{"id":10700,"date":"2026-05-01T00:34:05","date_gmt":"2026-05-01T00:34:05","guid":{"rendered":"https:\/\/www.truthforhealth.org\/?p=10700"},"modified":"2026-05-01T00:34:05","modified_gmt":"2026-05-01T00:34:05","slug":"dr-vliets-health-tip-midlife-shoulder-pain-inevitable-aging-or-fixable","status":"publish","type":"post","link":"https:\/\/www.truthforhealth.org\/es\/2026\/05\/dr-vliets-health-tip-midlife-shoulder-pain-inevitable-aging-or-fixable\/","title":{"rendered":"Dr. Vliet\u2019s Health Tip: Midlife Shoulder Pain: Inevitable Aging? or Fixable?"},"content":{"rendered":"<p><strong><em>\u00a9 by Elizabeth Lee Vliet MD and Kathy Kresnik<\/em><\/strong><\/p>\n<p>I often have patients tell me \u201cI have this shoulder pain that affects my sleep.\u00a0 Do you think I need to see an orthopedic surgeon to see if I have a torn rotator cuff, and need shoulder surgery?\u201d Whoa!\u00a0 Before you rush off to a <em>surgeon <\/em>to ask whether you need <em>surgery, <\/em>let\u2019s look at some really common causes of shoulder pain as we get older\u2026 and some simple steps you can take first to alleviate the \u201caches and pains\u201d so common in hips, knees, low back, neck and shoulder as we move past 40.<\/p>\n<p>Since I also follow these same approaches to deal with common \u201caches and pains\u201d I wanted to focus today\u2019s health tip on exploring some of the commonly overlooked causes and contributors to shoulder (and neck, low back, hip, knee) pain and give you some easy to try tips for both relief and prevention, as well as non-surgical techniques to regain mobility and stay active in midlife and beyond.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter  wp-image-10701\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" data-layzr=\"https:\/\/www.truthforhealth.org\/wp-content\/uploads\/2026\/05\/image011-831x1024.jpg\" alt=\"\" width=\"373\" height=\"761\" \/><\/p>\n<p>Did you know that most adults over the age of 40 have structural damage to or abnormalities of their shoulders? A 2026 JAMA Internal Medicine FIMAGE study of 602 adults aged 41\u201376 found that about 99% had at least one rotator cuff abnormality on 3T MRI, <strong><em>regardless of pain status<\/em><\/strong>. The abnormalities included tendon damage in about 25% of shoulders, partial\u2011thickness tendon tears in 62%, and full\u2011thickness tendon tears in 11%.\u00a0 Both prevalence and severity went up with age.\u00a0 Data from occupational and population groups show shoulder pain increasing steadily with age, worse after age 50. A 2024 <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11302932\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11302932\/&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw1kTfMgzYrwUon_-djjUM1s\">study<\/a> on older adults decline in overall shoulder strength with age also suggests age\u2011related <em>neuromuscular factors, not just <\/em>tendon structure changes.\u00a0 Clinical reviews show that degenerative rotator cuff tears and \u201cfrozen shoulder\u201d become much more common after 40, yet we can also see full\u2011thickness tears in adults over 65\u201380 that do not cause any pain and may have only minimal symptoms.<\/p>\n<p><strong>Emerging Perspectives:<\/strong><\/p>\n<ul>\n<li>For adults over 40\u201350, rotator cuff tears on MRI increasingly seem to be variants of <strong>normal<\/strong> aging changes (like gray hair).\u00a0 The current thinking is that MRI findings alone should not drive surgery decisions.<\/li>\n<li>Newer approaches emphasize <strong><em>correlating symptoms with function<\/em><\/strong> (night pain, loss of range of motion, weakness) and occupational load rather than relying on structural findings alone\u00a0to decide whether surgery is indicated.<\/li>\n<\/ul>\n<h3><strong>Beyond \u201cwear and tear:\u201d<br \/>\nOverlooked Causes of Joint Pain<\/strong><\/h3>\n<p><strong>I.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong><strong>Mitochondrial dysfunction<\/strong><\/p>\n<p><strong>Once again, we find damage to our MITOCHONDRIA is at the heart of problems we thought were \u201cjust aging!\u201d<\/strong>\u00a0 Mitochondrial dysfunction is a major contributor to joint degeneration, inflammation, and pain, particularly in osteoarthritis and inflammatory arthritis according to the latest research. For those seeking a deeper dive into this topic, I have summarized and provided a link to several studies exploring mitochondrial function in arthritis and joint pain.