{"id":1331,"date":"2021-02-18T04:33:25","date_gmt":"2021-02-18T11:33:25","guid":{"rendered":"https:\/\/edmontonboneandjoint.ca\/?page_id=1331"},"modified":"2021-03-02T01:48:12","modified_gmt":"2021-03-02T08:48:12","slug":"conservative-management-of-shoulder-pain-02","status":"publish","type":"page","link":"https:\/\/edmontonboneandjoint.ca\/resources-for-providers\/resources-for-physicians\/conservative-management-of-shoulder-pain-02\/","title":{"rendered":"Conservative Management of Shoulder Pain"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kgsbrcxr-af229da37594eac306384189b0813593\">\n.avia-section.av-kgsbrcxr-af229da37594eac306384189b0813593{\nbackground-repeat:no-repeat;\nbackground-image:url(https:\/\/edmontonboneandjoint.ca\/wp-content\/uploads\/2020\/11\/edmonton-bone-and-joint-hdr_shoulder.jpg);\nbackground-position:0% 0%;\nbackground-attachment:scroll;\n}\n<\/style>\n<div id='hdr'  class='avia-section av-kgsbrcxr-af229da37594eac306384189b0813593 alternate_color avia-section-default avia-no-border-styling  avia-builder-el-0  el_before_av_postcontent  avia-builder-el-first  avia-full-stretch avia-bg-style-scroll av-minimum-height av-minimum-height-custom av-height-custom  container_wrap sidebar_right'  data-section-bg-repeat='stretch' data-av_minimum_height_px='550'><div class='container av-section-cont-open' style='height:550px'><main  role=\"main\" itemprop=\"mainContentOfPage\"  class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-1331'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kgsbv8za-517d6935bb8f2f14a2a5e99af9ea632e\">\n#top .hr.hr-invisible.av-kgsbv8za-517d6935bb8f2f14a2a5e99af9ea632e{\nheight:24px;\n}\n<\/style>\n<div  class='hr av-kgsbv8za-517d6935bb8f2f14a2a5e99af9ea632e hr-invisible  avia-builder-el-1  el_before_av_one_full  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row_boxshadow='' row_boxshadow_color='' row_boxshadow_width='10' custom_margin='' margin='0px' mobile_breaking='' border='' border_color='' radius='0px' padding='0px' column_boxshadow='' column_boxshadow_color='' column_boxshadow_width='10' background='bg_color' background_color='' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' background_position='top left' background_repeat='no-repeat' highlight='' highlight_size='' animation='' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='' custom_class='' aria_label='' av_uid='av-bbm8v']\r\n[av_hr class='invisible' icon_select='no' icon='ue808' font='entypo-fontello' position='left' shadow='no-shadow' height='-34' custom_border='av-border-fat' custom_width='100px' custom_margin_top='0px' custom_margin_bottom='8px' custom_border_color='#b1c52e' custom_icon_color='' id='' custom_class='' av_uid='av-jxq9gmr4' admin_preview_bg='']\r\n\r\n[av_codeblock wrapper_element='' wrapper_element_attributes='' codeblock_type='' alb_description='' id='' custom_class='' av_uid='av-kjxju7uo']\r\n[av_breadcrumbs]\r\n[\/av_codeblock]\r\n[\/av_one_full]\r\n\r\n\n<div class='clear'><\/div><div id='sub_menu1'  class='av-submenu-container av-kkdygv7p-e9daa69d9e4bb231c03018ae096d5041 main_color  avia-builder-el-5  el_after_av_postcontent  el_before_av_postcontent  av-sticky-submenu submenu-not-first container_wrap sidebar_right' style='z-index:301' ><div class='container av-menu-mobile-disabled av-submenu-pos-center'><ul id='av-custom-submenu-1' class='av-subnav-menu' role='menu'>\n<li class='menu-item av-yb03-4513d655e67768ff1153df8595eddde5 menu-item-top-level menu-item-top-level-1' role='menuitem'><a href='\/services\/shoulder\/resources-for-patients\/conservative-management-of-shoulder-pain\/#physicaltherapy'  ><span class='avia-bullet'><\/span><span class='avia-menu-text'>Physical Therapy<\/span><\/a><\/li>\n<li class='menu-item av-jw62j-9ac55c504132ff10a3cfca9a50776ea5 menu-item-top-level menu-item-top-level-2' role='menuitem'><a href='\/services\/shoulder\/resources-for-patients\/conservative-management-of-shoulder-pain\/#pillars'  ><span class='avia-bullet'><\/span><span class='avia-menu-text'>Pillars of Rehabilitation<\/span><\/a><\/li>\n<li class='menu-item