Which is better for treating shoulder pain: heat or ice?

Post In: heat or ice
Which is better for treating shoulder pain: heat or ice?

Tendons are bands of fibrous tissue that connect the muscles to the bones and they help muscles initiate and control movement in the joints. Tendonitis (or tendinitis) is usually caused by repetitive motions, stress or repeat injuries which irritate the tendon over time. The result is pain and inflammation in the tendons in jointed areas such as the ankle, elbow or shoulder. Tendons become less flexible with age, so tendonitis is more common as one gets older.

Rotator cuff tendonitis is the most common cause of shoulder pain. The earliest symptom of rotator cuff tendonitis is a dull ache around the outside tip of the shoulder which gets worse when one pushes, pulls, reaches overhead or lifts an arm up to the side. Lying or rolling onto the affected shoulder as you sleep also hurts, and the pain may wake you at night. The pain may also become worse and spread throughout the entire shoulder.

Simple activities that make use of the arms, such as sports, gardening, lifting and sorting objects or even getting dressed are some of the movements made possible by the shoulder’s enormous range of motion. We depend so much on the shoulder’s mobility in so many activities that when the shoulder hurts, it can be disabling. For athletes, sports injuries are the main source of trouble. Regular people, on the other hand, have to be cautious with the wear and tear that weakens shoulder tissues over time and leaves them vulnerable to injury. Carpenters, painters, tennis players or baseball players have the greatest risk as their occupation or hobbies require repetitive or overhead movements.

If nothing is done about it, tendonitis can lead to the fraying or tearing of tendon tissue. Fortunately, rotator cuff tendonitis and muscle tears can usually be treated without surgery. The best way to treat this type of tendonitis is with simple home remedies.

Treatment for tendonitis

The minimum recovery time for rotator cuff tendonitis or a small tear is usually two to four weeks, with some cases taking several months. At the onset of the injury, the aim is to reduce swelling of the tendons and relieve compression in the subacromial space of the shoulder (or the space between the top of the arm bone and the acromion, or part of the shoulder blade). Later, exercises can be done to strengthen the muscles and improve range of motion.

The best way to treat shoulder tendonitis is through cold therapy. During the first few days of rotator cuff tendonitis, apply an ice pack to the shoulder for 15 to 20 minutes every four to six hours. If you are still experiencing pain, you may also take a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen. 

After the first three days of ice therapy, you may apply heat for chronic tendonitis pain. Heat increases blood flow to an injury, which promotes healing and pain relief.

You should avoid lifting heavy objects or reaching out, up or overhead as much as possible. However, you do not stop moving your shoulder altogether, because that can lead to “frozen shoulder,” a condition in which the tissues around the shoulder shrink and reduce its range of motion. Exercises such as the weighted pendulum reduce pressure on the rotator cuff by

widening the space for the tendons to pass through. As your shoulder’s condition improves, reinforce it with physical therapy that includes stretching and muscle-strengthening exercises. A physical therapist can help you with more exercises, some of which you can also do on your own. However, if you develop a sharp or severe pain in your shoulder again, stop from doing any exercise for a few days.

Before doing your exercises, warm up the muscles and tendons in a warm shower or with a heating pad. If you experience some mild soreness with muscle-toning exercises, applying ice to the shoulder should help relieve it. We recommend using a shoulder strap with an ice pack when icing your shoulder.

Ice massages for tendonitis

Ice massages are the best home remedy techniques for treating and relieving tendonitis pain. Therapists recommend for ice massages to be performed two to four times a day, especially after a long workday. You may also perform ice massages before work, at lunch or mid-shift or before bed if the pain and inflammation is severe and causes you to wake up at night.

There are two ice massaging methods. The first method is to use an ice cup. You can make one yourself by filling up a styrofoam cup with water and putting this in the freezer to freeze. Tearing off the top edges of the cup and rubbing the ice directly over the area of pain for two to four minutes until the body part is numb. The second method is simply using ice cubes directly from the freezer, wrapping them with a cloth or towel and massaging the impacted area with the makeshift ice pack. You may perform this same technique until that body part starts to feel numb.

With ice, you’ll feel the following progression of symptoms: first, it will feel cold and painful, then it will burn, ache and then turn numb. When the part of your body that you are icing is numb, you have completed the ice massage and your shoulder, elbows, wrists or thumbs will thank you.

Typically after three to seven days of performing ice massage two to four times each day, you should notice improvement as your shoulders regain ease with different ranges of motion. Your ability to do daily activities at work, home and play will improve, and you should see a significant reduction of pain with improved sleep, as well.

In addition to ice massages, you can also prevent and treat tendonitis by:

  1. Improving your posture habits (head up and shoulders back).
  2. Stretching your hips, chest and trunk two to three times throughout the workday.
  3. Drinking 40+ ounces of water, working towards half of your body weight in ounces.
  4. Quitting smoking or the use of tobacco products as they slow your body’s healing process.
  5. Improving the muscle strength of your abdominals, upper back postural muscles and rotator cuff muscles.

Got a question or anything I can help with?  My name is Steve Stretton, and I’m the owner and manager at Gelpacks.com. You can drop me a line here. Good luck!


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