<br \/>\n<strong>Human joint and synovial studies<\/strong><\/p>\n<ul>\n<li>In a 2022 <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9319158\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9319158\/&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw1rk9vmXv8rMmNEv_3xSzRf\">clinical study<\/a> comparing the synovial (joint) lining from patients with osteoarthritis, rheumatoid arthritis, and non\u2011arthritic controls, there was clear mitochondrial derangements in synovial lining in osteoarthritis (OA) and rheumatoid arthritis (RA) that included impaired electron transport, higher reactive-oxygen-species (ROS), and lower ATP (cellular fuel). All of these damaging changes led to inflammatory changes contributing to joint pain and limited motion.<\/li>\n<li>A 2025 <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11865096\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11865096\/&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw3A4mfMCJ8alte4GJkSmBvx\">review<\/a> on mitochondrial metabolism in osteoarthritis showed mitochondrial dysfunction in chondrocytes promotes local inflammation, chemokine release, synovitis, and a vicious cycle of cartilage degradation, osteophyte formation, synovial lining inflammation, stiffness, and pain.<\/li>\n<\/ul>\n<p><strong>Cartilage\/OA pain and mitochondria<\/strong><\/p>\n<ul>\n<li>A 2025 Nature <a href=\"https:\/\/www.nature.com\/articles\/s41413-025-00460-x\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/www.nature.com\/articles\/s41413-025-00460-x&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw1ggKSoIbjuy8OeXCOuBtmc\">review<\/a> on mitochondrial dysfunction in OA cartilage describes how mechanical overload and oxidative stress (1) down-regulate superoxide dismutase-2 (SOD2) in chondrocytes, (2) increase mitochondrial superoxide, and (3) cause mitochondrial dysfunction leading to cartilage damage and increased joint pain.\u00a0Improving mitochondrial biogenesis and fusion reduces oxidative stress in chondrocytes and spinal cord, which in turn helps relieve OA pain in experimental models.<\/li>\n<\/ul>\n<p>\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Other <a href=\"https:\/\/www.frontiersin.org\/journals\/immunology\/articles\/10.3389\/fimmu.2021.695257\/full\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/www.frontiersin.org\/journals\/immunology\/articles\/10.3389\/fimmu.2021.695257\/full&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw1U2DZs3vcMHgeQaOD1M6yP\">work<\/a> on joint\u2011injury models proposes mitochondrial dysfunction as the link between cartilage injury and eventual post\u2011traumatic OA, and discussed new drugs being tested that function to help protect mitochondria and prevent cartilage loss to reduce pain.<br \/>\nIn the meantime, I describe below several natural supplements that have profound effects to improve mitochondrial function and reduce damage!\u00a0 You can start there with your <strong><em>\u201cmitochondrial preservation strategies!\u201d<\/em><\/strong><\/p>\n<p><strong>Pain pathways and Pain data in Rheumatoid Arthritis<\/strong><\/p>\n<ul>\n<li>An International Association for the Study of Pain (ISAP) <a href=\"https:\/\/www.iasp-pain.org\/mitochondria-and-sensory-processing-in-inflammatory-and-neuropathic-pain\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/www.iasp-pain.org\/mitochondria-and-sensory-processing-in-inflammatory-and-neuropathic-pain\/&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw01Lgf2dJAoBjrFiSV7F41_\">review<\/a> on mitochondria and sensory processing in inflammatory and neuropathic pain concludes that mitochondrial dysfunction contributes to rheumatic pain not only in joint cells but also in peripheral and central neurons.\u00a0 Improving mitochondrial function can reduce or eliminate pain in early clinical studies.<\/li>\n<\/ul>\n<p><strong>Integrating these ideas:\u00a0 <\/strong><\/p>\n<p>A 2026 <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S104366182600085X\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/www.sciencedirect.com\/science\/article\/pii\/S104366182600085X&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw2pcuFx_S66BylKyUmSjGJ2\">review<\/a>, <strong><em>\u201cMitochondrial Dysfunction as a Driver of Chronic Pain,\u201d<\/em><\/strong> argues a key point that relates to all that I am presenting in this Health Tip to help improve Shoulder and other joint pain: <strong>mitochondrial changes are <em>not just a consequence of injury<\/em>, but a <em>fundamental driver of persistent pain<\/em> across many conditions, including musculoskeletal disorders and localized joint pain.