Wien Med Wochenschr. 1996 ; 146(6-7): 138-42.

[Conservative therapy of shoulder pain]

Tilscher H.

Ludwig Boltzman-Institut, Orthop�dischen Spitals Wien-Speising.

Prerequisite to conservative therapy for shoulder pain is the diagnosis. Along with the topical diagnosis (omarthralgia) the structure analysis aims to identify the site and manner of disturbed structure. Destroyed structures are, in most cases, an indication for anatomical reconstruction, and disturbed structures an indication for conservative methods. Hereby acute symptoms require pain stimulus pacification and chronic symptoms target-specific irritant application. With disorders of the muscles their insertions and the gliding tissue, and in addition to physical methods such as thermotherapy and electrotherapy, the so-called needle treatments (local anesthesia, combination with corticoids, needling, and acupuncture) are to be mentioned. Manual therapeutic methods will also be discussed. With disturbances of the joint function use of intra-articular injections is to be considered, with movement restriction the mobilisation techniques of chirotherapy. Physiotherapy exercises are of particular importance here.