PREVENTION & THERAPY

Beyond Surgery: Exploring Effective Non-Surgical Treatments for Chronic Shoulder Pain

If you are living with chronic shoulder pain, you know how much it can interfere with daily life, such as getting dressed in the morning to reaching overhead, or simply just getting a good night’s sleep. 

Fortunately, surgery isn’t your only option. A wide range of non-surgical shoulder pain relief treatments can help reduce discomfort, restore movement and improve your quality of life.

In order to help you make well-informed decisions regarding your care, we have examined some realistic, scientifically supported alternatives to shoulder surgery below.

ATTENTION!  If you are suffering from shoulder pain, Dr. Badia and his team are here to provide expert insight. Schedule a consultation at the Badia Hand to Shoulder Center to gain clarity and confidence in your treatment path.

Common Causes of Chronic Shoulder Pain

According to the International Association for the Study of Pain (IASP), pain is considered chronic when it persists beyond the normal healing time, typically defined as longer than 3 months. Therefore, shoulder pain lasting more than 3 months may be classified as chronic. 

Some of the most frequent causes include:

• Rotator cuff problems: inflammation, degeneration, or tears causing weakness and pain with overhead use
• Frozen shoulder: stiffness and restricted movement, often linked to diabetes or thyroid conditions
• Shoulder instability: looseness or slipping from prior dislocations
• Acromioclavicular (AC) joint arthritis: pain at the top of the shoulder, especially with cross-body motion

According to the American Academy of Orthopaedic Surgeons (AAOS), imaging tests like MRI or ultrasound may be recommended to determine the exact cause before beginning treatment.

Physical Therapy: A Cornerstone of Non-Surgical Recovery

Physical therapy is often the first and most effective step in chronic shoulder pain treatment without surgery. A customized program guided by a licensed therapist can:

• Strengthen supporting muscles
• Improve shoulder mobility and range of motion
• Reduce inflammation and discomfort
• Teach proper body mechanics to prevent further injury

The following exercises are commonly recommended as part of conservative management for chronic shoulder pain.

Always consult your doctor or physical therapist before beginning any exercise program, especially if your pain is severe or not yet diagnosed.

• Pendulum exercise: Lean forward with your healthy arm supported. Let the painful arm hang and gently swing it in small circles. Repeat for 30 seconds in each direction.
• Sleeper stretch: Lie on your side with the painful arm underneath and bent. Use your other hand to gently press the forearm down until a light stretch is felt. Hold for 20-30 seconds.
• Shoulder blade squeezes: Sit or stand upright. Gently pinch shoulder blades together (without shrugging). Hold for 5 seconds. Repeat 10-15 times.
• Wall walk: Facing a wall, walk your fingers upward as far as you can. Pause briefly, then return to the start. Repeat 10 times.
• Resistance band external rotation (if prescribed): With your elbow bent at 90 degrees and a band anchored at waist level, rotate your        forearm outward. Perform 10-15 repetitions if prescribed.

Medications and Injections for Pain Management

When managed properly, many cases of chronic shoulder pain can improve with physical therapy and targeted exercise. However, in some cases, additional support through medications or injections may be used to help control pain and inflammation, especially during flare-ups or when symptoms limit progress with movement-based therapy. 

According to the review article Diagnosis and Treatment of Chronic Painful Shoulder: Review of Nonsurgical Interventions by Dr. James R. Andrews and colleagues, the strategic use of non-surgical interventions can significantly reduce pain and improve function in many chronic shoulder conditions.

Oral medications

Over-the-counter NSAIDs like ibuprofen or naproxen may help relieve pain in the short term. They work by reducing inflammation, but their use should be limited, as long-term use can lead to side effects such as stomach irritation, gastrointestinal bleeding, kidney strain, and elevated blood pressure. 

Topical and intramuscular options

Topical NSAID gels or creams can target localized pain with fewer systemic side effects. Intramuscular NSAID injections may also be used for short-term relief. 

Corticosteroid injections

Steroid injections into the shoulder joint may help reduce inflammation and improve movement, especially in conditions like frozen shoulder or bursitis. Relief is often temporary, lasting a few weeks to a few months. These injections are most effective when combined with physical therapy. Repeated use should be avoided, as it may weaken tendons or damage joint tissue. Risks include infection, skin thinning, and joint instability.

Activity Modification and Supportive Devices

Small changes in how you move or support your shoulder can make a big difference. These everyday adjustments may include:

• Avoiding overhead movements or repetitive tasks that increase discomfort
• Using a brace, sling, or kinesiology tape to give the joint extra support during activity
• Changing your sleeping position to take pressure off the shoulder

These simple steps help reduce strain while still allowing you to stay active and comfortable during recovery.

Exploring Complementary Therapies for Shoulder Health

Complementary therapies can be a helpful addition to your care plan for chronic shoulder pain.

While they are not replacements for medical treatment, they may improve comfort, reduce stiffness, and support healing when used safely.

Common complementary therapies include:

• Acupuncture
  Stimulates specific points on the body to improve circulation, reduce inflammation, and ease pain.
• Chiropractic care
  Focuses on joint alignment and posture to relieve pressure and improve overall shoulder mechanics.
• Massage therapy
  Helps relax tense muscles, reduce discomfort, and improve blood flow around the shoulder.
• Yoga and Pilates
  Encourage flexibility, muscle strength, and better body control through slow, mindful movement.
• Herbal remedies
  Natural options like turmeric, ginger, or arnica may reduce inflammation. Always consult a doctor before use.
• Hydrotherapy
  Uses warm water exercises to relieve pain, support mobility, and make movement easier for sore joints.

Before starting any new therapy, talk to your healthcare provider to make sure it fits your condition and recovery plan.

Lifestyle Adjustments for Lasting Relief

Your habits play a big role in managing chronic shoulder pain without surgery. Consider these daily strategies:

• Stay lightly active (avoid full rest for extended periods)
• Maintain upright posture
• Set up ergonomic workstations
• Sleep on your back or with shoulder support
• Eat anti-inflammatory foods (e.g., leafy greens, berries, olive oil)
• Manage stress through breathing, meditation, or gentle movement

If you’re exploring non-surgical options for chronic shoulder pain, it’s essential to consult with an expert. Contact Dr. Badia and the Badia Hand to Shoulder Center today to discuss your treatment pathways and find the relief you need.

References

1. Andrews, J. R. (2021). Diagnosis and treatment of chronic painful shoulder: Review of nonsurgical interventions. Journal of Orthopaedic Research and Therapy
2. American Academy of Orthopaedic Surgeons (AAOS). (n.d.). Shoulder pain and common shoulder problems.
3. National Institutes of Health (NIH). (2023). Acupuncture for chronic pain. National Center for Complementary and Integrative Health.