Shoulder Pain Treatment Options for Adults and Elderly
Shoulder pain is a common complaint that can limit everyday activities such as dressing, reaching, or carrying items. Causes range from overuse and tendon irritation to arthritis and rotator cuff injury; the pattern of symptoms and the person’s age influence how providers evaluate and manage the problem. Understanding common causes, assessment steps, conservative treatments, and when more invasive options are considered can help adults and elderly patients and caregivers make informed decisions about care and local services.
This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.
What causes shoulder pain?
Shoulder pain can arise from the joint itself, surrounding tendons and muscles, or referred pain from the neck. Common causes include rotator cuff tendinopathy and tears, bursitis, adhesive capsulitis (frozen shoulder), and degenerative changes in the joint. Acute injuries such as falls can cause fractures or dislocations, and systemic conditions like inflammatory arthritis or infection are less common but important to consider. A clear history of symptom onset, activities that aggravate the pain, and any neurological signs can help narrow the likely cause.
How is shoulder pain assessed in the elderly?
Evaluation in elderly patients emphasizes safety and function alongside diagnosis. Clinicians begin with a focused history and physical exam to evaluate range of motion, strength, and specific tests that reproduce pain. Assessment often includes screening for red flags such as fever, sudden severe pain, or signs of neurologic compromise. Imaging may begin with plain X-rays to assess bone alignment and arthritis; ultrasound or MRI can visualize soft tissues like the rotator cuff. Medication interactions, bone density, and overall mobility are considered when planning treatment for older adults.
Non-surgical treatment approaches
Most shoulder pain is initially managed conservatively. Recommended options include activity modification, structured home exercises or supervised physical therapy to restore range of motion and strengthen shoulder stabilizers, and short-term use of analgesics such as acetaminophen or nonsteroidal anti-inflammatory drugs if appropriate for the patient. Ice or heat and education about pacing activities can reduce flare-ups. For focal tendon inflammation, a guided corticosteroid injection may provide temporary relief when combined with rehabilitation. Treatment selection should account for comorbidities, fall risk, and medication tolerability.
Managing arthritis-related shoulder pain
Arthritis of the shoulder—osteoarthritis or inflammatory types—typically causes joint stiffness and aching pain, often worse with certain movements or at night. Management focuses on reducing pain and preserving function: structured exercise programs to maintain range of motion, weight management when applicable, and joint-protecting activity modifications. Oral pain relievers or topical agents may be used, and intra-articular corticosteroid injections can be considered for short-term symptom control. In advanced cases where pain and functional loss persist despite conservative care, referral to orthopedic services may be appropriate to discuss surgical options based on overall health and goals.
When rotator cuff problems need intervention
Rotator cuff tendinopathy and tears are frequent contributors to shoulder pain, particularly in middle-aged and older adults. Small tears and tendinopathy often improve with physical therapy focused on rotator cuff and scapular stabilizer strengthening combined with activity modification. Persistent, large, or function-limiting tears may prompt referral for imaging and specialist consultation; for some patients, arthroscopic or open repair is an option, while others may benefit from tendon debridement, subacromial decompression, or reverse shoulder arthroplasty depending on tear size, muscle quality, and shoulder arthritis. Decisions weigh surgical risk, expected recovery, and the patient’s goals.
Conclusion
Effective shoulder pain treatment begins with an accurate assessment to identify the source of pain and factors that influence recovery, especially in elderly patients where comorbidities and functional status shape options. Most cases respond to conservative measures such as exercise-based rehabilitation, activity adjustments, and targeted medications or injections. When symptoms are severe, progressive, or materially limit independence despite appropriate non-surgical care, referral to specialty services helps clarify whether procedural or surgical options are warranted. Care plans should be individualized, balancing potential benefits, risks, and the patient’s priorities.
