Solving Chronic Shoulder Pain
If you are managing long term shoulder pain, there are a number of strategies that can help.
Diagnosing the problem - Sessions 1-2
Many clients are seeking solutions for difficult to treat shoulder and neck pain, often between one to 10 years of complaint, sometimes as long as 20 years.
Common pain patterns exist in the majority of patients presenting with chronic pain in the shoulder and neck region.
A careful history is taken, followed by an in-depth shoulder and spinal examination. For complex cases, a second appointment can be needed before confirming the diagnosis(es) and beginning the recovery. Subtle, yet persistent complaints, can require deeper investigation, including imaging and injection testing.
Persistent shoulder pain is often due to misdiagnosis, poor treatment strategy or complex muscle or joint dysfunction - sometimes associated with inflammatory or instability components. Examples might be undiagnosed calcific tendinopathy, PMR or cervical somatic referral. More complex complaints may include multiple pathologies, cervico-thoracic dysfunctions and difficult to image or subtle complaints in athletic populations.
Building the foundation - Sessions 3-4
A foundation for recovery is normally required to solve complex long term shoulder and spinal pain. It may take several weeks before the effects of treatment are felt. Effective strategies often include a combination of technical exercise, manual therapy and strengthening. Further support may be necessary to solve your concern, with guidance offered towards recommended imaging and treatment options including medical or surgical services.
Some chronic pain complaints can settle in just a few weeks, often with manual therapy techniques directed at the primary problem. If your pain does not improve, or you've had similar or many approaches in the past, a more comprehensive strategy for your recovery is necessary.
Improvements normally begin within 1-4 weeks for most patients, and 4-6 weeks for difficult pain complaints. For patients able to maintain this process, we witness the majority of patients reporting close to full recovery at 8-10 weeks of continuous therapy.
Stand alone massage therapy, machinery (EPAs), assistive braces / tapes, needling or traditional injection techniques typically have limited effect in solving long term shoulder complaints.
Strategies that work - Sessions 5-8
Developing a pace and strategy specifically for your problem is key.
Recovery times can differ based on your current fitness and your level of pain. An understanding of exercise and correct exercise training are generally beneficial for recovery (and will be taught in physio).
What are the key components of recovery ? Technical exercise training is vital and often takes several weeks and up to two months for some clients. This normally involves learning and mastering spinal movement concepts, flexibility techniques and scapular retraining. A combination of manual techniques are also used including massage, osteopathic and physiotherapy techniques.
All treatment is customized to your needs and each step of the way is explained through your recovery at a pace that fits your needs.
The Twin Circles Concept - Sessions 9-12
Many patients that have been through a complete chronic pain recovery process will understand the 'twin circles' concept.
As you continue to see improvement in your symptoms and complaint, there can be a short term return of symptoms after completing your first cycle of recovery. This will be explained during your treatment should you notice this effect. Difficult or persistent problems will require a progressive, but shorter secondary cycle of treatment, allowing for full resolution of your complaint.
There are no guarantees in medicine, but patient success rates are above 95% full recovery over the last 10 years of practice.
