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Pain Management

Shoulder Pain Treatment in Montville, NJ

Shoulder pain from the rotator cuff, a frozen shoulder or arthritis — examined properly, then treated without surgery.

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Does this sound like you?

  • Pain on the outside of the upper arm, especially reaching overhead
  • Pain lying on that side at night
  • Weakness lifting or reaching behind your back
  • Progressive loss of movement in every direction
  • Clicking or catching with certain movements

You do not need all of these, and having them does not confirm the diagnosis — that is what an examination is for. But if several look familiar, it is worth being seen.

The shoulder’s problem

The shoulder trades stability for range of motion. It moves further in more directions than any other joint in the body, and it does so because the socket is shallow and the joint is held together largely by muscle and tendon. That design is why the shoulder does what it does, and why it fails in the ways it does.

What it usually turns out to be

Rotator cuff tendinopathy or impingement. The most common shoulder complaint. Pain on the outside of the upper arm, worse reaching overhead or behind, and classically worse lying on it at night — the symptom that finally sends people to make an appointment.

Rotator cuff tears, partial or full thickness. Weakness is the giveaway, particularly if lifting the arm to the side or holding it out is difficult.

Adhesive capsulitis — frozen shoulder. The joint capsule thickens and contracts, and movement is lost in every direction, including when somebody else moves the arm for you. More common in people with diabetes or thyroid disease.

Glenohumeral or acromioclavicular arthritis, producing deep ache, stiffness and grinding.

Referred pain from the neck, which frequently masquerades as shoulder pain.

The examination

Active and passive range of motion in every direction — the single most informative part, because the gap between what you can do and what can be done for you separates a weak shoulder from a stiff one. Then strength testing of each cuff muscle, the specific impingement tests, palpation of the AC joint and the biceps tendon, an assessment of how the shoulder blade moves, and a neck screen.

Treatment

Injections to settle the inflamed structure, whether subacromial, intra-articular or into the AC joint. In a frozen shoulder, an injection during the painful phase can be the thing that makes the months tolerable and lets you keep the range you still have.

PRP in selected tendon problems, where supporting repair rather than suppressing inflammation is the goal.

Rehabilitation, which for the shoulder is not optional. Cuff strength and scapular control are what hold the joint together, and no injection substitutes for them. This is where a physician trained in Physical Medicine & Rehabilitation earns their keep: the programme is specific to the diagnosis, and it is progressed rather than handed over on a sheet.

Treatment

How shoulder pain is treated here

Which of these applies to you is decided by your examination, not by a price list. Each page says what the treatment involves and what it does not do.

Joint Injections

An injection into an irritated joint to reduce pain and inflammation — and, because the response is informative, to confirm that the joint is actually the problem.

What it involves →

PRP Injections

Platelet-rich plasma concentrated from your own blood and injected into a joint or tendon, to support repair rather than only suppress inflammation.

What it involves →

Trigger Point Injections

A fine needle into a muscle locked in spasm, to break the cycle and make rehabilitation possible. Minutes to do, and often the step that unblocks everything else.

What it involves →

Questions patients ask

How do I know if it is a rotator cuff problem or a frozen shoulder?

The distinguishing feature is passive movement. With a rotator cuff problem you struggle to lift the arm yourself, but someone else can usually move it through most of its range. With a frozen shoulder the movement is lost in every direction, including when someone else moves it for you, and external rotation goes first. They are examined differently, treated differently and take very different lengths of time.

How long does a frozen shoulder take?

Longer than anyone wants to hear — typically a year to three, through a painful freezing phase, a stiff frozen phase and a gradual thawing. That is not a reason to do nothing: treatment during the painful phase makes a substantial difference to how much of your life it takes, and maintaining range during the stiff phase affects where you end up.

Is my shoulder pain actually coming from my neck?

Sometimes. Pain that travels past the elbow, comes with pins and needles, or changes with neck movement points at the neck. Pain confined to the outside of the upper arm and provoked by specific shoulder movements points at the shoulder. Both are examined, because treating the wrong one is a common way to lose six months.

Will I need surgery for a rotator cuff tear?

Not necessarily. Many partial and even some full-thickness tears do well with rehabilitation and do not require repair, particularly in older patients. Acute traumatic tears in younger people are a different matter. This is a non-surgical practice — where a surgical opinion is warranted, you will be told and referred.

Related conditions

Neck Pain

Persistent neck pain and stiffness, including pain that refers into the shoulder, arm or head. Assessed properly before anything is injected.

Tendonitis

Tendon pain from overuse or repetitive strain — elbow, Achilles, knee, shoulder or hip — treated with loading, targeted injections and PRP where appropriate.

Arthritis

Joint pain, stiffness and swelling from osteoarthritis — managed actively rather than waited out, without surgery.

Tell us what’s going on

A consultation is a conversation and an examination, not a sales appointment. Dr. D’Alessio will tell you what she thinks is causing it, what can be done about it, and — when that is the honest answer — that you do not need a procedure.

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