Shoulder Pain - Natural Treatment

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Shoulder pain is one of the most common reasons for visits to general practitioners, often related to musculoskeletal issues.

The shoulder joint offers the widest range of motion in the human body. It is a complex joint that involves many structures working together. For optimal movement without pain, and to maintain joint stability, these structures must function in coordination.

Due to its high mobility and complexity, the shoulder is susceptible to many injuries caused by trauma, incorrect movement, overuse, poor posture, and other factors.

Pain may result from issues in muscles, tendons, joints, or other tissues in the area. The sensation of pain is transmitted via sensory nerve fibers present in various tissues throughout the body.

Because of the multitude of structures involved in the shoulder joint, there are many possible sources of injury, making accurate diagnosis and identification of the pain's origin very important.

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Common Pathologies Causing Shoulder Pain:

 

Rotator Cuff Tear
The shoulder joint is stabilized by a group of four muscles known as the "rotator cuff." Partial or complete tears of these tendons are among the most common injuries of the shoulder. The most frequent cause of this damage is natural degeneration related to aging (at age 60, there's a 50% chance of having a partial tear in one of the tendons). A tear in one or more tendons causes pain during movement, limited mobility, and difficulty sleeping due to discomfort.

 

Bursitis  
A bursa is a small fluid-filled sac located in joints, whose role is to absorb pressure and shocks, reducing friction between different structures in the joint—usually between muscle/tendon and bone. When one or more shoulder muscles shorten, this places pressure on the bursa, leading to inflammation.

 

Tendinitis
The shoulder joint connects multiple tendons, each of which can develop an inflammatory process due to various reasons such as trauma, overuse, or aging, causing pain and potential movement restriction.

 

Impingement Syndrome

This occurs when the space between the upper arm bone (humerus) and the acromion (shoulder blade extension) narrows, preventing the rotator cuff tendons from moving freely. This narrowing can result from factors like bursa inflammation, ligament calcification, or bone spur protrusions. Pain typically appears during arm elevation, side sleeping, or leaning on the affected shoulder.

 

Frozen Shoulder (Adhesive Capsulitis) 
This is a condition where the shoulder joint experiences a significant reduction in range of motion, both actively and passively, despite attempts to move it. It often develops after inflammation, scarring, thickening, or contraction of the capsule surrounding the joint. It frequently occurs following previous injury to the joint that limited movement due to pain or significant restriction.

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Trigger Points  
Trigger points are highly sensitive spots within taut, thickened bands of muscle fibers. These points cause various pain patterns (often remote from the point itself), movement limitations, muscle weakness, and even numbness.  
They develop for reasons such as poor posture, overactivity, repetitive movements, trauma, and more. Recent studies indicate that the prevalence of trigger points among patients with shoulder pain is very high (some research shows trigger points in 100% of examined individuals). Often, trigger points are a major part of the underlying problem in each of the pathologies described in this article. Treatment involves pressure, slow deep massage, dry needling (acupuncture directly into the muscle tissue), and stretching.

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Anti-Inflammatory Medications – Yes or No?  
When experiencing issues with body tissues, local inflammation often occurs as part of the natural healing process.  
However, chronic inflammation can worsen ongoing pain. Therefore, the first-line treatment offered by physicians is often anti-inflammatory drugs like Arcoxia, Ibugil, and others. These medications target the inflammation itself but do not address the underlying cause (e.g., muscle shortening), which means they often do not resolve the problem. Additionally, these drugs can cause side effects, drug interactions, and in severe cases, damage to the kidneys and stomach.

Accurately identifying the damaged tissue or source of pain, and providing targeted treatment — alongside comprehensive care of all shoulder structures — can reduce strain on the affected tissue, lower local inflammation, reduce pain, and improve range of motion.

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Conservative Treatment for Shoulder Pain  
The goal of conservative treatment is to reduce pain, improve range of motion, and prevent recurrence. This is achieved through releasing trigger points, breaking down adhesions in connective tissues, improving blood flow to the area, reducing inflammation, restoring joint mobility, and treating tendons.  
Non-invasive treatments include various manual techniques such as fascia therapy and Shiatsu, dry needling, electrotherapy, and Chinese acupuncture.

Accurate diagnosis is of great importance and is achieved through patient interviews, clinical examinations, imaging tests (CT, MRI, ultrasound), and, most importantly, diagnosis by touch. With skilled hands-on assessment, the practitioner can identify the affected muscle, tendon, or connective tissue and treat it accordingly.

Treatment varies from person to person and from one pathology to another due to the different structures involved, which can cause pain and have different underlying causes for the shoulder discomfort.

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Shoulder problems should only be treated by a qualified therapist, and after the patient has been examined by a physician to rule out internal or orthopedic pathologies that could endanger the patient.