Introduction
Shoulder stiffness is one of the degenerative changes of the shoulder joint. The joint is restricted in its mobility due to inflammation and shrinkage of the joint capsule. The following is a list and explanation of numerous treatment options. General information about shoulder stiffness can be found here: Shoulder stiffness – Everything you need to know
These are the treatment options
There are numerous possibilities for the treatment of shoulder stiffness. However, it can take some time until the complete healing is achieved. Which treatment is most suitable also depends on the phase of the disease.
Pain therapy is carried out with so-called non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac. These can be taken as tablets or applied directly to the shoulder as a gel or cream. A cortisone therapy as an injection or in tablet form serves to relieve pain and improve mobility in the shoulder joint.
A further possibility for pain therapy is the so-called nerve blockage. For this, the nerves that cause the pain in the shoulder are anaesthetized with local anaesthetics. The mobility in the shoulder joint is improved by stretching exercises.
These should initially be performed as part of physiotherapy and later by the patient alone. Alternative but not proven helpful treatment options include acupuncture, laser therapy, magnetic field therapy and homeopathy. If conservative measures do not result in an improvement of symptoms, surgery can help to improve the shoulder complaints.
The operation is then usually performed by means of a joint endoscopy (arthroscopy).
- The pain therapy is carried out with so-called non-steroidal anti-rheumatic drugs (NSAIDs) such as ibuprofen and diclofenac. These can be taken as tablets or applied directly to the shoulder as a gel or cream.
- A cortisone therapy as an injection or in tablet form serves to relieve pain and improve mobility in the shoulder joint.
- Another possibility for the therapy of pain is the so-called nerve blockage.
For this, the nerves that cause the pain in the shoulder are anaesthetized with local anaesthetics.
- The mobility in the shoulder joint is improved by stretching exercises. These should initially be performed as part of physiotherapy and later by the patient alone.
- Alternative but not proven helpful treatment options include acupuncture, laser therapy, magnetic field therapy and homeopathy.
- If conservative measures do not improve symptoms, surgery can help to improve shoulder complaints. The operation is then usually performed by arthroscopy.
Cortisone shock therapy is used to relieve pain and improve mobility in cases of shoulder stiffness.
Cortisone in tablet form is taken for about 3 weeks. The cortisone dose is initially high and is then gradually reduced. Although cortisone tablets do provide relief, they are not suitable for long-term therapy as side effects such as osteoporosis may occur.
It is also important that the cortisone tablets are not discontinued on their own, but are slowly withdrawn, as this can also lead to severe side effects in the hormone balance. The cortisone injection is given directly into the joint and therefore acts directly on the shoulder joint. The pain can be relieved and mobility improved.
However, it should also be noted that this can also lead to side effects. A cortisone injection should not be used too often, since in addition to the anti-inflammatory component, repeated use can lead to tissue shrinkage (atrophy). Furthermore, there is always the risk of infection during a puncture.
Whether tablets or injections are suitable should be discussed with the treating physician regarding the advantages and disadvantages of the therapies. Anti-inflammatory drugs are so-called NSAIDs or non-steroidal anti-rheumatic drugs. These painkillers include ibuprofen and diclofenac.
They are used for the pain that occurs in the first and second phase of shoulder stiffness. Care should be taken to ensure that the painkillers are taken early and then regularly to achieve the desired effect.Since the NSAIDs also attack the stomach lining, stomach protection should also be taken prophylactically during the period of intake. Proton pump inhibitors such as Pantoprazole are suitable for this.
NSAIDs can also be applied directly to the affected shoulder as a gel or cream. Physiotherapy is used to promote mobility, especially during the period of stiff shoulder. Here, the movement in the shoulder is only carried out by the physiotherapist, i.e. the patient does not actively move the shoulder.
With physiotherapy, the mobility in the shoulder is gradually improved. Physiotherapy can take several weeks before complete freedom of movement in the shoulder joint is achieved. Stretching exercises are an important part of the therapy for stiff shoulders.
There are various exercises that can be carried out by the patient during physiotherapy or independently. On the one hand, the stretching exercises serve to increase mobility in the joint. On the other hand, they counteract a loss of musculature through immobilization.
When performing the exercises, care should be taken to ensure that no pain occurs during the stretching. Which exercises are suitable and how they are performed correctly should be discussed during physiotherapy. Surgery becomes necessary if the stiffness of the shoulder does not improve with conservative therapy or if pain cannot be sufficiently controlled even under therapy.
It is important to perform physiotherapy even after surgery in order to maintain the mobility in the shoulder joint achieved by the operation. Even after an operation, limited range of motion and pain can still occur. During the operation, the joint capsule, which is stiffened and thus limits the mobility of the shoulder, is loosened and expanded.
In addition to manipulation under anesthesia (MUA), arthroscopy is often performed. In MUA, the patient is anesthetized, so the muscles in the shoulder are relaxed. The doctor then moves the shoulder in all directions to dilate and loosen the joint capsule.
In arthroscopy, instruments are inserted directly into the joint capsule through small skin incisions. These instruments are used to make small incisions in the joint capsule to widen the capsule and increase the range of motion in the shoulder. Manipulation and arthroscopy are often combined.
