From the Guidelines
For left shoulder pain lasting 3 weeks, I recommend starting with conservative management including rest from aggravating activities, ice for 15-20 minutes several times daily, and over-the-counter pain medications such as ibuprofen (400-600mg three times daily with food) or acetaminophen (500-1000mg every 6 hours, not exceeding 4000mg daily) 1.
Initial Management
The initial approach to managing left shoulder pain involves reducing inflammation and alleviating pain. This can be achieved through:
- Rest from activities that aggravate the pain
- Applying ice for 15-20 minutes several times daily
- Using over-the-counter pain medications like ibuprofen or acetaminophen
Further Interventions
If the pain persists beyond 2 weeks of conservative management, further interventions may be necessary, including:
- Gentle stretching and range-of-motion exercises to improve mobility and reduce stiffness
- Topical NSAIDs like diclofenac gel for localized pain relief
- Considering physical therapy to strengthen the shoulder muscles and improve function
- Corticosteroid injections to reduce inflammation and relieve pain
- Further imaging studies, such as MRI or ultrasound, to identify underlying causes like rotator cuff tendinopathy, bursitis, or impingement syndrome 1
Lifestyle Modifications
To reduce pain and prevent further injury, it is recommended to:
- Sleep with a pillow under the affected arm to reduce strain on the shoulder
- Avoid overhead activities that can exacerbate the pain These interventions aim to reduce inflammation, relax muscle tension, and promote healing of soft tissues while preventing further injury to the shoulder structures 1.
From the Research
Causes of Left Shoulder Pain
- Shoulder pain can be caused by various factors, including musculoskeletal disorders, trauma, and non-musculoskeletal diseases 2, 3
- Common causes of shoulder pain include impingement syndrome, adhesive capsulitis, calcified tendonitis, cervical radiculopathy, glenohumeral osteoarthritis, and biceps tendonitis 3, 4, 5
Diagnosis of Left Shoulder Pain
- A thorough history and physical examination are essential in diagnosing the cause of shoulder pain 3, 4, 5, 6
- Imaging modalities such as X-ray, ultrasound, and magnetic resonance imaging may be used to aid in diagnosis 3, 5
- Ultrasound is particularly useful in the diagnostic and therapeutic pathway, especially when surgery is being considered 5
Treatment of Left Shoulder Pain
- Most causes of shoulder pain can be treated non-surgically with treatments such as physiotherapy, anti-inflammatory medication, and local corticosteroid injections 3, 4, 5, 6
- Surgery may be necessary in some cases to correct and restore the patient's prior level of shoulder function 3, 4
- Treatment should be based on pain control and therapeutic exercises, with limited use of imaging studies 6