From the Guidelines
For shoulder pain with lifting, the most effective initial treatment approach is to start with rest from aggravating activities for 1-2 weeks, applying ice for 15-20 minutes several times daily, and taking over-the-counter pain relievers like ibuprofen or acetaminophen for pain management. This approach is based on general principles of managing musculoskeletal pain and inflammation. When considering diagnostic imaging for shoulder pain, particularly in cases where rotator cuff disease is suspected, MRI, MR arthrography, and ultrasound are equivalent in evaluation, depending on local expertise, as indicated by a rating of 9 in the appropriateness criteria for acute shoulder pain 1.
Given the complexity of shoulder anatomy and the variety of potential causes for shoulder pain, including instability, impingement, and osteoarthritis, a thorough evaluation is crucial. For patients with glenohumeral osteoarthritis, total shoulder arthroplasty is recommended over hemiarthroplasty, based on a moderate-rated recommendation from the American Academy of Orthopaedic Surgeons 1. However, management strategies must be individualized, considering factors such as patient age, symptom severity, and medical comorbidities.
In terms of specific exercises, gentle stretching and strengthening are beneficial. Pendulum stretches and using light resistance bands or small weights can help maintain mobility and rebuild shoulder stability. Proper lifting technique, including keeping objects close to the body and using legs for power, is crucial for preventing further injury. If pain persists or worsens, seeking medical evaluation is essential, as it may indicate conditions requiring professional treatment such as physical therapy, corticosteroid injections, or surgical intervention.
Key points for managing shoulder pain with lifting include:
- Initial rest and ice application
- Use of over-the-counter pain relievers
- Gentle stretching and strengthening exercises
- Proper lifting technique
- Consideration of diagnostic imaging if pain persists, with MRI, MR arthrography, and ultrasound being valuable tools
- Individualized treatment planning, potentially including physical therapy, injections, or surgery, based on the underlying cause of pain and patient factors.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... Mild to moderate pain: 400 mg every 4 to 6 hours as necessary for relief of pain. The treatment for shoulder pain with lifting using ibuprofen is 400 mg every 4 to 6 hours as necessary for relief of pain 2.
- The maximum daily dose should not exceed 3200 mg.
- It is recommended to use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
From the Research
Treatment Options for Shoulder Pain with Lifting
- Therapy for shoulder pain is based on pain control and therapeutic exercises in almost all cases 3
- Diagnosis is crucial in decision-making when treating a patient with shoulder pain, and ultrasound is very important in the diagnostic and therapeutic pathway, especially when surgery is being considered 4
- Treatment depends on the cause and can include physical therapy, injections of corticosteroids into the joint space or bursa, and surgery 5
Exercise and Physical Therapy
- Shoulder exercises are the best way to manage subacromial shoulder pain, and most people with this condition improve with physical therapy 6
- Exercise can reduce pain and improve mobility and function in patients with shoulder pain 6
Corticosteroid Injections
- Guidelines for shoulder pain recommend treatment with corticosteroid injections if initial pain management fails 7
- Corticosteroid injections are frequently administered in the first consultation, and older patients and patients with a history of shoulder pain are more likely to receive a corticosteroid injection for shoulder pain 7
- No serious adverse reactions were recorded by general practitioners when using corticosteroid injections for shoulder pain 7