Treatment

Medical

Most health care providers start treatment with medications in an effort to reduce both acute and chronic types of pain. Many physicians will prescribe NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), such as naproxen (Aleve) or ibuprofen (Advil). These medications are not recommended for people with gastric ulcers or kidney disease.  

Opiates include hydrocodone and oxycodone. These medications are available in combination with acetaminophen. These medications may also cause sedation and should not be used while operating a car or other machinery. Opiate analgesics are Schedule II controlled substances, meaning they have a significant potential for abuse and that the federal government regulates how they are distributed. 

Tramadol has some features that are similar in action to opiates. This medication is not a controlled substance, but is considered to have abuse potential. Common side effects include dizziness, nausea, and somnolence. 

Depending on the cause of pain, injection of local anesthetic and steroid directly to the problem area may be appropriate. For impingement, the needle is directed toward a fluid- filled cushion called the subacromial bursa in the space under the acromion. Rotator cuff tears may also be injected in the subacromial space. Because there is some concern that steroid may weaken intact tendons, rotator cuff tears are usually injected no more than twice. Often injections are provided to reduce pain with exercises in physical therapy. Injection of the AC joint is relatively simple and may provide short-term relief. Injections to the glenohumeral joint may be provided for glenohumeral arthritis and adhesive capsulitis. These are technically more difficult injections and as a result, are often performed under fluoroscopic (x-ray) or ultrasound guidance.