<\/strong><\/p>\n<p><strong>Mitochondrial health<\/strong>\u00a0<strong>is a critical factor in maintaining skeletal integrity.\u00a0 That\u2019s why our <\/strong><a href=\"https:\/\/shoptruthforhealth.com\/products\/trumitochondrial-boost?_pos=1&amp;_sid=115c01fdf&amp;_ss=r&amp;variant=47061555282242\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/shoptruthforhealth.com\/products\/trumitochondrial-boost?_pos%3D1%26_sid%3D115c01fdf%26_ss%3Dr%26variant%3D47061555282242&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw0UyCwxnXaQ0-XMXuJV07j7\"><strong>TruMitochondrial\u2122 Boost<\/strong><\/a><strong> supplement is a powerful foundation for your <em>total body health<\/em>, including joints and connective tissue!\u00a0 I take it morning and evening every single day!<\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-10702\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" data-layzr=\"https:\/\/www.truthforhealth.org\/wp-content\/uploads\/2026\/05\/image012-1024x572.jpg\" alt=\"\" width=\"1020\" height=\"570\" \/><\/p>\n<p>This graphic illustrates how damage to mitochondria, our cellular energy centers, contribute to the development of long-term joint pain and physical deterioration. When joints face mechanical pressure or inflammation, the mitochondria within the cartilage and surrounding tissues begin to malfunction. This failure triggers a harmful cycle of oxidative stress and reduced energy production, which directly fuels the erosion of protective joint structures. Then this erosion leads to persistent inflammation and heightened nerve sensitivity to pain. This inflammatory and metabolic damage leads to joint pain, widespread arthritis, maintains the chronic joint pain pathway.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-10703\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" data-layzr=\"https:\/\/www.truthforhealth.org\/wp-content\/uploads\/2026\/05\/image013-1024x559.jpg\" alt=\"\" width=\"1020\" height=\"557\" \/><\/p>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>II.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong><strong>Hormone Status in Women<\/strong><br \/>\nShoulder pain is more common in midlife women largely because perimenopausal decline in estradiol, and to a lesser extent women\u2019s androgens, <em>add to the tissue damage from age<\/em><em>\u2011<\/em><em>related changes,<\/em> metabolic risk factors, and diminished activity.\u00a0 This combination increases vulnerability of the shoulder and other joint capsules and tendons to the vicious cycle of <a href=\"https:\/\/ortho.duke.edu\/news\/why-midlife-women-face-surge-shoulder-pain-breaking-down-science\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/ortho.duke.edu\/news\/why-midlife-women-face-surge-shoulder-pain-breaking-down-science&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw2ijkU7g8gCeubBMX_Q7aCf\">pain and stiffness<\/a>.<\/p>\n<ul>\n<li><strong>Estradiol, the primary premenopausal estrogen lost at menopause, helps maintain strong bone, the integrity and strength of cartilage supporting all joints, keeps tendons and ligaments strong but properly flexible and elastic.<\/strong>\u00a0 Progesterone makes ligaments <em>more elastic and \u201cloose,\u201d as adaptation to help the pelvis expand during pregnancy to accommodate a growing baby \u2013 <\/em>but \u201cloose\u201d overly lax ligaments are not something desired as we get older.\u00a0 Loose ligaments in menopausal women lead to more joint dislocations and sprains<em>.\u00a0 <\/em><\/li>\n<li><strong>Hormone fluctuations, imbalances, and declines in perimenopause, menopause, and later years lead to marked disruptions in connective tissue homeostasis<\/strong>.\u00a0 As a result of the loss of estradiol, excess progesterone, imbalance in androgens (ovarian and adrenal), joint tissues become more prone to inflammation, stiffness, and pain.<\/li>\n<li>My own 40 years of treating women\u2019s hormone imbalances, plus recent observational data, shows systemic estradiol therapy to reach physiologic optimal levels can substantially decrease the risk of shoulder and other joint pain in women.