Tag Archive for: shoulder pain

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Steroid injections may do more harm than good, research shows

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Have you been told you need to get a cortisone injection? Have you already tried them more than once? 

Research is now showing that cortisone injections may hurt more than help in the long run! 

The results of a recent study from Radiology has raised concerns in the medical community about potentially adverse effects on joints following corticosteroid injections. These injections are commonly used to treat arthritis, especially osteoarthritis of the hip and knee. The researchers in this study observed patients who had previously received steroid injections and found that some of the patients exhibited further joint damage on medical imaging tests. According to the original article, these patients presented with “accelerated OA [osteoarthritis] progression, subchondral insufficiency fracture, complications of osteonecrosis, and rapid joint destruction, including bone loss.” 

The joint issues that can be triggered by cortisone injections don’t just show up right after the procedure — which makes it easy to see the steroid shot as a quick fix with no drawbacks.

And it’s true that there are usually no short-term side effects. However, when it comes to your joints, it’s all about the long game. And it’s worth noting that an analysis from the Cochrane Review in 2015 found that the benefits of steroid injections usually wear off after about six months…  meaning it’s a temporary “band-aid” solution to a bigger problem — a band-aid with the potential to result in permanent degradation of your joints!  

Arthritis is an issue we see all the time in our physical therapy practice, and that’s why patient and physician concerns with steroid injections are so relevant to us. Many of our clients have had injections suggested to them or have gone through with the procedure but not experienced any long-term healing. In many cases, this can be an overly simplified answer to the very complicated question of individual pain. Physical therapy, on the other hand, isn’t a one-size-fits-all solution. Our treatment model is entirely based around addressing the root cause of your pain instead of just providing temporary relief. Plus, we’re all about keeping your treatment non-invasive, movement-based, and entirely customized to YOU. 

If you’ve been told that you need a cortisone injection in your back, knee, or shoulder, think twice and get informed about other options!

If you’d like a NATURAL route to pain relief — and one that will make you more mobile and active at the same time — come talk with us! You can even schedule a FREE 30 minute Discovery Session with our Portsmouth, NH physical therapy specialists right now — no strings attached. 

How to NOT let Aches and Pains Ruin your New Year’s Goals

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It’s that time of year, when we start looking ahead and setting goals for ourselves. It’s especially exciting now because we aren’t only entering a new year – but a new DECADE!

Exercising more and losing weight are the top New Year’s resolutions on everyone’s lists year after year. But what if you’re suffering from back or knee pain?  One of the worst things you can do is ignore pain and assume that by simply exercising more or losing weight, your ailments will just go away. It’s certainly a reasonable expectation, however, I typically see an influx of people calling my office right around March because these aches and pains have not only worsened — but derailed their New Year’s goals completely.

I don’t want to see that happen for you. So here are my top tips to NOT let aches and pains ruin your New Year’s goals:

1. Get assessed by an expert:

 

Your first thought might be to go see your doctor if you’re suffering from something like back or knee pain. But most medical doctors are trained to screen you for problems like broken bones or serious pathologies – not to actually assess your movement. You need to know how your pain behaves during everyday functional movements to truly fix it – and to avoid unnecessary procedures and surgery.  X-rays, MRI’s, or simply moving your limbs around on a treatment table won’t do that… but that is what a medical doctor is trained to do. A specialty physical therapy practice will be able to assess your movement in detail, through various movement tests, which will tell a much better story about how your pain may or may not impact the new exercise or weight loss program you’re about to start. Plus, we’ll be able to give you customized modifications so that you can embark on your new goal while decreasing your risk of injury.

2. Mobility before Stability:

This is a saying you hear me say all the time in my office. Your muscles won’t function at their best if you don’t have optimal joint mobility. In other words, you don’t want to strengthen around a stiff joint, or you’ll encourage compensation. Full and free mobility requires adequate flexibility in your joints as well as your muscles. Most people don’t think – or even know – how to assess their joint mobility. If you’re suffering from chronically stiff joints, you’ll want to get them checked before you start a new exercise program. I recommend seeing a movement expert, like those employed in our office, to make sure you’re ready and able to start on that new exercise program you’re so excited about!

