Initial treatment of superior labrum anterior and posterior (SLAP) tears includes non-surgical methods that alleviate pain and regain optimal shoulder function.

The objective is to relieve discomfort, improve mobility, and enhance the stability of the shoulder joint.

Pain-Relieving Medication

Over-the-counter medications, including acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen, are typically used for alleviating pain associated with labral tears.

If over-the-counter medications fail to relieve pain, prescription medications, such as tramadol, are recommended.

Physical Therapy

One of the mainstays of the treatment of SLAP tears is physical therapy.

The goals of physical therapy for SLAP tear injuries include:

  • Improving strength and mobility of the rotator cuff, chest, and shoulder blade muscles 
  • Ensuring smooth movement of the shoulder blade and the ball and socket shoulder joint

If engaging in physical therapy is too painful, doctors recommend corticosteroid injections into the shoulder joint to reduce pain and inflammation before commencing the exercise program.

Studies suggest that physical therapy is as effective as surgical procedures in the management of SLAP tears, especially in recreational athletes.

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Home Remedies 

Natural therapies complement physical therapy and accelerate the healing of the labrum cartilage. These remedies include:

  • Resting and avoiding overhead activities prevents aggravating the injury
  • Immobilizing the shoulder using a sling or brace to limit motion in the injured arm reduces pain and facilitates faster healing
  • Modifying daily activities to reduce stress on the affected shoulder, such as avoiding lifting heavy objects or modifying the workstation, prevents exacerbation of the injury
  • Applying ice packs to the shoulder for 15-20 minutes 2-3 times per day to reduce pain and swelling

Additionally, obtaining adequate sleep, consuming a balanced diet, and staying hydrated support the overall healing of the shoulder’s soft tissues.

Injection Treatments 

While not a definitive cure, injections offer a minimally invasive approach to alleviate SLAP tear pain and potentially promote labral healing.Injections provide an alternative for individuals who prefer to avoid surgery.

Injections for SLAP tears work in one of two ways: 

  • Relieve inflammation and pain
  • Promote healing through the regeneration of tissues

Most patients receive a series of injections over a specific period of time.

Steroid injections

A mixture of anesthetic medication (such as lidocaine) and steroids are injected into the shoulder joint.

A study involving 46 middle-aged patients with SLAP tears, all of whom received a corticosteroid injection in the shoulder joint in conjunction with physical therapy, found :

  • All patients showed an improvement in pain during the initial 2 months
  • Around 26% of patients showed recurrence of pain after 2.4 months, with about 40% showing improvement with a second corticosteroid injection

If the pain returns, a follow-up injection is sometimes prescribed after a few months.  

Potential risks associated with steroid injections include,,:

  • Temporary increase in pain
  • Transient increase in blood glucose levels
  • Increased risk of infection
  • Headache
  • Tendon rupture

Corticosteroid injections also have the potential to cause permanent skin atrophy (wrinkling or thinning of skin) or depigmentation in some individuals.

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Platelet-rich plasma (PRP) therapy 

Blood plasma enriched in platelets (a type of blood cell) contains a high concentration of growth factors to potentially stimulate the healing of degenerated labral tissue.,

PRP therapy involves injecting the patient’s own plasma enriched in platelets to accelerate the healing of musculoskeletal injuries, including injured tendons, joints, ligaments, and muscles.

Emerging evidence suggests that platelet-rich plasma therapy could be an effective option for SLAP tear injuries, but more research is needed to establish the efficacy of this treatment.

See Are PRP Injections Effective?

Surgery for SLAP tears involves removing or reattaching the damaged shoulder labrum, and/or reattaching the accompanying tear in the biceps tendon.

Dr. Terry Gemas is an orthopedic surgeon and the founder of Lakewood Orthopaedics and Sports Medicine in Dallas, TX. He specializes in sports medicine and has been in practice for more than 15 years. Dr. Gemas has treated professional athletes and currently serves as the head team physician for several Dallas-Forth Worth area high school, college, and club teams.

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