<\/li>\n<li><strong>\u201cFrozen shoulder\u201d (<em>adhesive capsulitis<\/em>) peaks in women between 40 and 60<\/strong>, which is the time of major ovarian hormonal upheaval, imbalance and decline in women. \u201cFrozen shoulder\u201d diagnoses are many times more common in women than men, and the majority of these cases rise <em>without major trauma. <\/em>\u00a0Declining estradiol <em>plus comorbidities such as diabetes, thyroid disease, hypertension, and autoimmune conditions<\/em> further increase risk for frozen shoulder in midlife women.<\/li>\n<li><strong>Rotator cuff tendinopathy and partial tears become more common after 40,<\/strong> and sex\u2011hormone\u2013related changes to decrease tendon and ligament strength and increase brittleness are factors making women more susceptible to this damage.<\/li>\n<li><strong>Midlife loss of estradiol and testosterone lead to acceleration of bone loss (osteopenia, osteoporosis) in women<\/strong>, altering bone quality in ways that can contribute painful degenerative changes and even to increased shoulder fractures.<\/li>\n<li><strong>BOTTOM LINE: What does this mean for you practically?<\/strong>\u00a0 If you are midlife or older, hormone decline, loss of muscle, bone and ligament strength AND sudden increased exercise intensity can lead to joints like shoulders, hips, and knees being \u201cweak links\u201d more prone to injury and chronic inflammatory pain.<\/li>\n<\/ul>\n<p><strong>III.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong><strong>Hormone Status in Men<\/strong><br \/>\nDecline in total and free testosterone as men age is a factor that increases overall joint vulnerability and another link to higher rates of <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11706034\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11706034\/&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw0pTrBgxCa-DiLMXzI7F7nl\">rotator\u2011cuff pathology and worse healing<\/a>. The research below shows that testosterone decline contributes to shoulder pain through several converging pathways: (1) increased systemic and local inflammation, (2) poorer rebuilding of cartilage and tendon, (3) accelerated muscle loss (sarcopenia) around the shoulder girdle, and reduced bone strength.<\/p>\n<p><strong>Mechanisms: How Low T Worsens Joint Pain<\/strong><\/p>\n<ul>\n<li><strong>Testosterone receptors are present in articular cartilage, and testosterone has anabolic effects on cartilage matrix synthesis and reduces cartilage breakdown<\/strong>. Low T (hypogonadism is T levels &lt;300 ng\/dL) removes this protection, leads to increased release of inflammatory cytokines and increases oxidative stress.<\/li>\n<li><strong>Low testosterone increases pro\u2011inflammatory cytokines<\/strong> (such as IL\u20116 and TNF\u2011\u03b1), which drive cartilage breakdown, inflammation of the synovial joint lining, and inflammation of joint nerve endings, micro blood vessels, and bony structures. All of these adverse changes lead to intensified shoulder pain typical of osteoarthritis and degenerative rotator cuff tendon damage.<\/li>\n<li><strong>Testosterone decline contributes to loss of muscle mass and strength<\/strong>. Men commonly lose 3\u20135% of muscle mass per decade. Low T accelerates muscle loss and loss of tendon\/ligament strength, which <em>increases instability of the shoulder and other joints,<\/em> and increases risk of injury and pain.<\/li>\n<li><strong>Low T also reduces bone density, raising fracture risk<\/strong>. Micro\u2011fractures or osteoporotic changes near the shoulder (humeral head, scapula, spine) and knees can present as, and intensify, shoulder\/neck girdle, and knee pain.<\/li>\n<\/ul>\n<p><strong>Data on osteoarthritis and joint pain<\/strong><\/p>\n<ul>\n<li><strong>Low testosterone levels in men AND women were independently associated with increased osteoarthritis (OA) risk in a 2025 NHANES\u2011based analysis<\/strong>. OA risk rose sharply when T levels fell below a threshold around 51 ng\/dL.\u00a0\u00a0 These data are consistent with a protective effect on joint structures in men and women when testosterone levels are above this threshold.\u00a0 <em>Note: These levels in men are severely low but often found in men on androgen deprivation therapy, called ADT or \u201chormone therapy,\u201d for prostate cancer.