av-czjgb-0b2dc3506f538f27050cf913c3d79596 menu-item-top-level menu-item-top-level-3' role='menuitem'><a href='\/services\/shoulder\/resources-for-patients\/conservative-management-of-shoulder-pain\/#injections'  ><span class='avia-bullet'><\/span><span class='avia-menu-text'>Injections<\/span><\/a><\/li>\n<li class='menu-item av-wb8r-17ee6bafc0783e895f7911020eeb91dd menu-item-top-level menu-item-top-level-4' role='menuitem'><a href='\/services\/shoulder\/resources-for-patients\/conservative-management-of-shoulder-pain\/#procedures'  ><span class='avia-bullet'><\/span><span class='avia-menu-text'>Procedures<\/span><\/a><\/li>\n<\/ul><\/div><\/div><div class='sticky_placeholder'><\/div>\n[av_one_fifth first min_height='av-equal-height-column' vertical_alignment='av-align-top' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='' border_color='' radius='0px' radius_sync='true' padding='0px' padding_sync='true' column_boxshadow_color='' column_boxshadow_width='10' background='bg_color' background_color='' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='pop-up' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='' custom_class='' aria_label='' av_uid='av-mj03w'][\/av_one_fifth]\r\n\r\n[av_three_fifth min_height='av-equal-height-column' vertical_alignment='av-align-top' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='' border_color='' radius='0px' radius_sync='true' padding='0px' padding_sync='true' column_boxshadow_color='' column_boxshadow_width='10' background='bg_color' background_color='' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='pop-up' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='' custom_class='' aria_label='' av_uid='av-mj03w']\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' av_uid='av-jnw5fpmv' admin_preview_bg='']\r\n<h2 style=\"text-align: center;\">Not all patients require surgery<\/h2>\r\n[\/av_textblock]\r\n\r\n[av_hr class='custom' icon_select='no' icon='ue808' font='entypo-fontello' position='center' shadow='no-shadow' height='60' custom_border='av-border-fat' custom_width='100px' custom_margin_top='0px' custom_margin_bottom='8px' custom_border_color='#b1c52e' custom_icon_color='' id='' custom_class='' av_uid='av-jxq9gmr4' admin_preview_bg='']\r\n\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' template_class='' av_uid='av-jnw5fpmv' sc_version='1.0' admin_preview_bg='']\r\n<p style=\"text-align: center;\">Not all patients require surgery. Eighty percent of patients with shoulder pain will get better with non-operative treatment. In fact, only a very small percentage of patients will go on to require surgery for their shoulder. There are many conservative treatments that can effectively treat shoulder pain and restore your function and quality of life.<\/p>\r\n[\/av_textblock]\r\n[\/av_three_fifth]\r\n\r\n[av_one_fifth min_height='av-equal-height-column' vertical_alignment='av-align-top' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='' border_color='' radius='0px' radius_sync='true' padding='0px' padding_sync='true' column_boxshadow_color='' column_boxshadow_width='10' background='bg_color' background_color='' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='pop-up' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='' custom_class='' aria_label='' av_uid='av-mj03w'][\/av_one_fifth]\r\n\r\n[av_section min_height='75' min_height_pc='25' min_height_px='500px' padding='huge' custom_margin='0px' custom_margin_sync='true' color='main_color' background='bg_color' custom_bg='' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='https:\/\/edmontonboneandjoint.ca\/wp-content\/uploads\/2020\/12\/edmonton-bone-and-joint-bg-shoulder-01.jpg' attachment='618' attachment_size='full' attach='fixed' position='top left' repeat='stretch' video='' video_ratio='16:9' overlay_opacity='0.5' overlay_color='' overlay_pattern='' overlay_custom_pattern='' shadow='shadow' bottom_border='no-border-styling' bottom_border_diagonal_color='#333333' bottom_border_diagonal_direction='' bottom_border_style='' custom_arrow_bg='' id='physicaltherapy' custom_class='' aria_label='' av_element_hidden_in_editor='0' av_uid='av-kgs9i427']\r\n[av_three_fifth