Treatment options for shoulder pain 

Treatment
Pros
Cons
Avoiding activities that make it worse

For example, avoiding overhead arm movements for a frozen shoulder, or overarm throwing for instability disorders

  • Reduces the pain in the early stage of frozen shoulder
  • Prevents instability symptoms
  • May limit day-to-day activities
Sling

A supportive bandage to hold up the arm on the side with the injured shoulder

  • May be used for sprains to the acromioclavicular joint (top of the shoulder)
  • Will limit day-to-day activities
Simple painkillers

For example, paracetamol and codeine

  • Some available without a prescription
  • Relieve pain
  • Do not reduce swelling
  • Only temporary symptom relief
Anti-inflammatory painkillers (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen

  • Some available without a prescription
  • Can relieve pain and reduce swelling
  • May not be suitable if you have asthma, high blood pressure, kidney or heart conditions
  • Long-term use can cause indigestion and stomach ulcers
Corticosteroid tablets

Tablets containing steroid hormones that reduce pain and swelling

  • Relieves frozen shoulder pain for a few weeks
  • Are no longer effective after six weeks
  • Can cause side effects, such as weight gain
  • Not clear if these are as effective as other treatments, such as corticosteroid injections
Corticosteroid injection

Medicine containing steroid hormones that is injected into the shoulder joint to reduce pain and swelling

  • Relieves frozen shoulder pain for several weeks
  • Relieves pain caused by tendonitis (inflammation of a tendon) for up to eight weeks
  • Cannot have more than three injections in the same shoulder in one year
  • Not effective for all types of shoulder pain
  • Can cause pain after the injection, lightening of the skin and thinning of the skin
  • Less effective for tendonitis than NSAIDs
  • Only temporary symptom relief
Physiotherapy and exercise

Physical techniques, such as massage and manual therapy (where the therapist moves the arm) to relieve symptoms  

  • Many different techniques can be tried
  • Can improve stability and strength for shoulder instability
  • Can improve range of movement and flexibility for frozen shoulder
  • May be too painful in the first stage of frozen shoulder
  • May be difficult to follow if exercising without supervision
Surgery for frozen shoulder

Either manipulation, where the shoulder is gently moved under anaesthetic, or arthroscopic capsular release, where the shoulder capsule is opened up and scar tissue is removed

  • An option if other treatments are not effective after six months
  • Can be carried out as keyhole surgery (using a small incision)
  • Surgery carries higher risks than other treatments, such as infection 
  • Will need time off work to recover
  • Will need physiotherapy after surgery
Surgery for rotator cuff tears

Bone and damaged tissue and tendons are removed from the shoulder to allow the joint to move freely

  • An option if other treatments are not effective after three to six months
  • Can be carried out as keyhole surgery (using a small incision)
  • Surgery carries higher risks (such as infection) than other treatments
  • Will need time off work to recover
  • Will need physiotherapy after surgery
Surgery for shoulder instability

Stretched or torn ligaments can be repaired, or the shoulder capsule can be tightened

  • May prevent the shoulder dislocating (the ball coming out of the socket)
  • Can be carried out as keyhole surgery (using a small incision)
  • Surgery carries higher risks (such as infection) than other treatments
  • Will need time off work to recover
  • Will need to wear a sling for several weeks
  • Will need physiotherapy after surgery