<\/em><\/li>\n<li><strong>Low T levels cause increased systemic inflammation and oxidative stress, which are key drivers of osteoarthritis damage and chronic joint pain<\/strong>.\u00a0 Androgen decline in men and women is one of many factors contributing to joint degeneration and pain symptoms.<\/li>\n<li><strong>BOTTOM LINE: <\/strong>for all the years I have been helping men with low T (hypogonadism) restore optimal, physiologic and stable testosterone levels, the problems reported prior to Rx therapy&#8212;diffuse joint and muscle pain&#8212;improves markedly with testosterone Rx medication.<\/li>\n<\/ul>\n<p>This is one of <em>many reasons <\/em>I think men need testosterone levels checked as part of annual check-ups. Low T is a risk factor for many major medical and metabolic health risks, including musculoskeletal conditions, but also heart disease, diabetes, sleep disorders, depression and later dementia.<\/p>\n<p><strong>IV.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Declining Strength and Muscle Mass<\/strong><\/p>\n<p><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8567712\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8567712\/&amp;source=gmail&amp;ust=1777244706576000&amp;usg=AOvVaw2AWunPqvKJ4r0DexFu40Zy\">Studies<\/a> highlight that maintaining strength and conditioning, especially in physically demanding workers over 50, may be key modifiable factors in reducing painful shoulders as men age. When tendons hurt, rest is not always the answer. With acute pain and injury \u2013 yes backing off activity and strain on the joint \u2013 is part of the healing process, but it should not become the main strategy. Gentle and gradual return to activity and life should be the goal and maintaining pain-free. Rest will give you temporary relief, but if you return regular activities without fixing underlying issues, including range of motion and strength, the same problems often return.<\/p>\n<p>Maintaining muscle mass and strength through a full range of motion can be achieved through regular strength training and proper nutrition.\u00a0 This is key to preventing and recovering from shoulder pain as we get older. I discussed this concept in detail in previous health tips and have included links in the resources at the end.<\/p>\n<p><strong>Nutritional Supplements to Reduce Joint Aches and Pains<\/strong><\/p>\n<p>There are many supplements that can help with specific aspects of shoulder and other joint pain syndromes. I have broken them down into <strong>four categories<\/strong> to help you navigate what may be most beneficial for your situation.<\/p>\n<p><strong>1. Supplements to reduce pain and inflammation<\/strong> &#8211; Most data are in knee\/hand osteoarthritis (OA), but mechanisms also generalize to shoulder OA and degenerative rotator\u2011cuff\u2013related pain.<\/p>\n<ul>\n<li><strong>Omega<\/strong><strong>\u2011<\/strong><strong>3 fatty acids (EPA\/DHA, fish oil; green<\/strong><strong>\u2011<\/strong><strong>lipped mussel oil)<\/strong> as in our <strong>TruOmega\u2122 Pure and TruSynovial\u2122 Support<\/strong> (with New Zealand green-lipped mussel extract).\u00a0 These powerful anti-inflammatory nutrients decrease production of pro\u2011inflammatory eicosanoids; randomized clinical trials (RCTs) show improvements in arthritic pain, stiffness, and function; green\u2011lipped mussel extract appears particularly helpful for arthritis and menopausal joint pain.<\/li>\n<li><strong>MSM (methylsulfonylmethane<\/strong>) \u2013 Some RCTs show reduced OA pain and improved function; also used in multi\u2011ingredient joint formulas.<\/li>\n<li><strong>Collagen peptides (type II or hydrolyzed collagen)<\/strong> \u2013 Trials show improved joint pain and function in OA and menopause\u2011related joint pain at doses up to ~10 g\/day. <strong>Dr. Vliet NOTE: I only recommend wild-caught whitefish marine collagen peptide products, not <em>bovine peptides derived from slaughtered cattle parts.<\/em><\/strong><\/li>\n<li><strong>Curcumin (turmeric extracts)<\/strong> \u2013 Multiple RCTs and meta\u2011analyses show standardized, highly bioavailable curcumin formulations can reduce OA pain and improve function, sometimes approaching NSAID\u2011level effect, especially at 500\u20132,000 mg\/day with piperine (black pepper) or specialized formulations.