Treating Shoulder Pain

Shoulder pain can be mild during specific movements, or unbearable even at rest. For an accurate assessment, it is important to determine whether the pain is triggered by movement, by which specific movements, how long it takes to subside, or whether it persists, and for how long while at rest. It is also important to determine whether there is night pain and how long it lasts. Shoulder pain can have the following characteristics:

• Sharp

• Knife-like

• Throbbing

• Burning

• Like an electric shock

• Superficial

• Deep

• Mild

• Dull

• Constant

• Intermittent

When shoulder pain appears, the immediate steps we take are:

• Resting the arm and avoiding the activity that triggers the pain

• Applying ice to the shoulder, over the painful area, for 15–20 minutes, 2–3 times a day (the ice should be wrapped in a towel)

• Gentle stretches of the shoulder, elbow, wrist and fingers help maintain the flexibility of the arm

Assessment by the physiotherapist is essential in order to identify the affected structures and to rule out, or confirm, the coexistence of other pathological conditions that present with similar symptoms, such as:

• Impingement Syndrome

• Frozen Shoulder

• Supraspinatus Tendinopathy

• Calcific Tendinopathy

• Shoulder Dislocation

• Bursitis

• Joint Pathology

• Fracture

The assessment by Orthopaedic Manual Physiotherapist Konstantinos Danalis is carried out through a detailed history-taking, the performance of clinical tests, and the trial treatment that follows.

The priority is to reduce pain, which in some patients can be extremely acute. This is achieved through a combination of treatment options such as specialised massage and the application of electrotherapy, which will reduce the pain in every case. The shoulder is then mobilised with specialised exercises. Gradually, as range of motion increases, shoulder strengthening exercises are introduced, which over time regulate the correct movement and position of the shoulder blade, increase the space beneath the acromion that the tendons and other shoulder structures need in order to raise the arm, and allow the arm to move freely without triggering a relapse. The interventions applied are:

• Stretches and stretching exercises to increase elasticity

• Dynamic stability of the shoulder through strengthening

• Orthopaedic Manual Physiotherapy to reduce pain and increase flexibility

• Electrophysical modalities such as diathermy, cryotherapy and electrotherapy, to reduce pain and inflammation

• TECAR for deep heating of the tissues and to accelerate shoulder rehabilitation

Verified user

He examined my neck thoroughly and was very detailed, explaining what I am dealing with. He truly understood how much this pain affects my daily life. He helped me effectively; I trust him completely.

Verified user

He devoted a great deal of time to the neck pain that had been troubling me for a long time. I am already much better just one day later. I will continue the treatments — he is an excellent professional with extensive knowledge. I recommend him without reservation.

Verified user

Mr Danalis took great care of the pain I have in my shoulder. I am already much better, and I will continue the treatments as he suggested! An excellent professional with extensive knowledge. I recommend him without reservation!

To prevent shoulder pain in patients with chronic problems, a monthly programme is required that includes:

• Orthopaedic manual massage

• A structured exercise programme

More advice on prevention and self-management by the patient can be found in the links below:

• Recommendations for Patients by the American Physical Therapy Association

The cost of treatment is not high. Usually 6 sessions are required, in which the treatment programme is adapted each time to the patient's current condition. Once the symptoms subside, a structured exercise programme is introduced that prevents any relapses. The programme is provided to the patient electronically so that they can follow it on their own, but there is also the option of online supervision at a low cost. The patient has the ongoing support and communication they need with the physiotherapist in order to address any difficulties.

If you have Shoulder Pain, call PhysioDanali today for specialised advice from the physiotherapist!

• Pieters L, Lewis J, Kuppens K, et al. An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain. J Orthop Sports Phys Ther. 2020;50(3):131-141. doi:10.2519/jospt.2020.8498

• Lafrance S, Charron M, Roy JS, et al. Diagnosing, Managing, and Supporting Return to Work of Adults With Rotator Cuff Disorders: A Clinical Practice Guideline. J Orthop Sports Phys Ther. 2022;52(10):647-664. doi:10.2519/jospt.2022.11306

• Dyer JO, Doiron-Cadrin P, Lafrance S, et al. Diagnosing, Managing, and Supporting Return to Work of Adults With Rotator Cuff Disorders: Clinical Practice Guideline Methods. J Orthop Sports Phys Ther. 2022;52(10):665-674. doi:10.2519/jospt.2022.11307