat or rice), herbs and/or essential oils. Apply the heat for 15-20 minutes first thing in the morning or before exercise.
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    • Taking a warm bath also provides moist heat. Add some Epsom salt for even more muscle relaxing and soothing potential.
    • Avoid dry heat from traditional heating pads because it can dehydrate soft tissues and increase the risk of injury.
  4. Take over-the-counter pills. If your shoulder ache is too much to bear and isn't impacted significantly by the application of either cold therapy or moist heat, then consider taking over-the-counter anti-inflammatories or painkillers. Anti-inflammatories are most appropriate for significant shoulder swelling (such bursitis and tendonitis) and include aspirin, ibuprofen (Motrin, Advil) and naproxen (Aleve). Painkillers (analgesics) are most appropriate for nondescript pain not caused by inflammation and include acetaminophen (Tylenol and Paracetamol). Remember that these medications are short-term solutions for shoulder pain and not meant for daily use beyond a few weeks due to their negative impact on the liver, kidneys and stomach.[5]
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    • Alternatively, you can try muscle relaxants (such as cyclobenzaprine) for your shoulder ache, but never take them together with other medications.
    • Ibuprofen is not appropriate for very young children, whereas acetaminophen is not recommended for those under the age of 18 due to the risk of Reye's syndrome.
  5. Do some simple shoulder stretches. Your shoulder ache may be caused by stiff and tight muscles, possibly due to poor posture or lack of use. As long as you don't feel sharp, electric or stabbing pain with shoulder movements, then light shoulder stretches are likely of benefit. Sore and tight muscles respond well to stretching because it reduces muscle tension, promotes blood flow and improves flexibility.[6] Shoulder flexibility is important because it has the most range of motion of any joint in the body for a reason. Hold shoulder stretches for about 30 seconds while deeply breathing and do them 3-5x daily until the achiness diminishes.
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    • While you're standing or sitting up, reach around the front of your torso and grab underneath the opposite elbow. Pull on the back of your flexed elbow across your torso until you feel a nice stretch in the corresponding shoulder.
    • Also while standing straight or sitting up, reach behind your back and up towards your shoulder blade and interlock with your other hand. Slowly pull down on the hand attached to the achy shoulder until you feel a stretch.
  6. Consider changing your workstation. Your achy shoulder might be caused by a poorly designed work station. If your computer, desk and/or chair isn't positioned properly for your height and body type, it can put strain on your shoulders, neck and mid-back. As such, when sitting at your desk and looking straight ahead: your eyes should be looking at the top 1/3 of the monitor; your forearms should be roughly parallel with the floor when typing and supported by arm rests; your elbows should be within a few inches from your sides; and your feet should be positioned flat on the floor.[7]
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    • If you work standing up, make sure your body isn't constantly rotated or twisted — maintaining symmetry and balance is the key.
    • To prevent shoulder injury, minimize overhead work by using a taller ladder or getting closer to your task.

