Abstract
Chronic shoulder pain is costly and painful, affecting between 18-22% of the United States population. There are very few treatments and many gaps in the care continuum for these patients. The opportunity to delay and often prevent surgical interventions, permanent implants, and/or neurolytic procedures is a tremendous benefit while evading the addictive challenges presented by opioids. In normal bodily function, sensory and motor signals are coordinated to balance the central nervous system. After musculoskeletal diseases or trauma occur, peripheral pain signals activate protective mechanisms including arthrogenic inhibition, which reduces activity to protect and assist with recovery. After extended periods of inactivity, normal proprioceptive information to the cortex is diminished and central sensitization may play a larger role in refractory pain states.
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