My Symptoms

Shoulder pain: Treatments

Treatments of tendon wear
When wearing tendons, consult your doctor. At the clinical examination, the particular movements that will make you suffer during the consultation, will allow him to establish a diagnosis. An ultrasound of the shoulder can be very useful.

The conservative treatments proposed here will initially be anti-inflammatory drugs, and especially re-education. One must learn to lift the shoulder by blocking the humerus down. One or two infiltrations can also relieve you some time, but it allows only to pass a sharp course.

For surgical treatment, it will be a small procedure performed under arthroscopy (tiny scars), under general anesthesia. The purpose of the procedure is to remove the beak and tendon between the acromion and the clavicle, causing irritation and wear.
In this case, you stay in hospital for two days. Then, no splint, you can resume your activities normally. Physiotherapy sessions are often necessary. Lying, you raise your arm.

For sport, it will be necessary to wait until there is no pain at all. The pain disappears within six months of the procedure.

Treatments of a rupture of a tendon
When a tendon ruptures, consult your doctor. Before any further examination, he will give you a clinical examination to establish a diagnosis. This exam will highlight the pain at certain movements, or the decrease in the strength of your shoulder. He may ask for additional examinations.

A simple X-ray and an ultrasound are usually sufficient to establish the diagnosis.
If the doctor judges a necessary surgical intervention, it is the arthro-scanner which will make it possible to evaluate the size of the rupture (one injects a product in the articulation to see the state of the tendons, and one makes a scanner next ). The treatment chosen will depend on the severity of the break.
For the treatment of a tendon rupture, it all depends on your age, the importance of the inconvenience, and the importance of the rupture. Based on these criteria, your practitioner will advise you on conservative treatment or surgical treatment.

When we talk about conservative treatment, we refer to the physiotherapist.
Indeed, she will teach your joint to compensate for the deficient area by strengthening other muscles. This treatment is useful in any case, regardless of the lesion, the cause, and your age. To move and activate what remains of muscle is very important: the movement under the control of a physiotherapist is never bad. Massages are however uninteresting.
You may also be offered symptomatic treatment of pain: anti-inflammatories, or one or two infiltrations, but not more. Conservative treatment is preferred, if discomfort is not important, if you are old or, simply, if the break is not repairable.

In fact, we only choose surgical treatment if we can not do otherwise, and especially for young people who keep muscles and tendons in good condition.
During surgical treatment repair is often difficult. And that's understandable. This is a wear. Over time, the importance of breaking up has increased. The end of the tendon has retracted like an elastic and is very far from its original attachment. To the point that sometimes it is no longer repairable.

The first surgery is to attach the tendon (s) to the head of the humerus using sutures. This can be done conventionally, or under arthroscopy (tiny scars). It all depends on the size of the break!

Complications are rare. After the operation, you will have to wear a splint for three weeks. You will have to stay still, the time of healing.
Then you will start physiotherapy. First, alone, lying on your bed, simply moving your arm, then to the physiotherapist who will teach you to restore strength to your arm and your joint.

That said: patience! The repair is slow. Count well six months.

Treatments during calcifications
During the clinical examination, the doctor will have to make the difference with a "sub-acromial conflict". In the acute phase, the mobility of the shoulder is greatly diminished.
A simple x-ray will show calcification. Ultrasound can confirm the diagnosis, but sometimes when you have an acute attack, it is the moment when the calcification disappears.
In chronic phase, anti-inflammatory drugs are prescribed.
In acute phase, infiltration, to relieve pain. This is a very good indication of infiltration.
Another treatment of this pain of the shoulder: the puncture-trituration of the tendon. Clearly, this involves puncturing the calcification using a needle. This is done under radiological control. This can only be done when the calcification is not very solid: in the acute phase, the calcification is practically liquid, therefore, easy to puncture. This treatment is reserved for recurrent calcific tendinitis.
Other treatment: shock waves. It is a treatment whose purpose is to break the calcification, as is done in the case of kidney stones.
The surgical procedure, may also allow to remove the calcium deposit, such as curettage. The postoperative course is simple. No splint, no scarf. The pain disappears between three and six months after the procedure.

Shoulder stiffness treatments
The doctor may ask for an X-ray, or an ultrasound, or arthrography that will show a decrease in the volume of the joint (the retraction of the capsule).
When you have too much pain, an infiltration can relieve you. But, the best treatment is physiotherapy that will allow you to recover your mobility.

Treatments of chronic stiffness
In case of chronic pain, very often, psychological help may be necessary. And that's understandable. When one suffers, the day, the night, the psychological state is altered. If depression can sometimes cause pain, conversely, chronic pain can lead to depression. It is important not to take your pain lightly.

A specialist, a psychologist or psychiatrist can help you manage your physical pain. Relaxation techniques, for example, are an effective aid. To treat the psychological aspect of a pain is also to treat its social consequences, at the level of the work and at the level of the family, to keep the head on the shoulders. So if you suffer, do not keep your suffering for yourself, be supported!

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