Alternativesto shoulder arthroscopy

There may be non-surgical ways to relieve your shoulder pain and things you can do to delay your need for surgery.

Changing the way you do things

There are several causes of shoulder pain you can address yourself. You can try and avoid repeating activities that bring the pain on, be careful when you lift things, address muscle imbalances and sleep in a way that supports your shoulder.

Avoiding certain activities

Repeated activity involving your shoulder can put more strain on the joint. Try and take regular breaks if you’re hammering, sawing, painting, polishing your car, serving in tennis or bowling in cricket.

Careful lifting

Lifting heavy objects can injure your shoulder. Ask for help or use devices to help you do the heavy lifting.

Restoring muscle balance

Many shoulder problems begin with a muscle imbalance, where one muscle becomes stronger than the muscle that opposes it. This leads to abnormal shoulder function, making the shoulder more susceptible to injury. Improving your core stability and doing specific shoulder-strengthening exercises can help with this.

Supporting your shoulder

Sleeping with your shoulder supported can take the strain off it. Experiment with using pillows for support and try to find sleeping positions that keep your shoulder in a comfortable position. When you’re travelling, put a pillow under your arm to support it.

Hot and cold packs

After you’ve injured or aggravated your painful shoulder, putting a cold pack on it can help reduce the initial pain and stiffness. Apply the cold pack to your shoulder for 15–20 minutes every 3 or 4 hours. After a few days, or when things have improved, hot packs or a heating pad may also help.

Oral medications

There are several oral medications that can help reduce shoulder pain and improve function. Chances are you’ve already tried paracetamol.

Your doctor may also have recommended or prescribed a non-steroidal anti-inflammatory agent (NSAID). Common NSAIDs have the generic names aspirin, meloxicam, celecoxib, ibuprofen, mefenamic acid, diclofenac, naproxen, piroxicam and ketoprofen. They can cause gastric side effects and you should consult your doctor before trying them if you have any other health conditions.

You may need to try more than one NSAID before finding one that works for you.

More powerful analgesics containing opioids such as codeine, oxycodone, morphine or tramadol can be prescribed but they’re not recommended for long-term use due to their side effects, toxicity and potential for addiction.

Topical medications

Ointments containing methyl salicylate, capsaicin, camphor, menthol or eucalyptus oil can help relieve pain by stimulating the nerves near the painful area and interrupting pain signals. Herbal versions often contain these same ingredients, plus herbs as well.

Note: If you’re using painkillers, gels or ointments every day, it’s time to see your doctor. Long-term use of painkillers can have adverse effects.

Steroid injection

Your doctor may recommend a corticosteroid injected into your shoulder. It’s possible this will give you relief that lasts for weeks or even months.

Your GP may refer you to a rheumatologist for the steroid injection or to a radiologist where you can have an ultrasound-guided steroid injection. The injection sometimes causes side effects and can take a while to relieve your pain, so you may need to schedule some time off work or have the injection before a weekend break.

Physiotherapy

A physiotherapist can assess and treat your shoulder pain, giving you a program that includes exercise, stretching and strengthening exercises as well as practical advice on how to look after your shoulder.

Massage

A program of massage may ease your shoulder pain, increase your range of motion and help you relax. Many physiotherapy practices offer massage therapy.

Acupuncture

An acupuncturist works to relieve pain by inserting fine needles into your skin. The needles are thought to stimulate the production of natural painkilling chemicals. Because the needles are so thin, it’s not usually painful. The use of acupuncture isn’t part of traditional western medicine and its effects are unproven, but some Eastern medicine practitioners, as well as some doctors, chiropractors and osteopaths believe it’s an effective way to treat pain.  However, clinical evidence of its effectiveness is limited.

Make sure your acupuncture practitioner is qualified and registered with the Australian Acupuncture and Chinese Medicine Association.

Note: Eligible HCF members can claim for sessions with qualified physiotherapists, chiropractors, osteopaths, acupuncturists, and massage therapists (subject to annual limits).