Tratamiento de la artritis del hombro: consejos y ejercicios para el dolor y la movilidad

Having a shoulder to cry on is a good thing. Having one that you want to cry about — say, because of shoulder arthritis — is anything but. 

Arthritis is characterized by normal joint-related changes that occur over time. While these changes don’t always cause symptoms, they can contribute to pain, stiffness, and reduced range of motion that make some daily activities more challenging.

Although shoulder arthritis can be difficult to live with, conservative measures, including shoulder physical therapy and activity modifications, can go a long way in managing arthritis symptoms. 

Here, learn more about arthritis in shoulder treatment — including the exercises our Hinge Health physical therapists recommend to keep your shoulders healthy and in less pain.

Movement is medicine for shoulder arthritis

Your first instinct when you hear you have shoulder arthritis may be to avoid moving your shoulder. After all, pain is often aggravated by activity, right? Wrong. Movement is actually one of the best things you can do for arthritis in shoulder treatment. 

“Our mental model is that if something — like a shoulder with arthritis — hurts when we move it, we’re probably doing more damage by moving it,” says Dylan Peterson, PT, DPT, a physical therapist at Hinge Health. “We now know that arthritis can actually become worse with too much rest. Not moving is riskier than moving in spite of some pain.” Movement is a vital part of arthritis in shoulder treatment, promoting healthy cartilage and strengthening muscles to alleviate pain.

Shoulder arthritis treatment: exercise and physical therapy

Shoulder arthritis can impact your daily activities and quality of life, but there are many ways you can manage your symptoms, reduce pain, and improve mobility. Physical therapy, including home exercise therapy, is especially helpful.

“Physical therapy is one of the most effective arthritis in shoulder treatments that we can offer," says Dr. Peterson. A physical therapist can help you learn range-of-motion exercises, as well as stretching, strengthening, and stabilization exercises. This helps you build up strength and mobility in your shoulder joint so you can maintain good shoulder function — even with arthritis. 

You can see a physical therapist in person, or use a program like Hinge Health to access a PT via telehealth/video visit.

Top exercises for shoulder arthritis 

Many types of everyday movement can help shoulder pain, but targeted exercises are especially helpful for shoulder arthritis treatment. These engage your shoulder, arm, and upper back muscles to improve strength, endurance, and range of motion. This makes it easier to lift or reach overhead.

The exercises below are generally beneficial for treating shoulder arthritis, but a physical therapist can provide more tailored exercises to suit your needs. Interested in getting a personalized exercise therapy plan? Learn more about Hinge Health’s digital physical therapy program and see if you’re eligible.

This movement targets the stabilizing muscles of your shoulder to help improve shoulder mobility and stability. To make this exercise easier, bend your elbow as you raise your arm. To make it more challenging, keep your arm straight and add a resistance band to increase tension. (Get more information on how to do a forward shoulder raise.)

This gentle exercise works the muscles of your upper back, lower neck extensor, and core to help reduce pain, tightness, and tension. Try to reach higher each time you repeat the move. (Get more information on how to do wall slides.)

This exercise strengthens the muscles in your back and shoulders to help reduce pain during everyday activities. Step closer to the door to make this move easier, or farther away to make it more challenging. (Get more information on how to do shoulder rows.)

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

More shoulder arthritis treatments

Beyond staying active, there are numerous non-invasive shoulder arthritis treatment options available that can provide significant relief. These approaches recommended by Hinge Health physical therapists aim to manage symptoms and enhance quality of life without the need for surgery.

• Gentle movements. Most types of movement are medicine for shoulder arthritis. So rather than avoiding all activities that involve shoulder movement, try carrying your groceries, opening the car door, or styling your hair with your painful shoulder, advises Dr. Peterson. This helps keep your shoulder engaged — making it a little bit stronger and more resilient to pain — without blowing past your movement sweet spot. “Remember: Nothing is off-limits forever,” says Dr. Peterson. “You may not be ready for a particular exercise right now, but you can always modify it or come back to it later.” The key is to nudge into discomfort while listening to your body and modifying activities when necessary.

• Ice and heat. Each therapy can help with shoulder arthritis. Ice can help with swelling, while heat can reduce tightness. “Try both and lean toward the one that makes you feel better,” Dr. Peterson suggests. “Often, you’ll intuitively know.”

• Over-the-counter (OTC) pain medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for shoulder pain. It’s important to make sure that you are safely able to take these medications, based on your medical history. For acute pain flares, your doctor may prescribe OTC medications in combination with other medications, such as oral corticosteroids or muscle relaxants.

  • Note: If you have rheumatoid arthritis or another form of inflammatory arthritis, your doctor should refer you to a rheumatologist. Certain medications, known as disease-modifying anti-rheumatic drugs (DMARDs), have been shown to be very effective in preventing your immune system from attacking your joints, which can reduce symptoms and disease progression. Gout, too, is usually treated with prescription medications that target inflammation and/or uric acid production.

• Injections. Corticosteroid injections and hyaluronic acid injections can help provide temporary pain relief through medication that is delivered directly into the affected joint. They are generally reserved for people who have not responded well to other treatments. Corticosteroid injections reduce inflammation. Hyaluronic acid injections, also known as viscosupplementation, lubricate the joint. Experts recommend combining injections with exercise or physical therapy. The temporary pain relief injections provide help you build strength and stability through movement, which contributes to lasting pain relief. Talk to your provider to find out if you’re a good candidate for injections.

• Alternative therapies. When used in combination with movement, some alternative therapies can help with pain management and improved joint function. Massage therapy in particular helps reduce muscle tension, improve circulation, and enhance overall relaxation. Studies show that this can help improve shoulder mobility and ease discomfort. 