\u00a0<strong>Dr. Vliet CAUTION: Curcumin has strong phytoestrogen properties that competitively inhibits estradiol receptors and minimize effectiveness of Rx hormone therapy.\u00a0 Studies also show that concentrated curcumin supplements can interfere with Rx thyroid medication. For men, the phytoestrogens in curcumin supplements can lower testosterone levels or inhibit effectiveness of Rx testoterone. This caution applies to concentrated curcumin supplements, not the small amounts used in seasoning food.<\/strong><\/li>\n<li><strong>Boswellia serrata (AKBA \/ 5<\/strong><strong>\u2011<\/strong><strong>Loxin \/ Aflapin)<\/strong> \u2013 Anti\u2011inflammatory resin; reviews and a 2025 meta\u2011analysis identify Boswellia extracts (especially Aflapin) among the most effective botanical supplements for reducing OA pain and stiffness.<\/li>\n<li><strong>Ginger extract<\/strong> \u2013 Anti\u2011inflammatory; included by menopause and arthritis resources as a supportive option for stiffness and pain, though data are less robust than curcumin or Boswellia.<\/li>\n<\/ul>\n<p><strong>2.\u00a0Supplements to strengthen muscle and support joints structurally<\/strong> The goal here is better peri\u2011scapular and rotator\u2011cuff strength, bone\/joint integrity, and neuromuscular support.<\/p>\n<ul>\n<li><strong>Protein and essential amino acids<\/strong> \u2013 Sufficient high\u2011quality protein intake is fundamental for maintaining shoulder girdle and global muscle mass supporting joints. Experts specializing in joint\u2011health emphasize diet plus whey or plant protein, and amino acid complexes such as <strong>TruAmino Complex\u2122<\/strong> with essential amino acids to support muscle mass.<\/li>\n<li><strong>Vitamin D3 with K2 <\/strong>\u2013 Supports muscle function and bone health; low vitamin D is linked with muscle weakness and joint pain.\u00a0RDA recommendations of 600 IU have been found to be far too low and newer professional recommendations find higher levels (2000 \u2013 4000+ IU) to maintain adequate levels of vitamin D in the optimal range of 70-90 for immune as well as muscle and bone health.\u00a0 Try our <strong>TruBioD3 2000 IU and TruOptiD3 5000 IU+K2!<\/strong><\/li>\n<li><strong>Calcium plus magnesium<\/strong> <strong>supplements, but taken separately to improve absorption of each one! <\/strong>Both are critical for bone mineral density and muscle contraction\/relaxation.\u00a0 Both are especially important for postmenopausal women to prevent osteopenia and osteoporosis that can exacerbate shoulder pathology.\u00a0I recommend trying our TruMagnesium\u2122 supplement, which is hard to get adequate amounts in our diet.\u00a0 But for calcium, I recommend you focus on getting calcium from food sources spread throughout the day. Plain full fat Greek yogurt (also a great source of protein, Vit D3), goat\u2019s milk Kefir (plain) and other dairy products are your best source of calcium, but also canned fish with bones, beans, nuts\/seeds and leafy greens.<\/li>\n<li><strong>B<\/strong><strong>\u2011<\/strong><strong>vitamins (esp. B3, B6, B12)<\/strong> as found in <strong>TruB Full Spectrum<\/strong> &#8211;\u00a0 Support mitochondrial cellular energy metabolism and neuromuscular functions that play important roles in muscle performance, endurance, and red blood cell production.<\/li>\n<\/ul>\n<p><strong>3. Supplements to support joint and muscle mitochondrial function<\/strong><br \/>\nThe nutritional target is to improve mitochondrial function, energy production, and reduced oxidative stress in chondrocytes and muscle.<\/p>\n<ul>\n<li><strong>Targeted mitochondrial antioxidants:<\/strong>\u00a0 Our unique L-ergothioneine supplement, <strong>TruMitochondrial\u2122 Boost<\/strong>, features the concentrated form of the histidine derivative L-ergothioneine produced via the natural fermentation of mushrooms in a proprietary process to improve potency and purity.\u00a0 Erothioneine\u2019s antioxidant and cytoprotectant actions combat oxidative stress at the mitochondrial cellular level throughout the entire body to provides multiple health benefits for mitochondrial function.<\/li>\n<li><strong>Coenzyme Q10 (CoQ10),<\/strong> found in our <strong>TruActive CoQ10<\/strong> <strong>(Active Ubiquinol),<\/strong> is a key component of the electron transport chain and is widely used in mitochondrial medical strategies for repair of damage because it serves as an ATP\u2011supportive nutrient (with extensive research data in primary mitochondrial disorders and muscle function).