Dear Dr Nina: Will dry needling cure shoulder pain?
Q My shoulder is often sore and I sometimes have trouble getting dressed in the morning.
I haven't injured it to my knowledge. The pain is sometimes intense, but I don't like to use painkillers. A friend suggested that it could be frozen shoulder and that I should try something like dry needling. What other routes should I take?
Dr Nina replies: Injuries to the shoulder may occur due to a sudden injury or due to repeated episodes of strain. Things like falling onto an outstretched arm, a direct blow to the shoulder, forceful overhead motion or sudden pulling may all cause injury and pain.
More complicated injuries may involve tendons and muscles surrounding the shoulder. Simple sprains can also occur.
Pain on raising your arm over your head may indicate fluid or bursitis in the shoulder joint. It may also be due to inflammation of the tendons supporting the muscles of this joint. Shoulder impingement syndrome normally leads to pain on moving the arm outward from your body and over your shoulder. Inflammation in the joint may make moving the arm beyond 90 degrees too painful.
Minor injuries may be managed with rest, slinging and an anti- inflammatory. Physiotherapy is always a good place to start with musculoskeletal pain. A good physiotherapist will fully assess your muscles and joints and can usually pinpoint the origin of the problem. Exercises may help rebalance your shoulder joints and improve pain.
Treatments such as ultrasound and dry needling do help in some cases but should always be done by a professional trained in this technique.
Posture also plays a role in shoulder pain. Most of us could benefit from standing taller. Those who lean forward at desks or work on computers are particularly at risk of shoulder and neck pain. The muscles may feel tight and tender.
Those who work in jobs that require frequent reaching overhead like builders, painters and plasterers are also prone to shoulder impingement injuries.
Recovery from any inflammation or injury takes time. The initial goal of treatment is to ensure healing, control pain and swelling, prevent stiffness and regain a very gentle range of motion. Gentle strengthening of the shoulder joint and increasing the range of motion can follow.
Wear and tear in the neck is a very common cause of shoulder pain. This is called degenerative change or cervical spondylosis. The bones in the shoulder change with age and become worn.
This may lead to a narrowing in the space between them or small bony outgrowths which can put pressure on nerves causing pain. The bony change may also cause stiffness.
Pressure on nerves may lead to weakness, pins and needles or numbness in the arms and hands.
If you have shoulder pain, start with a physio to get a diagnosis. To prevent future pain stay active, exercise regularly and if your physiotherapist gives you an exercise prescription, do these daily. Pay attention to your pillow and mattress as poor support at night can make shoulder pain worse.
X-rays and scans are not normally indicated. If pain is persisting, visit your GP and they can advise you in this regard.
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