Shoulder pain treatment with myofascial trigger point release, orthopedic massage, and other modalities

Are you looking for shoulder pain treatment in Orlando and Central Florida?

Shoulder pain can take a toll on your life. Imagine not being able to write, brush your teeth, feed yourself, or put your shirt on.

I’ve been there! Being a pain doctor, I had to take time off work because I had too much pain and stiffness in my shoulder. What an irony! Even my patients were worried about me. What helped me the most was massage! Keep reading to learn how orthopedic massage and myofascial trigger point release can help with shoulder pain.

Causes of shoulder pain

Shoulder pain may be due to inflammation, arthritis, overuse and repetitive movements, sports lesions, strain or trauma. Shoulder pain can also be associated with poor ergonomics and posture and may be seen commonly in people with fibromyalgia and during the perimenopause transition.

Common causes of shoulder pain include:

• Bursitis
• Tendinitis (tendon inflammation)
• Rotator cuff impingement
• Rotator cuff tears (tendon tears)
• Adhesive capsulitis (frozen shoulder)
• Osteoarthritis
• Joint instability
• Cervical radiculopathy (pinched nerve)
• Muscle spasms
• Myofascial pain

Myofascial pain as a cause of shoulder pain

In many cases, people with shoulder pain have myofascial trigger points, which are highly sensitive spots within taut bands of muscle tissue that can cause pain locally and in distant areas. Trigger points can lead to restricted range of motion, weakness, fatigability, and altered movement patterns of the affected muscles. Trigger points could be the primary cause of pain or could occur secondary to other pain sources such as bursitis or tendinitis.

Treatment of shoulder pain

Shoulder pain is usually accompanied by stiffness, reduced range of motion, and limitation in daily activities. Therefore, the goals of treatment are to reduce pain and muscle spasm, and to improve mobility and function in the shoulder. Common treatment options for shoulder pain include:

• Medications such as anti-inflammatories and muscle relaxants.
• Physical therapy with range of motion, strengthening, and stretching exercises.
• Pain modalities such as ultrasound therapy, electrical stimulation, or laser therapy.
• Lifestyle and posture modifications.
• Some patients may have injections. Others may need surgery depending on the cause of pain (for example a full thickness rotator cuff tear).
• Manual medicine (including orthopedic massage and myofascial trigger point release) is often combined with one or more of the above options.

Manual medicine for shoulder pain (orthopedic massage, myofascial trigger point release)

Manual therapy can help with different types of shoulder pain. For example, in rotator cuff related shoulder pain, exercise is a priority to improve pain, function, and mobility. Research strongly recommends adding manual therapy for further improvement.

Different manual therapy techniques can be used for treatment. In general, massage therapy can improve shoulder range of motion. Myofascial trigger point release combined with stretching exercise and ergonomic recommendations have been found to help with chronic shoulder pain.

Correction of posture is essential to obtain and maintain relief. Correcting a forward head is a classic example because this posture may put stress in the neck and shoulders and can lead to myofascial trigger points.

We often need to treat distant areas because trigger points can cause local pain and pain referred to other areas in specific patterns and can have satellite trigger points. For instance, to treat shoulder pain we often need to treat trigger points in muscles of the neck, upper back, and upper arm.

Muscles generally don’t act alone during movement and usually act within the context of body parts connected to one another (a kinetic chain). Also, the body is connected by fascia, a network of connective tissue that surrounds the bones, nerves, muscles and blood vessels. It is thought that the fascia can contract, thicken, get inflamed and irritated. In some cases, the layers of fascia are too stiff and cannot glide past one another, in other cases the fascia is hypermobile.

Considering those factors, in a patient with shoulder pain, we often need to treat the neck, temporomandibular joint (TMJ) and even the hip in some cases for a whole body alignment.

Exercise and stretching for shoulder pain

An exercise program after other treatments for myofascial trigger points may help keep the progress gained. Exercise may help inactivate trigger points, relax muscles, reduce pain, increase range of motion, improve blood flow, and help reorganize the muscle fibers. Exercise at the right time and at the right intensity and duration may help with better long term outcomes.

The specific exercises to perform depend on the cause of pain or type of injury but generally consist of strength and strengthening exercises targeting the muscles of the shoulder, upper arm and upper back. These are more safely performed under your doctor’s supervision.

Takeaways

Manual medicine can help improve your shoulder pain, range of motion, and function. This can include different techniques such as orthopedic massage and myofascial trigger point release and a rehab program emphasizing adequate posture, ergonomics, and exercise based on your stage of healing.

Looking for a physiatrist in Orlando, Central Florida for shoulder pain relief?

We are here to help with your shoulder pain and stiffness. Reach out today to schedule your appointment at Getting Well Physiatry.

References inserted as links within the text.