Acute (recent or fresh) injury to the shoulder is treated initially by controlling the pain and swelling. Use of a sling during this time is often helpful to protect and support the injured shoulder but is often symptom driven. Unless one is instructed otherwise, as in the case of a fracture, suspected fracture or dislocation, use the sling for comfort only.
Ice is applied for 20 minutes on and 20 minutes off throughout most of the day for the first 2-3 days. After that time, it is OK to switch to heat. Get in a hot shower and begin some simple pendulum exercises by letting the arm fall away from the body and make big circles with the arm. Do not do this if you are still unsure and there might be a fracture.
During this time, the use of an anti-inflammatory medication is also helpful but not essential. Motrin (Ibuprofen and Advil are the same) in doses of 600 mg 3 times a day for about 5-7 days is the suggested dose. Those with aspirin allergy, severe asthma, and ulcers, bleeding disorders or those who take blood thinners (such as Coumadin or Plavix) should not take these medications. Any stomach upset during this time is also a reason to stop these medicines immediately.
An MRI test may be ordered to further evaluate the extent of injury to the soft tissues which cannot be seen on x-rays. Often physical therapy is helpful to restore motion, strength and function. Return to work, school and sports will be determined on an individual basis depending on severity of injury and type of activity.