How lifestyle habits affect arthritis

When dealing with shoulder arthritis, it's important to realize your lifestyle habits can affect your pain and symptoms. Managing stress, getting good sleep, and eating wholesome foods can all play a big role in how you feel.

Stress management. Managing stress is a lot easier said than done. But research suggests that reducing stress may reduce pain and help you better manage arthritis symptoms. Chronic stress can trigger the release of inflammatory chemicals, exacerbating pain and stiffness in arthritic joints. By employing techniques such as mindfulness, meditation, and deep breathing exercises — in addition to regular physical activity — you can help to lower your stress levels and improve sleep quality, mood, and overall well-being, all of which contribute to better pain coping mechanisms. 

Adequate sleep. “Anything that makes you healthier can also affect your shoulder and make it feel better,” says Dr. Peterson. This includes getting enough sleep. “If you don’t get enough sleep, you feel it all throughout your body. And poor sleep can affect your shoulder directly because it’s already primed to be more sensitive to pain,” he explains. If shoulder pain affects your sleep, try stretching before bed and adjusting your sleeping position. There’s no such thing as a “right” and “wrong” way to sleep — and you may need to experiment to find what works best for you —  but these tweaks may help:

• For back sleepers: Rest your painful arm on a folded blanket or low-lying pillow. This helps take strain off your affected shoulder. 

• For side sleepers: Lie on the side of your body without shoulder pain and use pillows to support your butt, shoulder, and arm.

• For stomach sleepers: Turn your face toward the side of your body that bothers you. Many people find that this is less likely to cause shoulder pain.

Wholesome foods. Research shows that incorporating plenty of whole foods — particularly anti-inflammatory foods — into your diet may help reduce pain related to different types of arthritis, including rheumatoid arthritis and osteoarthritis. Eat a mix of fruits, vegetables, whole grains, and healthy fats like wild-caught salmon and olive oil. By eating plenty of these anti-inflammatory foods, you can simultaneously crowd out less nutrient-dense and inflammatory foods from your diet. 

Combining treatments like exercise therapy with healthy behaviors around stress management, sleep, and diet can help your body cope with arthritis better. This can help you avoid, or at least delay, the need for more invasive treatments, like surgery. 

When to see a doctor 

Shoulder arthritis can usually be managed with movement and other conservative measures. If your symptoms are causing you concern — for instance, they begin to interfere with your ability to go about your daily activities and at-home shoulder arthritis treatment is not effective — see your doctor. They can further tailor your treatment plan or, in some cases, discuss whether you’re a good candidate for surgery.

PT tip: Practice muscle relaxation

When you have shoulder pain, it’s common to tense up. “Tensing your muscles is a protective habit and, in small doses, it can be helpful,” says Dr. Peterson. “But when you tense your muscles too often throughout the day, your neck and shoulder muscles can get stiff and sore, and put pressure on sensitive shoulder structures, causing more discomfort.” To avoid overdoing it, practice relaxing your muscles as you work and move, Dr. Peterson advises. “Check in with your body every once in a while by taking a deep breath, and relaxing the muscles around your shoulders as you exhale.” 

How Hinge Health can help you 

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.  

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Yeun, Y.-R. (2017). Effectiveness of massage therapy on the range of motion of the shoulder: a systematic review and meta-analysis. Journal of Physical Therapy Science, 29(2), 365–369. doi:10.1589/jpts.29.365

2. Marais, C., Song, Y., Ferreira, R., Aounti, S., Duflos, C., Baptista, G., & Pers, Y.-M. (2022). Evaluation of mindfulness based stress reduction in symptomatic knee or hip osteoarthritis patients: a pilot randomized controlled trial. BMC Rheumatology, 6(1). doi:10.1186/s41927-022-00277-9

3. Yilmaz, V., Umay, E., Gundogdu, I., Ozgur Karaahmet, Z., & Ozturk, A. E. (2017). Rheumatoid Arthritis: Are psychological factors effective in disease flare? European Journal of Rheumatology, 4(2), 127–132. doi:10.5152/eurjrheum.2017.16100

4. Schönenberger, K. A., Schüpfer, A.-C., Gloy, V. L., Hasler, P., Stanga, Z., Kaegi-Braun, N., & Reber, E. (2021). Effect of Anti-Inflammatory Diets on Pain in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Nutrients, 13(12), 4221. doi:10.3390/nu13124221

5. Morales-Ivorra, I., Romera-Baures, M., Roman-Viñas, B., & Serra-Majem, L. (2018). Osteoarthritis and the Mediterranean Diet: A Systematic Review. Nutrients, 10(8), 1030. doi:10.3390/nu10081030

6. Buck, A. N., Vincent, H. K., Newman, C. B., Batsis, J. A., Abbate, L. M., Huffman, K. F., Bodley, J., Vos, N., Callahan, L. F., & Shultz, S. P. (2023). Evidence-Based Dietary Practices to Improve Osteoarthritis Symptoms: An Umbrella Review. Nutrients, 15(13), 3050–3050. doi:10.3390/nu15133050

7. Shoulder Arthritis. (n.d.). Johns Hopkins Medicine. Retrieved from ​​https://www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-arthritis

8. Shoulder Arthritis. (2022, February 28). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22491-shoulder-arthritis

9. Arthritis of the Shoulder. (n.d.). Hospital for Special Surgery. Retrieved from https://www.hss.edu/condition-list_arthritis-shoulder.asp

10. Athwal, G. S. & Wiater, J. M. (2021, March). Arthritis of the Shoulder. OrthoInfo – American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-shoulder

11. Chillemi, C., & Franceschini, V. (2013). Shoulder Osteoarthritis. Arthritis, 1–7. doi:10.1155/2013/370231