ROSH Geriatrics Practice Test

The most appropriate initial treatment for a patient experiencing right shoulder pain and stiffness is physical therapy with gentle range of motion exercises. This approach is beneficial because it helps to restore flexibility and reduce stiffness in the shoulder joint, which is essential for pain relief and functional recovery. Gentle range of motion exercises can also promote blood flow to the area, encouraging healing and decreasing discomfort associated with immobility. Immobilization with a shoulder sling may seem intuitively beneficial to protect the joint, but it can lead to increased stiffness if maintained for too long, which is counterproductive for a condition that often involves restricted mobility. Shoulder arthroscopy with lysis of adhesions or rotator cuff repair are more invasive interventions typically reserved for specific cases, such as when conservative treatments have failed or when there is significant structural damage. These options are not appropriate as first-line treatments, especially when the symptoms are mainly stiffness and pain that may respond well to non-invasive measures like physical therapy. By starting with physical therapy, patients often experience improvement without the risks associated with surgical procedures, making it a sound first choice in managing shoulder pain and stiffness.