Non-Surgical Shoulder Treatment
The treatment options covered here relate to osteoarthritis, although many of them may be helpful for patients with other arthritic conditions. Please ask your physician before starting any treatment.
- Physical Therapy
- Modify Your Activities
- Weight Control
- Self-Help/Assistive Devices
- Heat and Cold Treatments
- Nutritional Supplements
- Over-The-Counter Medications
Moderate doctor-prescribed exercise is an integral part of treating arthritis. Joints that are not regularly exercised can become tight and painful. Activities such as walking, swimming or gardening can assist in keeping your bones strong and your joints limber, which may help relieve stiffness. Low-impact exercise will not wear out your joints. Although exercise may sometimes cause discomfort, proper exercise will help nourish the cartilage, strengthen the muscles, and prolong the life of your joints.
Aquatic therapy is an excellent form of exercise to help manage arthritis pain. Water's buoyancy helps protect your joints from impact injury. Water also resists movement, which is helpful for strengthening.
Walking is an excellent form of endurance exercise for almost anyone, including those with arthritis. Be sure to have a good pair of walking shoes to help cushion impact. Check with your physician to obtain any exercise precautions or guidelines. You should be able to speak clearly without feeling out of breath when you are walking. Always warm up and cool down by walking slowly.
Either regular biking or stationary biking is an excellent endurance exercise. However, patients with kneecap problems may aggravate their condition with biking. Be careful not to increase the resistance or ride up and down hills too quickly. As with any endurance exercise, you should be able to carry on a conversation while you are engaged in the activity.
How much exercise is too much?
If you note increased joint swelling, decreased joint motion, unusual or persistent fatigue or continuous pain, you may be exercising too much. You should expect some muscle soreness, especially if you are just beginning an exercise program or have changed exercises. Joint pain should not last more than several hours after exercise.
For an in-depth guide on starting and maintaining a walking program, reference Walk With Ease by the Arthritis Foundation.
How do I stay consistent with exercise?
- Seek help from a health care professional to assist you in setting up an individualized program
- Make a plan! Write it down! Set goals!
- Exercise at the same time each day so it becomes part of your routine
- Find an exercise buddy
- Look for an appropriate exercise class
- Stay in the habit of doing some exercise each day
- Vary your exercise routine and rotate your exercises
- Evaluate your progress and enjoy your success
Physical therapy is a very important role in the recovery process. A physical therapist may demonstrate a variety of low-impact exercises designed to increase the strength and mobility of your shoulder joint. However, you should only perform the exercises that are ordered by your surgeon.
Proper body mechanics can lead to less strain on your joints. The following activity modification guidelines may be helpful:
- Practice good posture by standing up straight
- Avoid stooping while standing
- Avoid impact-loading activities
- Avoid any activity that causes prolonged discomfort
Being overweight puts weight-bearing joints under extra pressure and stress. Extra pressure on your joints can make arthritic symptoms worse, leading to pain and stiffness.
A well-balanced diet coupled with regular doctor prescribed low-impact exercise can help reduce excess body weight, decrease pressure on the joints and increase joint strength. Many claims have been made concerning diet as a cause of arthritis but none have been proven to date. Maintaining your ideal body weight will help keep your joints healthy. If you are overweight, ask your doctor to advise you on a weight-loss program to fit your needs.
Simple everyday tasks may be hard to accomplish with joint pain. The self-help devices listed below can help minimize pain, discomfort, stress, and can assist you in accomplishing tasks. Ask your physician or physical therapist about these self-help devices:
- Shoulder sling for rest
- Jar openers
- Button threaders
- Large grips for pencils, garden tools or other hand-held objects
- Abdominal supports to reduce stress on the back
- Long-handled reachers or grabbers to help you pick things up without bending
Heat or cold treatments may be used to decrease pain and increase flexibility. Heat or cold treatments may be combined with the exercises prescribed by your physical therapist.
You may want to purchase a gel pack that can be kept cold in your freezer or heated in a microwave.
Recently, nutritional supplements have become popular with arthritis patients. Glucosamine and Chondroitin have been the most widely used. Consult your physician before beginning treatment.
Glucosamine is a building block of cartilage and may be found as a hydrochloride or sulfate. It may be useful in strengthening and repairing cartilage. Studies have shown it to be effective in reducing pain, especially painful arthritis of the hands. Glucosamine is not a cure and has not been shown to rebuild cartilage.
Chondroitin Sulfate is commonly taken in conjunction with Glucosamine. It is found in cartilage and acts somewhat like a sponge for the fluid found in cartilage, which makes the cartilage more elastic and spongy. Chondroitin may help prevent the breakdown of cartilage as well.
Vitamins C and D
Some studies have indicated that patients low in Vitamins C and D may have a higher incidence of arthritis. Arthritis patients should take vitamins regularly, or as prescribed by a medical professional.
Some people confuse osteoporosis with osteoarthritis. Osteoporosis is a thinning of the bone, not the joint. High amounts of Calcium is not the cause of osteoporosis but calcium may accumulate in bone spurs around arthritic joints in response to increased pressure on the joint.
Talk to your physician before taking any medications.
Many medications are available to help treat arthritis and can function as a pain-reliever and as an anti-inflammatory to help relieve joint swelling and pain. These medications can lead to improvement in everyday function and quality of life. Always consult your physician before beginning treatment.
The non-narcotic analgesic Tylenol® is generally effective in relieving minor pain and discomfort. The Academy of Rheumatology has suggested this as the first-line arthritis treatment. Tylenol®, however, does not reduce the inflammation caused by arthritis. Ask your physician about dosing and safety.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) can be purchased over-the-counter with some common forms being Aspirin, Motrin®, Advil®, and Aleve®. NSAIDs are usually indicated for mild to moderate arthritis pain and may be effective where Tylenol® is not. They are very effective in reducing inflammation caused by arthritis. However, they can also increase your chance for gastric (stomach) ulcers and can alter your blood by affecting your platelets. Therefore, patients with stomach problems, bleeding problems or on blood thinners should not take these medications. Always check with your physician before starting NSAIDs.
Patients with chronic pain may need to take medication daily. However, many may only need to take it when necessary or when they anticipate a strenuous activity that is likely to lead to pain. This may not be true for patients with inflammatory forms of arthritis such as rheumatoid arthritis or lupus.
Many topical creams on the market can reduce pain from arthritis. The American College of Rheumatology does recommend Capsaicin as part of a treatment plan. Capsaicin is thought to help block the release of the body’s painkillers while also blocking a chemical that transmits pain signals. Check with your physician before applying any topical creams.
Talk to your physician before taking any medications.
Cortisone, which is injected directly into joints, may be used to help relieve both swelling and pain. Cortisone is a naturally occurring hormone produced by the adrenal gland. It helps regulate inflammation and when injected into a joint it can relieve or reduce both swelling and pain. Relief usually occurs within a day or two of the injection. Patients do not need to change activities following injections. Many patients elect to receive cortisone injections prior to big events when they will be more active.
Cortisone may play a role in weakening tendons or cartilage if used too often. Therefore, most physicians limit its use to a few times per year depending on the circumstances.
Always consult your physician before participating in any treatment option.
All patient education materials are provided by OrthoPatientEd.com and have been reviewed by our Advisory Board of leading Orthopedic Surgeons to ensure accuracy. All materials are provided for informational purposes only and are not intended to be a substitute for medical advice from your orthopedic surgeon. Any medical decisions should be made after consulting a qualified physician. This site includes links to other web sites. OrthoPatientEd.com takes no responsibility for the content or information contained in the linked sites.