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I've had chronic shoulder pain from wear and tear of the rotator cuff. I really want to avoid surgery. I've tried rest, antiinflammatory drugs, and exercise with only mild improvement. Is there anything else out there that could help?

Scientists at the Orthopaedic Research Institute in Australia tried nitroglycerin (GTN)patches with patients who had chronic shoulder pain. They had good results. There was less shoulder pain at rest and with activity. Even pain at night was better. Range of motion was much better, too. In fact, muscle testing showed increased strength after a six-month trial.

You may think there was a placebo effect with these patches. In other words, just putting a patch on someone's shoulder makes them feel better. In this study they compared two groups of shoulder pain patients. All patients got a shoulder patch. Some had medication on it while others just got a plain patch.

The patients with the GTN patches had twice as much improvement in all areas. It should be noted that all patients did a home program of exercises, too. The authors suggested using the patches along with exercise might be the best approach. Talk with your doctor about this idea for treatment.

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