first min_height='av-equal-height-column' vertical_alignment='av-align-middle' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='6' border_color='rgba(255,255,255,0.85)' radius='0px' radius_sync='true' padding='30px' padding_sync='true' column_boxshadow='aviaTBcolumn_boxshadow' column_boxshadow_color='#2d2d2d' column_boxshadow_width='10' background='bg_color' background_color='rgba(255,255,255,0.85)' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='' custom_class='' aria_label='' av_uid='av-q1cy']\r\n\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' av_uid='av-jnw5fpmv' admin_preview_bg='']\r\n<h2 style=\"text-align: left;\">Physical Therapy<\/h2>\r\n[\/av_textblock]\r\n\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' template_class='' av_uid='av-jnw5fpmv' sc_version='1.0' admin_preview_bg='']\r\n<p style=\"text-align: left;\">Physical therapy can help you decrease your shoulder pain and restore the range of motion, strength and function of the shoulder. A good physical therapy approach will be <strong>exercise-based<\/strong> and include a home exercise program so that frequent appointments are not necessary. The therapist may use modalities and manual therapy treatment to facilitate your patient\u2019s recovery in addition to their exercise program. The physical therapist should incorporate these principles as the foundation for treatment.<\/p>\r\n[\/av_textblock]\r\n\r\n[av_hr class='custom' icon_select='no' icon='ue808' font='entypo-fontello' position='left' shadow='no-shadow' height='60' custom_border='av-border-fat' custom_width='100px' custom_margin_top='0px' custom_margin_bottom='8px' custom_border_color='#b1c52e' custom_icon_color='' id='' custom_class='' av_uid='av-jxq9gmr4' admin_preview_bg='']\r\n\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' template_class='' av_uid='av-jnw5fpmv' sc_version='1.0' admin_preview_bg='']\r\n<h3>1. Manage pain<\/h3>\r\n<ul>\r\n \t<li>Activity modification - education related to <strong>do\u2019s and don\u2019ts<\/strong> e.g. what activities and positions to avoid.<\/li>\r\n \t<li>Work on shoulder positioning to help with pain at rest and at night.<\/li>\r\n \t<li>Use Adjunctive treatments such as heat or ice may be helpful and taught for home use.<\/li>\r\n<\/ul>\r\n<h3>2. Improve\/maintain shoulder mobility<\/h3>\r\nThe physical therapist should give your patient joint and soft tissue mobility exercises to maintain or improve their range of motion. This may include the use of a cane\/stick, pulleys or stretches using the patient\u2019s \u201cgood\u201d arm to assist moving their affected shoulder.\r\n<h3>3. Establish a strong, stable base of support for the arm to work from<\/h3>\r\nThe shoulder is a ball and socket joint. The socket, or<strong> glenoid<\/strong>, is part of the shoulder blade, or <strong>scapula<\/strong>. Many patients with shoulder pain have poor posture and poor positioning of their shoulder blades on their rib cage. This results in weakness of the muscles (<strong>scapular stabilizers<\/strong>) that attach the shoulder blades to the spine and move the scapula when you move your shoulder. Abnormal movement patterns of the shoulder blade are referred to as scapular dyskinesis. This abnormal movement may contribute to shoulder pain. Shoulder rehabilitation should <strong>ALWAYS<\/strong> include <strong>posture education<\/strong> and <strong>strengthening of scapular stabilizers<\/strong>.\r\n\r\nIn addition, spinal posture is important and directly impacts how your patient moves their shoulders. Posture correction related to the entire spine and core\/lower abdominal strengthening is essential. <strong>Optimal posture and stability<\/strong> (using the core and scapular stabilizers) <strong>should be incorporated into all of their shoulder exercises<\/strong>.