Shoulder pain treatment Chandler: what to consider

What to try before a procedure

Cut back the reach, lift, or swing that keeps bringing the soreness back. Don’t quit all movement. Comfortable motion helps keep the joint from growing stiffer. With physical therapy, you’ll learn to lift the arm while its shoulder blade moves smoothly, then build strength without forcing the movement. There isn’t one exercise that suits every shoulder. If you hurt more the next day, you’ve likely done too much.

The next morning won’t lie about overdoing it.

What to ask about medicine and cortisone

Pain medicine can’t be chosen without considering your other health needs. Before taking it, speak with a doctor or pharmacist who knows about your bleeding risks and any trouble with your heart, kidneys, or stomach. Cortisone may ease some shoulder problems for several weeks. In one large study, people given cortisone weren’t doing better after a year than those who didn’t get it. Repeated use can also matter when surgery may be ahead, so ask about timing and risk.

Brief relief may still help, but it won’t answer every need.

What to know before choosing PRP or surgery

PRP means platelet-rich plasma, made by drawing some of your blood and spinning it so platelets gather in the part used for care. That prepared part is placed in the sore shoulder with a needle. Some reviews found a small benefit over cortisone after several months. Others didn’t find a clear benefit that patients would notice. Ask about total cost, return visits, and what comes next if it doesn’t help. Surgery may come up after a sudden tear with weakness or for severe arthritis.

QC Kinetix offers non-surgical regenerative treatments made from prepared blood through medical providers, the people who assess your shoulder and carry out the procedure; since the title doesn’t say whether yours is a doctor, ask.

Sources

1. The August 2025 AAOS Evidence-Based Clinical Practice Guideline on Management of Rotator Cuff Injuries issued 25 recommendations and 4 consensus statements. Among its updates it clearly RESTRICTS the use of platelet-rich plasma and marrow stimulation in rotator cuff repair, limits prolotherapy in full-thickness tears, establishes CT as an adjunctive imaging modality, and endorses early mobilization after repair of small-to-medium tears.

   Ye Y, et al. — [Interpretation of the 2025 American Academy of Orthopaedic Surgeons (AAOS) on Management of Rotator Cuff Injuries Evidence-Based Clinical Practice Guideline].. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi, 2026. DOI: 10.7507/1002-1892.202511084.

2. In the MOON Shoulder prospective cohort of 452 patients with symptomatic, ATRAUMATIC full-thickness rotator cuff tears, physical therapy succeeded in more than 70% of patients at 10 years: only 115 (27.0%) had surgery at any point over the decade. Patient-reported outcomes improved with physical therapy and did NOT decline over 10 years in those who never had surgery. The strongest predictor of early surgery was low patient expectation of physical therapy, not tear anatomy.

   Kuhn JE, et al. — The Predictors of Surgery for Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears Change Over Time: Ten-Year Outcomes of the MOON Shoulder Prospective Cohort.. J Bone Joint Surg Am, 2024. DOI: 10.2106/JBJS.23.00978.

3. The GRASP trial randomized 708 adults with a rotator cuff disorder to progressive exercise (up to 6 sessions), a single best-practice advice session, or either of those preceded by a corticosteroid injection. Over 12 months there was no evidence of a difference in Shoulder Pain and Disability Index between progressive exercise and one advice session (adjusted mean difference -0.66, 99% CI -4.52 to 3.20), and no evidence of a difference between having a corticosteroid injection and not having one.

   Hopewell S, et al. — Progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of patients with rotator cuff disorders (GRASP): a multicentre, pragmatic, 2 × 2 factorial, randomised controlled trial.. Lancet, 2021. DOI: 10.1016/S0140-6736(21)00846-1.

4. UK FROST randomized 503 adults with primary frozen shoulder to manipulation under anaesthesia, arthroscopic capsular release, or early structured physiotherapy with steroid injection. At 12 months every between-group difference on the Oxford Shoulder Score was smaller than the target difference, so NONE of the three was clinically superior. Capsular release carried the most serious adverse events (8 versus 2 with manipulation), and manipulation under anaesthesia was the most cost-effective.

   Rangan A, et al. — Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, three-arm, superiority randomised clinical trial.. Lancet, 2020. DOI: 10.1016/S0140-6736(20)31965-6.