EditSeeking Professional Treatment

  1. Get a deep tissue massage. If your shoulder ache is lingering longer than you'd anticipated, then consider a deep tissue massage from a qualified massage therapist. Deep tissue massage targets chronic muscle tightness and tension, which limits movement, reduces flexibility, hampers blood circulation and promotes inflammation.[8] Massage is most helpful for mild-to-moderate muscle strains, but it's not recommended for more serious joint injuries.
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    • Start with a 30 minute session focusing on your afflicted shoulder, but also including your lower neck and mid-back between your shoulder blades.
    • Allow the masseuse to go as deep as you can take it without wincing — there are many muscle layers in your shoulder that the therapist needs to access.
  2. Get a referral to a physical therapist. If your achy shoulder is caused by overexertion or overuse, then consider making your shoulders stronger and more able to take the abuse with strength-building exercises. A physical therapist can show you specific and tailored strengthening exercises for your shoulders (utilizing machines, free weights, rubber bands and/or exercise balls) that will allow them to handle your work environment or better perform while exercising or playing sports.[9] Furthermore, physical therapists are also trained to treat your achy muscles with therapeutic ultrasound or electronic muscle stimulation, if need be.
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    • Physical therapy is typically needed 2-3x per week for 4-6 weeks to positively impact shoulder problems.
    • If your achy shoulder is caused by a joint sprain, then your physical therapist can help relieve the pain by taping the area with medical-grade tape.
    • Good strengthening activities for your shoulder include rowing, swimming, bowling and archery.
  3. See an osteopath or chiropractor. If your achy pain is in someway joint related, a shoulder joint or spinal joint, then see an osteopath or chiropractor for a physical examination. Osteopaths and chiropractors are basically joint specialists who focus on establishing normal range of motion and function within the spine and peripheral joints, such as those that make up the shoulder.[10] Shoulder pain can obviously be caused by the underlying joints (glenohumeral and/or acromioclavicular), but the perceived pain can also be referred from dysfunction or injury in the lower cervical spine (neck) or thoracic spine (mid-back). If need be, the involved joints can be unstuck or slightly repositioned by a manual adjustment, which usually creates a "popping" or "cracking" sound.
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    • Although a single joint adjustment can sometimes significantly impact a musculoskeletal problem, more than likely it will take a few treatments to settle the area down.
    • Osteopaths and chiropractors can also use manual joint maneuvers to set a dislocated shoulder.
  4. Consider acupuncture needle treatments. Acupuncture is a form of treatment developed many centuries ago, primarily in ancient China, designed mainly to reduce pain and stimulate healing.[11] It involves sticking thin needles into the skin at specific points (sometimes close to the injured area, but often in distant areas of the body) for between 20-60 minutes at a time, which causes pain-reducing compounds to be released in the body. Acupuncture is not very well established by scientific studies to be able to help relieve most causes of shoulder pain, but there are many anecdotal reports that claim it can be very effective.[12] Given it's excellent safety record, it may be worth a try if you can afford the out-of-pocket expense.
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    • Acupuncture is practiced by a wide variety of medical people including some physicians, chiropractors and physiotherapists — whoever you decide on should be NCCAOM certified.
    • One acupuncture treatment may not make a significant impact on your shoulder pain, so consider at least 3 treatments before your render judgement on its effectiveness.
  5. Talk to your doctor about more invasive options. If your achy shoulder does not respond to home remedies or other more conservative therapies, then talk to your family physician about more invasive treatments, such as corticosteroid injections and/or surgical options. A corticosteroid injection (such as prednisolone) into a swollen shoulder can quickly reduce the inflammation and pain, allowing for greater range of motion and function.[13] Injections are most appropriate for severe tendonitis and bursitis. Surgery, on the other hand, is reserved for mending severed tendons, fractures, severe arthritis, blood clots, or draining accumulated fluid. Your doctor may need to refer you to a specialist for treatment, who may take an x-ray, bone scan, MRI or nerve conductance study to better understand your shoulder problem.
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    • Possible complications of steroid injections include tendon / muscle atrophy and weakening, nerve damage and reduced immune function.
    • Possible complications from shoulder surgery include local infection, excessive bleeding, allergic reaction to anesthesia, nerve damage, paralysis, reduced movement fro scar tissue and chronic swelling / pain.
    • You may also consider a newer treatment, platelet-rich plasma (PRP). Platelets are found in your blood and have proteins which are essential to heal injuries.[14] During this treatment, your blood will be drawn and the platelets separated, their concentration increased.[15] The platelets will then be injected into the area where you are experiencing pain.

EditTips

  • To minimize the ache in your shoulder, you may have to sleep on your back. In general, stomach sleeping often irritates the shoulder joints and lower neck.
  • To avoid shoulder problems, avoid carrying bags that distribute weight unevenly across your shoulders. Instead, use a traditional backpack with well-padded straps.
  • If your shoulder pain is severe or debilitating, and seemingly getting worse, then make an appointment with your doctor as soon as you can.
  • Try treating shoulder pain by treating certain trigger points, such as using your hands or a trigger point ball.
  • Avoid sleeping on your side with your shoulder pulled forward, as this can cause really bad shoulder pain through the night.
  • If you sleep with the affected shoulder at top, place a pillow in front of you and rest your shoulder there. This can help prevent an overstretch of any pain causing muscles and ligaments in the shoulder

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EditSources and Citations


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