\r\n<h3>4. Strengthening of the rotator cuff<\/h3>\r\nThe <strong>rotator cuff<\/strong> muscles compress and centre the ball of the shoulder in the socket during movement, providing stability to the shoulder joint. The rotator cuff initiates movement when we lift our arm, gives the ability to lift the arm above shoulder height and rotates the shoulder to reach behind our back (to tuck in a shirt or do up a bra) or up behind our head (to comb or wash our hair or pull a shirt off overhead). In addition, the rotator cuff is crucial in providing strength at shoulder height and overhead.\r\n[\/av_textblock]\r\n\r\n[\/av_three_fifth][av_two_fifth min_height='av-equal-height-column' vertical_alignment='av-align-top' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='' border_color='' radius='0px' radius_sync='true' padding='0px' padding_sync='true' column_boxshadow_color='' column_boxshadow_width='10' background='bg_color' background_color='' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='pop-up' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='' custom_class='' aria_label='' av_uid='av-mj03w']\r\n\r\n[\/av_two_fifth]\r\n[\/av_section]\r\n\r\n[av_section min_height='25' min_height_pc='25' min_height_px='500px' padding='default' custom_margin='0px' custom_margin_sync='true' color='main_color' background='bg_color' custom_bg='' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' attach='fixed' position='top left' repeat='stretch' video='' video_ratio='16:9' overlay_opacity='0.5' overlay_color='' overlay_pattern='' overlay_custom_pattern='' shadow='shadow' bottom_border='no-border-styling' bottom_border_diagonal_color='#333333' bottom_border_diagonal_direction='' bottom_border_style='' custom_arrow_bg='' id='pillars' custom_class='' aria_label='' av_element_hidden_in_editor='0' av_uid='av-kgs9i427']\r\n[av_one_full first min_height='av-equal-height-column' vertical_alignment='av-align-top' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='' border_color='' radius='0px' radius_sync='true' padding='0px' padding_sync='true' column_boxshadow_color='' column_boxshadow_width='10' background='bg_color' background_color='' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='pop-up' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='' custom_class='' aria_label='' av_uid='av-mj03w']\r\n\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' av_uid='av-jnw5fpmv' admin_preview_bg='']\r\n<h2 style=\"text-align: center;\">Pillars of Rehabilitation for Shoulder Health<\/h2>\r\n[\/av_textblock]\r\n\r\n[av_hr class='custom' icon_select='yes' icon='ue810' font='entypo-fontello' position='center' shadow='no-shadow' height='60' custom_border='av-border-fat' custom_width='100px' custom_margin_top='12px' custom_margin_bottom='8px' custom_border_color='#b1c52e' custom_icon_color='' id='' custom_class='' av_uid='av-jxq9gmr4' admin_preview_bg='']\r\n\r\n[\/av_one_full][av_one_fifth first min_height='av-equal-height-column' vertical_alignment='av-align-top' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='' border_color='' radius='0px' radius_sync='true' padding='0px' padding_sync='true' column_boxshadow_color='' column_boxshadow_width='10' background='bg_color' background_color='' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='pop-up' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='' custom_class='' aria_label='' av_uid='av-mj03w']\r\n\r\n[\/av_one_fifth][av_three_fifth min_height='av-equal-height-column' vertical_alignment='av-align-top' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='' border_color='' radius='0px' radius_sync='true' padding='0px' padding_sync='true' column_boxshadow_color='' column_boxshadow_width='10' background='bg_color' background_color='' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='pop-up' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='' custom_class='' aria_label='' av_uid='av-mj03w']\r\n\r\n[av_textblock size='20' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' template_class='' av_uid='av-jnw5fpmv' sc_version='1.0' admin_preview_bg='']\r\n<div class=\"flex_column av_one_half first\" style=\"text-align: left;\">\r\n<p style=\"text-align: center;\">Education on activity modification<\/p>\r\n<p