<\/li>\n<li><strong>Alpha<\/strong><strong>\u2011<\/strong><strong>lipoic acid (ALA)<\/strong> \u2013 <strong>TruAlpha-Lipoic SR <\/strong>is a mitochondrial cofactor and antioxidant. For individuals with mitochondrial disorders, ALA 50\u2013200 mg\/day is used for mitochondrial support, pain reduction.<\/li>\n<li><strong>Acetyl<\/strong><strong>\u2011<\/strong><strong>L<\/strong><strong>\u2011<\/strong><strong>carnitine \/ L<\/strong><strong>\u2011<\/strong><strong>carnitine<\/strong> \u2013 Supports mitochondrial fatty acid transport and energy production and is commonly used in mitochondrial and neuropathic pain protocols, though OA\u2011specific data are limited.<\/li>\n<li><strong>NAD+<\/strong> precursors (nicotinamide riboside, nicotinamide mononucleotide, and niacin) as found in <strong>TruNiacin\u2122 SR<\/strong>.\u00a0 Not directly joint\u2011specific in the sources above but increasingly used to support mitochondrial function and sirtuin activity, which are implicated in OA cartilage mitochondrial dysfunction.<\/li>\n<li><strong>Urolithin A<\/strong> \u2013 A gut-microbiome derived metabolite (a postbiotic) of ellagic acid found in pomegranates, strawberries, raspberries, and walnuts, that promotes selective recycling of damaged mitochondria. Urolithin A has been shown (in a OA mouse model) to improve mitochondrial health in joint tissue, reduced cartilage degeneration, synovial inflammation, and pain, and improved mobility, suggesting disease\u2011modifying potential.\u00a0If you don\u2019t eat a lot of fruit every day, you may want to try our <strong>TruFruits&amp;Berries\u2122<\/strong> for a good source of concentrated ellagic acid and other great polyphenols found in fruits and berries!<\/li>\n<\/ul>\n<p><strong>4. <\/strong><strong>Supplements helpful in menopause<\/strong><strong>\u2011<\/strong><strong>related joint\/shoulder pain<\/strong><\/p>\n<p>These are not substitutes for the more potent anti-inflammatory and anti-oxidant bone and joint repair\/regeneration properties of Rx estradiol therapy, but these nutrients can help modulate inflammation, bone\/muscle health, and vasomotor symptoms that worsen pain. The list includes magnesium, calcium, vitamin D3, and Omega-3s already covered above. Our <strong>TruMagnesium\u2122<\/strong> which comes in a chelated form that is well-absorbed, less likely to cause diarrhea and helps anti\u2011inflammatory and protective roles to reduce cartilage breakdown, Magnesium also plays a major role in sleep and muscle relaxation.<\/p>\n<p><strong>Self-Help Treatments For Joint Aches and Pains<\/strong><\/p>\n<p>So many people think that shoulder, knee and hip pain means you have to see an orthopedic surgeon and either get \u201csteroid shots\u201d or have surgery for joint replacement.\u00a0 LONG before you may have to consider surgery, there are MANY conservative, self-help options you can try first.\u00a0 And you may find these do the trick and you don\u2019t need more invasive and risky options.\u00a0 It\u2019s worth trying these approaches.\u00a0 As always, if pain gets worse, or mobility more impaired, it is wise to see a Physicial Medicine and Rehabilitation (PM&amp;R, or physiatrist) specialist physician, or a surgical specialist.<\/p>\n<p>I have found that for most age\u2011related joint pain, a structured exercise\u2011based program plus simple analgesia is more effective long term than injections or surgery, which should be reserved for severe and select cases based on individual evaluation. Any surgery, but especially shoulder surgery, can be tricky in older people with multiple medical problems, and generally involve long and challenging recovery and continuing physical therapy for 3-6 months.<\/p>\n<p>Here is how I generally guide my patients with shoulder and other joint pain syndromes. I have used most of these modalities myself and they really do work!<\/p>\n<p><strong>I.\u00a0\u00a0\u00a0\u00a0\u00a0 Targeted exercise and physical therapy<\/strong> are most often the first\u2011line evaluation and treatment for rotator cuff\u2013related pain, many degenerative arthritic shoulder disorders and other localized joint pain. \u00a0Well-designed physical therapy focuses on scapular control, rotator cuff and periscapular strengthening, capsular stretching, and proprioceptive training, and can provide meaningful pain relief and functional gains for most older patients with rotator cuff problems. A consistent home-exercise program is essential for improvement \u2013 don\u2019t just throw the exercise handouts in a drawer and forget about them once you get home!