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Chronic shoulder pain: part II. Treatment.
Kelton M Burbank1, J Herbert Stevenson, Gregory R Czarnecki
1Longview Orthopaedic Center, HealthAlliance Hospital, Leominster, Massachusetts 01453, USA. kmbortho1@aol.com
American Family Physician
|March 11, 2008
Summary
Accurate diagnosis is key for treating chronic shoulder pain. Treatment involves activity modification, medication, physical therapy, and targeted injections, with referral to an orthopedic specialist if symptoms persist.
Area of Science:
- Orthopedics
- Primary Care Medicine
Background:
- Chronic shoulder pain is a prevalent issue encountered in primary care settings.
- Effective management hinges on precise diagnosis of common causes like rotator cuff disorders, adhesive capsulitis, and osteoarthritis.
Purpose of the Study:
- To outline diagnostic and treatment strategies for chronic shoulder pain in primary care.
- To emphasize the importance of accurate diagnosis for effective patient outcomes.
Main Methods:
- Initial treatment includes activity modification and analgesics.
- Physical therapy tailored to the specific diagnosis is recommended if initial treatments fail or for severe cases.
- Pharmacological interventions such as combined steroid and local anesthetic injections are utilized, with injection site determined by diagnosis.
Main Results:
- Conservative measures form the first line of treatment.
- Targeted physical therapy and/or injections offer further therapeutic options.
- Fluoroscopic guidance is recommended for glenohumeral joint injections.
Conclusions:
- A stepwise approach to chronic shoulder pain management is effective.
- Referral to an orthopedic specialist is indicated for persistent or worsening symptoms after 6-12 weeks of directed treatment.
- Accurate diagnosis guides the selection of appropriate interventions, including injection site and technique.
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