style=\"text-align: center;\">Posture education<\/p>\r\n<p style=\"text-align: center;\">Core strengthening<\/p>\r\n\r\n<\/div>\r\n<div class=\"flex_column av_one_half\" style=\"text-align: left;\">\r\n<p style=\"text-align: center;\">Correcting faulty movement patterns<\/p>\r\n<p style=\"text-align: center;\">Scapular stabilization and strengthening<\/p>\r\n<p style=\"text-align: center;\">Rotator cuff strengthening<\/p>\r\n\r\n<\/div>\r\n[\/av_textblock]\r\n\r\n[\/av_three_fifth][av_one_fifth min_height='av-equal-height-column' vertical_alignment='av-align-top' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='' border_color='' radius='0px' radius_sync='true' padding='0px' padding_sync='true' column_boxshadow_color='' column_boxshadow_width='10' background='bg_color' background_color='' background_gradient_color1='' 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shadow='shadow' bottom_border='no-border-styling' bottom_border_diagonal_color='#333333' bottom_border_diagonal_direction='' bottom_border_style='' custom_arrow_bg='' id='injections' custom_class='' aria_label='' av_element_hidden_in_editor='0' av_uid='av-kgs9i427']\r\n\r\n[av_one_full first min_height='av-equal-height-column' vertical_alignment='av-align-middle' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='6' border_color='rgba(255,255,255,0.85)' radius='0px' radius_sync='true' padding='30px' padding_sync='true' column_boxshadow='aviaTBcolumn_boxshadow' column_boxshadow_color='#2d2d2d' column_boxshadow_width='10' background='bg_color' background_color='rgba(255,255,255,0.85)' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='' custom_class='' aria_label='' av_uid='av-q1cy']\r\n\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' av_uid='av-jnw5fpmv' admin_preview_bg='']\r\n<h2 style=\"text-align: left;\">Injections<\/h2>\r\n[\/av_textblock]\r\n\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' av_uid='av-jnw5fpmv' admin_preview_bg='']\r\n<p style=\"text-align: left;\"><span style=\"font-weight: 400;\">Shoulder injections are used for both diagnosis and treatment.\r\nThe substances most commonly injected are corticosteroids and hyaluronans.<\/span><\/p>\r\n[\/av_textblock]\r\n\r\n[av_hr class='custom' icon_select='no' icon='ue808' font='entypo-fontello' position='left' shadow='no-shadow' height='60' custom_border='av-border-fat' custom_width='100px' custom_margin_top='0px' custom_margin_bottom='8px' custom_border_color='#b1c52e' custom_icon_color='' id='' custom_class='' av_uid='av-jxq9gmr4' admin_preview_bg='']\r\n\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' template_class='' av_uid='av-jnw5fpmv' sc_version='1.0' admin_preview_bg='']\r\n<div class=\"flex_column av_one_half first\" style=\"text-align: left;\">\r\n<h3>Corticosteroid Injections<\/h3>\r\nThese are strong anti-inflammatory medications that help decrease swelling and inflammation. If indicated, the assessment physician will order an ultrasound-guided injection. They are often prescribed in conjunction with physical therapy to help patients have less pain with exercise and gain the mobility and strength needed to have long-term improvement of their shoulder pain. Conditions that may benefit from a corticosteroid injection include subacromial bursitis, tendinosis of the rotator cuff or biceps tendon, AC joint pathology and osteoarthritis or rheumatoid arthritis of the glenohumeral joint.<\/div>\r\n<div class=\"flex_column av_one_half\" style=\"text-align: left;\">\r\n<h3>Hyaluronic Acid (HA) Injections<\/h3>\r\nHyaluronic acid (HA) is a naturally-occurring molecule that provides lubrication and cushioning in a normal joint. When a patient has osteoarthritis, the naturally-occurring HA in the fluid of their joint becomes diluted and breaks down, causing increased inflammation and arthritic change. A HA injection can be given to reduce pain and improve joint lubrication in mild to moderate arthritis of the shoulder. The effect can last 6-12 months. There is usually a cost associated with these injections, however, most private insurance covers this treatment.