Shoulder pain treatment often involves reducing inflammation, the body’s natural response to injury. Common causes include bursitis (swelling of the fluid-filled sac near the joint) or tendonitis (inflammation of the shoulder tendons). Since the source and severity of inflammation vary widely, the most effective anti-inflammatory approach is specific to the individual’s condition and health profile. No single medication is universally “best,” as treatment requires weighing potency against potential side effects and the depth of the affected tissue.
Common Over-the-Counter Oral Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are the most accessible oral option for reducing mild to moderate shoulder pain and inflammation. These medications work by interfering with the body’s inflammatory cascade. Specifically, NSAIDs inhibit cyclooxygenase (COX) enzymes, which are responsible for creating prostaglandins.
Prostaglandins are lipid compounds that promote inflammation, pain, and fever. By blocking their production, NSAIDs reduce swelling and alleviate discomfort throughout the body, providing systemic relief. For instance, the over-the-counter maximum daily dose for ibuprofen is typically 1,200 milligrams, while naproxen sodium is often limited to 660 milligrams.
While effective, oral NSAIDs carry significant safety considerations, especially with prolonged use. The most well-known risk is gastrointestinal irritation, ranging from stomach upset to ulcers and bleeding. Furthermore, these drugs can affect kidney function and may increase the risk of cardiovascular events, such as heart attack or stroke, particularly in individuals with pre-existing conditions.
Because of these systemic risks, use the lowest effective dose for the shortest duration necessary. Individuals with a history of stomach problems, kidney disease, or heart conditions should consult a healthcare provider before starting oral NSAIDs. These medications offer a broad anti-inflammatory effect but require careful monitoring to balance the benefit against potential adverse effects.
Targeted Topical Relief Options
Topical anti-inflammatory treatments deliver medication directly to the site of pain, targeting shoulder inflammation more precisely. The most common topical anti-inflammatory is diclofenac, an NSAID formulated into gels or patches. This application allows the drug to penetrate the skin and reach underlying superficial joint tissues, such as tendons and bursa.
A primary advantage of topical NSAIDs is the significant reduction in systemic absorption compared to oral pills. Less than 5% of the medication may enter the bloodstream, substantially lowering the risk of gastrointestinal, kidney, and cardiovascular side effects. Studies suggest that topical diclofenac can be as effective as its oral counterpart for managing pain in superficial joints, though it may be less potent for deeper joint inflammation.
It is important to distinguish anti-inflammatory topicals from purely analgesic options like lidocaine patches. Lidocaine is a local anesthetic that temporarily blocks the electrical signals of pain nerves in the skin and underlying tissues. Lidocaine does not possess anti-inflammatory properties; instead, it provides pain relief by interrupting the pain signal transmission.
Topical NSAIDs are most beneficial for localized conditions like tendonitis or bursitis where the inflamed tissue is close to the skin surface. Common side effects are generally limited to the application site, including local reactions such as dry skin, itching, or rash. Topical application provides a strong alternative for individuals who cannot tolerate the systemic side effects of oral anti-inflammatory drugs.
When Prescription Treatment is Necessary
When over-the-counter medications and topical applications fail to control severe or persistent shoulder inflammation, stronger prescription treatments become necessary. A physician might prescribe a higher dose of an oral NSAID or a different class of anti-inflammatory medication. For many moderate-to-severe shoulder conditions, local steroid injections are often considered.
Corticosteroid injections, commonly called cortisone shots, deliver a powerful anti-inflammatory compound directly into the inflamed area, such as the subacromial bursa or joint space. Corticosteroids mimic hormones naturally produced by the adrenal glands, potently suppressing the immune response that drives inflammation. This action limits capillary dilation and reduces the accumulation of inflammatory cells in the tissue.
The localized, high concentration of medication provides a rapid and significant reduction in swelling and pain. This strong anti-inflammatory effect offers a therapeutic window for the patient to begin physical therapy and regain motion. Due to the potency and potential for side effects, such as tendon weakening or tissue damage with repeated use, these injections are limited in frequency and must be administered under professional medical guidance.
Prescription-strength options are not a first-line defense but are reserved for professionally diagnosed cases that do not respond to conservative management. Consulting a healthcare provider is essential to determine if the shoulder pain is due to inflammation that will respond to a steroid injection or if it stems from a structural issue requiring a different intervention.
Anti-Inflammatory Strategies Without Medication
Managing shoulder inflammation involves several non-pharmacological methods crucial for recovery and long-term joint health. The RICE principle—Rest, Ice, Compression, and Elevation—is a standard initial approach for acute injuries. Applying ice to the shoulder for 15 to 20 minutes several times a day helps reduce acute inflammation by constricting blood vessels, limiting swelling and numbing the area.
Resting the joint by avoiding activities that cause pain prevents further irritation of the inflamed tendons or bursa. While compression and elevation are less practical for the shoulder than for an extremity, modifying activities to reduce strain remains a fundamental step. These physical strategies slow the inflammatory process and protect the injured tissues.
Dietary choices also support modulating the body’s inflammatory status. Incorporating foods rich in omega-3 fatty acids, such as salmon, flaxseeds, and walnuts, helps because these compounds possess natural anti-inflammatory properties. Conversely, reducing the intake of processed foods, refined sugars, and excessive saturated fats is beneficial, as these components promote systemic inflammation.
Spices like turmeric (which contains the active compound curcumin) and ginger are also known to support the body’s anti-inflammatory pathways. A holistic approach combining targeted physical strategies with a supportive diet provides a foundation for reducing inflammation and promoting tissue repair.