A continuous nagging pain at the shoulder could be due to an injury or an underlying disease of the shoulder joint. The shoulder is an extremely mobile joint which is always at the risk of an injury that could lead to complete instability of the joint.
There are varied approaches by different surgeons to treat shoulder pain. The objective of treatment is to prevent further injuries and ease discomfort, thus enabling easy movement. The line of treatment adopted mainly depends upon the cause and the severity of the condition. The initial treatment mainly consists of rest, ice packs, anti-inflammatory medication and physiotherapy. Steroids are also commonly used to reduce pain and inflammation.
New studies question the value and need of steroids in treatment of shoulder pain. Steroids are compounds which are synthetically similar to steroid hormones produced in the human body. Research has found that physical therapy and steroids often produce the same results when treating shoulder pain. In fact many studies were conducted on separate groups of people with shoulder pain, one receiving steroids and others physiotherapy.
These studies showed that the group who received steroidal injections always returned back with shoulder pain. Rhon, a physical therapist at the Centre for Intrepid at Brooke Army Medical Centre in Fort Sam Houston, Texas conducted these studies along with his team. Both groups showed improvement but the group who received steroid shots always returned back.
In comparison, steroids mainly act as palliatives, suppressing the inflammation and pain with no permanent cure. It is not advisable to take more than 3 shots of steroids in a year. Some people benefit from steroid injections, however they should mainly be used after proper rest, medication and physical therapy have been tried, as steroids can cause more harm than benefit. It is also important to note that steroid injections can interfere with other medications taken by the patient (especially blood thinners).
At Onto Orthopedics, we believe in comprehensive orthopaedic care. Physical therapy along with muscle strengthening techniques and exercise should be done to encourage movement. Patients should be given an exercise program for home care so as to reinforce physical therapy.
Penned by Dr. Rachita Narsaria, MD
- Buchbinder R, Green S, Youd JM, Johnston RV. Oral steroids for adhesive capsulitis. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD006189.
- Burbank KM,StevensonJH,Czarnecki GR et al; Chronic shoulder pain: part II. Treatment. Am Fam Physician. 2008 Feb 15;77(4):493-7.