5. A current-concepts review of non-operative management of shoulder osteoarthritis states plainly that biologics such as PRP, bone marrow aspirate concentrate and mesenchymal stem cells 'are helpful in decreasing shoulder pain but neither stopping the progression nor improving OA', and that first-line care is physical therapy with NSAIDs.

   Yamamoto N, et al. — Non-operative management of shoulder osteoarthritis: Current concepts.. J ISAKOS, 2023. DOI: 10.1016/j.jisako.2023.06.002.

6. At 10 years, arthroscopic subacromial decompression offered NO benefit over placebo surgery for subacromial pain syndrome: the mean difference in VAS pain was -1.5 points (95% CI -8.6 to 5.6) at rest and -3.2 points (-13.0 to 6.5) on arm activity, against a minimally important difference of 15. It also showed no benefit over exercise therapy.

   Kanto K, et al. — Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome: 10 year follow-up of the FIMPACT randomised, placebo surgery controlled trial.. BMJ, 2025. DOI: 10.1136/bmj-2025-086201.

7. A JBJS review of orthobiologics for glenohumeral osteoarthritis notes the glenohumeral joint ranks third after knee and hip for osteoarthritis, that standard non-surgical options have shown only moderate and short-term effectiveness, and that despite promising early results for PRP and cell therapies, ADDITIONAL STUDIES are needed before definitive conclusions can be drawn.

   Rossi LA, et al. — Glenohumeral Osteoarthritis: The Role for Orthobiologic Therapies: Platelet-Rich Plasma and Cell Therapies.. JBJS Rev, 2020. DOI: 10.2106/JBJS.RVW.19.00075.

8. A systematic review of seven case series (469 reverse total shoulder arthroplasties, mean age 71, mean 12-year follow-up) found weighted mean revision-free implant survivorship of 88% at 10 years, an overall complication rate of 36% and revision in 23% of patients - most often for infection (8%), instability (7%) and glenoid complications (3%) - alongside large functional gains (absolute Constant score 27 to 62).

   Biner M, et al. — Long-Term Outcomes Following Reverse Total Shoulder Arthroplasty: A Systematic Review with a Minimum Follow-Up of 10 Years.. JB JS Open Access, 2025. DOI: 10.2106/JBJS.OA.25.00025.

9. A systematic review of 87 studies of extra-articular (soft tissue) corticosteroid injection found major adverse events in 0-5.8% and minor adverse events in 0-81% of patients depending on the study. Reported major events included osteomyelitis, cellulitis, tendon ruptures, skin atrophy and hypopigmentation, and one fatal necrotizing fasciitis; increased pain or steroid flare after injection was reported in 19 studies.

   Brinks A, et al. — Adverse effects of extra-articular corticosteroid injections: a systematic review.. BMC Musculoskelet Disord, 2010. DOI: 10.1186/1471-2474-11-206.

10. Among 88 patients presenting with adhesive capsulitis and no reported history of diabetes, blood testing found diabetes in 38.6% and prediabetes in 33.0% - a total of 71.5% with a diabetic condition, including 2% newly diagnosed diabetes and 28.4% newly diagnosed prediabetes.

    Tighe CB, et al. — The prevalence of a diabetic condition and adhesive capsulitis of the shoulder.. South Med J, 2008. DOI: 10.1097/SMJ.0b013e3181705d39.

11. A meta-analysis of eight randomized trials of PRP for rotator cuff tendinopathy concluded PRP was a safe and effective intervention for long-term pain control and shoulder function - but the review itself records that PRP preparation and injection technique varied between studies and that the control interventions differed (saline in four trials, rehabilitation or dry needling in the other four), which is why its conclusion sits alongside more cautious reviews rather than settling the question.

    A Hamid MS, et al. — Platelet-rich plasma for rotator cuff tendinopathy: A systematic review and meta-analysis.. PLoS One, 2021. DOI: 10.1371/journal.pone.0251111.

12. A network meta-analysis of randomized trials found double-row repair combined with platelet-rich plasma optimized retear rates after small-to-medium full-thickness rotator cuff repair - a result about SURGICAL TECHNIQUE plus augmentation, which is a different question from whether an injection of PRP helps an unoperated shoulder.

    Lavoie-Gagne O, et al. — Double-Row Repair With Platelet-Rich Plasma Optimizes Retear Rates After Small to Medium Full-Thickness Rotator Cuff Repair: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.. Arthroscopy, 2022. DOI: 10.1016/j.arthro.2022.03.014.