From the Guidelines
To self-manage right shoulder pain, particularly in the deltoid region, it is crucial to prioritize strategies that minimize discomfort and promote recovery, focusing on proper positioning, maintenance of shoulder range of motion, and motor retraining, as these approaches have been supported by recent evidence 1.
Understanding the Condition
Right shoulder pain in the deltoid region can be multifactorial, involving tissue injury, abnormal joint mechanics, and central nociceptive hypersensitivity. The development of shoulder pain is often associated with shoulder subluxation and motor weakness, especially in conditions like stroke, where hemiplegic shoulder pain is a common complication 1.
Self-Management Strategies
- Proper Positioning: Utilize devices such as lap trays and arm troughs for individuals in wheelchairs to reduce shoulder pain and subluxation.
- Maintenance of Shoulder Range of Motion: Gentle exercises can help maintain the range of motion without causing further injury. However, aggressive passive range-of-motion exercises should be avoided as they could potentially do more harm than good if not performed correctly.
- Motor Retraining: This involves exercises that help in regaining and strengthening the muscles around the shoulder, which can be beneficial in managing pain and improving function.
- Avoid Overhead Pulley Exercises: These exercises can exacerbate the condition by putting unnecessary strain on the shoulder joint.
- Use of Slings: Especially during ambulation training, to protect the shoulder from traction injury.
Additional Considerations
- Pain Management: While the provided evidence does not directly address over-the-counter pain medications for the deltoid region specifically, in general practice, medications like ibuprofen or acetaminophen may be considered for pain relief under the guidance of a healthcare professional.
- Alternative Therapies: Acupuncture, in combination with standard therapeutic exercise, may be a safe and effective adjuvant for the treatment of hemiplegic shoulder pain, as suggested by recent systematic reviews 1.
Importance of Professional Evaluation
If the pain persists, worsens, or is accompanied by other concerning symptoms such as numbness, tingling, or significant limitation in daily activities, it is essential to seek professional medical evaluation. These symptoms may indicate a more serious condition that requires specialized treatment and intervention.
From the Research
Self-Management Strategies for Right Shoulder Pain (Deltoid Region)
- The use of patient-reported outcome measures (PROMs) can play a crucial role in supporting patient self-management, as seen in a study where a patient used the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire to monitor and self-manage recovery after a rotator cuff injury 2.
- Exercise-based rehabilitation is a key component of self-management for shoulder pain, with studies showing that it can reduce pain and improve mobility and function 3.
- Physiotherapy, pain management, and platelet-riched plasma treatment (PRP) can also be effective in managing shoulder pain and improving function 2.
- Patient-centred support, patient beliefs, clinician beliefs, pain, and therapeutic response are identified as key barriers and facilitators to self-management of shoulder pain 4.
- A thorough history, physical examination, and limited diagnostic tests can help diagnose the cause of shoulder pain, and most cases can be treated non-surgically with physiotherapy, anti-inflammatory medication, and local corticosteroid injections 5, 6.
Key Factors Influencing Self-Management
- Patient motivation and expectations can influence self-management, with patients who are motivated and have positive expectations tend to have better outcomes 4.
- Clinician support and education can also play a crucial role in facilitating self-management, with clinicians who provide patient-centred support and education tend to have better patient outcomes 4.
- Access to equipment and patient digital literacy can also facilitate self-management, with patients who have access to equipment and are digitally literate tend to have better outcomes 4.