Are you suffering from shoulder pain & stiffness. It can be very disturbing and painful. More than you can express it to your doctor. You may find trouble sleeping. You may become fearful of any activity as the pain can suddenly attack you.
SUDDEN ONSET PAIN:
The shoulder pain and stiffness can be acute (starting suddenly without any notice). This may be because you have suffered from a sudden injury or overstrain. This results in injury to shoulder cuff muscles or ligaments.It can come even without any injury or strain. This usually happens when there is chalk like calcific body which ruptures on its own.
PAIN OF PROLONGED DURATION:
Is your pain and stiffness has been of long duration? Has it gradually increased?You must understand following.Check your blood sugar, thyroid or kidney parameters. Lot of people suffering from high blood sugar, get shoulder stiffness.
DO NOT IGNORE INITIAL SHOULDER PAIN. If treated early shoulder stiffness and pain is not very difficult to manage and can lead to easy and fast recovery.
Most of the cases of spontaneous onset shoulder stiffness are due to contracture of shoulder capsule, which worsens over time leading to increasing pain and restriction of movements.
The two most important treatment principles are-
1. PAIN RELIEF: This is brought by temporary use of anti-inflammatory & pain relieving medicines. However it can not be given for long time as they have side effects. Occasionally we need to give injections in shoulder joint. However these treatment modalities have limitations.
2. THE MOST IMPORTANT TREATMENT IN THESE CASES IS EXERCISES:Exercises to stretch shoulder capsule. The exercises have to be systematic as guided as guided by us. They have to be repeated frequently during the day. We recommend that you repeat it at least 5 times a day minimum. More the better.
• THEY CAN BE DONE AT WORK. Don’t worry if you are working in offices. Our exercises are designed such that you can do them at office or work place too.
• THEY ARE NOT PAINFUL. They are designed to be least painful and very comfortable to do.
• THEY DO NOT NEED FREQUENT VISITS TO YOUR THERAPIST. After initial training and closed supervision, most of the patients learn to do them on their own. This saves time and expense to visit the therapist.
Most of the patient will have significant relief with this treatment protocol. Even the advanced cases of stiffness respond well though they take a longer time.
However very few cases, which have pathologically tight structures, may not respond to this. These patients need further investigations like MRI to find out any other problems in shoulder. Occasionally one needs to under go arthroscopic shoulder capsule release to improve the shoulder movements and relieve pain.
SHOULDER PAIN DUE TO INJURY:
You may suffer from shoulder pain due to injury. This injury can be minor repeated strain like lifting weights, professions where there is heavy load on shoulders. Or it can be sudden injury due to fall or accident or sports.Our shoulder joint is surrounded by 5 muscles called rotator cuff, which are in turn surrounded by bigger muscles. The smooth functioning of shoulder requires a great co-ordination between these muscles. It also involves coordination muscles of shoulder blade.Injury to shoulder muscles lead to total disturbance in the functioning of shoulder joint. This results in weakness and pain.
If your shoulder pain is due to injury, the treatment depends on diagnosing extent of injury and disturbance in function.We will evaluate your shoulder joint to see how much is the disturbance in the power and coordination in shoulder.We may ask you to do certain investigations like MRI when deemed necessary to define the status of your muscles and joint.
THE IMPORTANT PART OF TREATMENT in this condition is
1. Reversing the stiffness of your joint by flexibility exercises
2. Re- strengthening of your shoulder muscles by specific muscle strengthening exercises. This is a very important aspect. As anything inadequate will not give you recovery and anything excessive will further injure your joint.
3. Re- establish co-ordination of the shoulder and shoulder blade muscles.
The surgery is to repair the torn rotator cuff muscles. This is necessary only if the muscles are torn completely from their insertion. Incomplete tears or intrinsic tendon injury can be taken care by exercise program.The surgical repair is achieved by arthroscopic procedure. The tendon tissue is repaired to bone by means of bone anchors. The Hospital stay after surgery is very short. The important factors in recovery after surgery are;1. Condition of torn muscle and tendon tissue. 2. Quality of bone 3. Post surgery rehabilitation of repaired muscles by exercises.
We make the whole process very simple for you. Whether it is surgery or exercise program or going back to your work or sports, we are there to help you at every stage.