3. Stay Hydrated:

Drinking lots of water has two great benefits. It will give you the extra hydration you need if you’re planning to be more active. And it will help you lose weight by curbing your appetite. Some additional benefits of staying hydrated include increased muscle strength and stamina, more lubrication in your joints, more supple skin, better cardiovascular function, and improved energy and mental alertness. One really easy tip to jumpstart your day and improve your daily hydration intake is to begin with 10 oz of water first thing upon waking. Add a squeeze of lemon for extra vitamin C and supported weight loss.

4. Pace yourself:

It’s very appealing and motivating to go “all in” on your new exercise or weight loss goal and 10x it… and I applaud you for it. But remember, you have 12 months, and really, the rest of your life to accomplish your goal in any way that you see fit. In other words, take pleasure and pat yourself on the back for simply setting a goal. That’s a first step that many don’t even get to. Be proud of yourself for setting an intention and envisioning a better quality of life. To give yourself the best odds of staying on that path, I encourage you to listen to your body and take your time in acclimating to a new exercise program. Don’t fight your body if it’s talking to you.  Our bodies talk to us for a reason. If you need help figuring out what your body is trying to say to you – click here to schedule a FREE Discovery Session with us in Portsmouth. We’re happy to translate for you!

Happy New Year – and Happy New Decade! 

Questions About Your Shoulder Pain? Here are Some Real Answers.

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Often when clients come to us with shoulder pain, they’ve already tried several approaches without success. But the real issue is that everyone they’ve seen up to that point has failed to give them an accurate diagnosis.

Without an accurate diagnosis, treatment fails.

It’s not surprising. The true cause of shoulder pain is missed by many and can actually be difficult to diagnose. Sometimes it really is your shoulder, but in other cases the pain is actually caused by a problem in your neck. If there is irritation or inflammation in your neck, but someone is aggressively treating your shoulder, guess what? You aren’t going to see results and your pain may even worsen.

Here are a few questions to ask if you’re wondering if really have a shoulder problem… or if you should be getting help for your neck instead.

Where is your pain?

 When you have an actual shoulder problem, the pain is always going to be just in your shoulder. The most common areas to experience pain are directly in front of your shoulder, directly on top of your shoulder, or in a more involved shoulder problem – like a rotator cuff injury – you might feel achiness on the side of your shoulder and down into the side of your arm a little. If the pain goes past your elbow, is above your shoulder and into your neck (the upper trap area), deep inside of your shoulder, or in the back into the shoulder blade, it’s entirely possible (and maybe even likely) that your neck is involved or totally responsible for your “shoulder pain.”

Do you have numbness, tingling or burning?

These are signs of nerve compression or irritation. If that’s happening in your neck – say due to a bulging disc or restricted/faulty movement patterns that irritate your nerve roots – you can feel it into your shoulder, shoulder blade, or even down into your arm.

What’s particularly misleading is that all of this nerve difficulty in the neck will only be felt in your shoulder or arm.

When do you feel stiff?

Lack of mobility and stiffness are common symptoms associated with a rotator cuff injury or the dreaded “frozen shoulder.” If your neck moves well, is pain free, and your shoulder is stiff, odds are that the problem is in your shoulder. Now, let’s say you’ve got stiffness in your neck as well as your shoulder. It’s possible the neck stiffness is a result of your shoulder not moving properly. However, you’ll never know for sure without a proper assessment. If there is even a hint of a neck issue being fully or partially responsible for your shoulder problem, it must be addressed or you will never achieve full recovery.

I do everything I’m told, why won’t my shoulder get better?

This is probably the number one sign that your shoulder problem is not really a shoulder problem at all. If you’ve had pain for months, or if you fix your pain but it keeps coming back, then there is a very good chance someone has missed something. Quite possibly, it’s a hidden neck problem. I can’t tell you how many times I’ve seen this happen. I’ve seen people try three different therapists who’ve prescribed the best rotator cuff exercises on the planet. I’ve seen people get multiple cortisone injections in their shoulder. And worse, I’ve seen people get surgery – only for their shoulder to problem return months or years later. If this sounds like you, then someone has missed the boat and your shoulder problem may not be a shoulder problem at all. You need to find a physical therapist who is a specialist and can properly assess you. They’ll know the right questions to ask, take their time doing a thorough and proper assessment, and get you on the right track to getting better.