<\/div>\r\n[\/av_textblock]\r\n\r\n[\/av_one_full][av_one_full first min_height='av-equal-height-column' vertical_alignment='av-align-middle' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' border='6' border_color='rgba(255,255,255,0.85)' radius='0px' radius_sync='true' padding='30px' padding_sync='true' column_boxshadow='aviaTBcolumn_boxshadow' column_boxshadow_color='#2d2d2d' column_boxshadow_width='10' background='bg_color' background_color='rgba(255,255,255,0.85)' background_gradient_color1='' background_gradient_color2='' background_gradient_direction='vertical' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' id='procedures' custom_class='' aria_label='' av_uid='av-q1cy']\r\n\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' av_uid='av-jnw5fpmv' admin_preview_bg='']\r\n<h2 style=\"text-align: left;\">Procedures<\/h2>\r\n[\/av_textblock]\r\n\r\n[av_hr class='custom' icon_select='no' icon='ue808' font='entypo-fontello' position='left' shadow='no-shadow' height='60' custom_border='av-border-fat' custom_width='100px' custom_margin_top='0px' custom_margin_bottom='8px' custom_border_color='#b1c52e' custom_icon_color='' id='' custom_class='' av_uid='av-jxq9gmr4' admin_preview_bg='']\r\n\r\n[av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' template_class='' av_uid='av-jnw5fpmv' sc_version='1.0' admin_preview_bg='']\r\n<div class=\"flex_column av_one_half first\" style=\"text-align: left;\">\r\n<h3>Arthrodilation<\/h3>\r\nFrozen shoulder, or adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. Signs and symptoms usually begin gradually and worsen over time. Without treatment, most patients\u2019 symptoms resolve in one to three years. It generally has three phases:\r\n<ol>\r\n \t<li><strong>Freezing stage<\/strong> - any movement causes pain and mobility starts to decrease.<\/li>\r\n \t<li><strong>Frozen stage<\/strong> - pain starts to decrease but the shoulder becomes stiffer, limiting mobility and function.<\/li>\r\n \t<li><strong>Thawing stage<\/strong> - the shoulder\u2019s range of motion begins to improve.<\/li>\r\n<\/ol>\r\nArthrodilation is a non-surgical intervention done by a radiologist. The radiologist injects the joint with a mixture of sterile saline, local anaesthetic and steroid. This injection stretches the joint capsule to help improve the range of motion of the shoulder joint and decrease pain in the shoulder. It is important that your patient follows up with physical therapy immediately after the procedure. Performing range of motion exercises consistently and frequently is very important for their recovery after this procedure.<\/div>\r\n<div class=\"flex_column av_one_half\" style=\"text-align: left;\">\r\n<h3>Barbotage<\/h3>\r\nCalcific tendinitis of the shoulder is caused by the deposit of calcium hydroxyapatite crystals most often inside or around the tendons of the rotator cuff. Barbotage is a procedure done under local anaesthetic. A radiologist uses an ultrasound-guided needle to break up the calcium deposits so they can be absorbed by the body. In some cases, saline fluid is injected to flush the area of the calcium particles.<\/div>\r\n[\/av_textblock]\r\n\r\n[\/av_one_full][\/av_section]\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":670,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/edmontonboneandjoint.ca\/wp-json\/wp\/v2\/pages\/1331"}],"collection":[{"href":"https:\/\/edmontonboneandjoint.ca\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/edmontonboneandjoint.ca\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/edmontonboneandjoint.ca\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/edmontonboneandjoint.ca\/wp-json\/wp\/v2\/comments?post=1331"}],"version-history":[{"count":0,"href":"https:\/\/edmontonboneandjoint.ca\/wp-json\/wp\/v2\/pages\/1331\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/edmontonboneandjoint.ca\/wp-json\/wp\/v2\/pages\/670"}],"wp:attachment":[{"href":"https:\/\/edmontonboneandjoint.ca\/wp-json\/wp\/v2\/media?parent=1331"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}