<\/p>\n<p>For my patients, and our readers, you may want to consider a Virtual Consult with Ken Lamm PT, a physical therapist and pain specialist in Tucson who founded the Tucson Pain Network 35 years ago.\u00a0 I have referred patients from all over the country to him for in-person or virtual consults for many, many years.\u00a0 He is superb at identifying myofascial and biomechanical factors that restrict movement and cause localized should neck, knee, hip pain. You would be surprised how many people I send him for shoulder pain that is NOT due to arthritis or \u201crotator cuff tear\u201d but due to body posture and myofascial restriction.\u00a0 He teaches people to relieve such pain with simple exercises at home. \u00a0One consult well worth it to have an assessment and initial recommendations \u2013 then if helpful, you can schedule more sessions. I see him regularly. Email to request a consult \u2013 <a href=\"mailto:Klamm@comcast.net\">Klamm@comcast.net<\/a>. Fees are reasonable and paid by credit card. You can tell him I sent you, no physician Rx needed.<\/p>\n<p><strong>II.\u00a0\u00a0\u00a0 <\/strong><strong>Topical pain relievers\u00a0widely used for localized arthritis pain areas<\/strong><\/p>\n<p><strong>1.\u00a0\u00a0\u00a0 <\/strong><strong>NSAID: Voltaren<\/strong> (brand name)\/diclofenac (generic name) over the counter gel that can be used AM and PM daily for extended periods of time. \u00a0I use it regularly for knee, hip, and hands (thumb joints that hurt). \u00a0After rubbing on area, you don\u2019t have to wait until the \u201cgel\u201d dries \u2013 the diclofenac is absorbed under the skin quickly, you can put on clothes and go ahead with activities.\u00a0 There are minimal risks of GI bleeding or increased BP with topical use of NSAID gels compared to oral meds.<\/p>\n<p><strong>2. Licart Patches<\/strong> (Diclofenac): \u00a0Another option for those who don\u2019t like the gel (above) or who want 24 hour relief.\u00a0 Licart Patches can be applied once a day to a local area like knee, shoulder, feet, etc. Licart Patches are Rx from your doctor &#8211; but end up costing less than the Salon Pas patches that are OTC, and LESS effective. \u00a0May be covered by some health insurance plans.\u00a0 <strong>SalonPas patches<\/strong> 4% Lidocaine patch for short-term pain relief. Lidocaine is a topical anaesthetic but does not have anti-inflammatory benefits like Voltaren gel or Licart Patch<\/p>\n<p><strong>3.<\/strong> <strong>DMSO<\/strong> (Dimethylsulfoxide) Liquid (or Gel) also OTC: \u00a0This can be used topically for localized joint pain. I use it for arthritis in my thumbs and find that it has similar anti-inflammatory pain-relief effectiveness to Voltaren gel.\u00a0 I found a reliable resource: <a href=\"http:\/\/www.DMSOStore.com\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=http:\/\/www.DMSOStore.com&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw0bPIOOaPjNRqUzH2guhuWa\">www.DMSOStore.com<\/a>, which sells pharmaceutical grade, highly purified, low-odor DMSO. \u00a0Veterinary products of DMSO have been used for DECADES for musculoskeletal injuries, pain and promoting healing for dogs and horses especially. \u00a0But these products are higher in the garlic odor and not as purified as the above option. I tried a veterinary product but could not tolerate the intense and pervasive odor.\u00a0 I have a whole seminar on DMSO &#8211; what it is, what it is used for, etc. archived under Faith Over Fear tab on our website <a href=\"http:\/\/www.TruthforHealth.org\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=http:\/\/www.TruthforHealth.org&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw3Nvckr0JhFfcfNxWzDOE9L\">www.TruthforHealth.org<\/a> and <a href=\"https:\/\/www.truthforhealth.org\/es\/2024\/12\/faith-over-fear-dec-17-2024-dmso-discover-its-many-health-and-medical-benefits\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/www.truthforhealth.org\/2024\/12\/faith-over-fear-dec-17-2024-dmso-discover-its-many-health-and-medical-benefits\/&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw2PBx4bQ5FZIztOi-FHMV_T\">here<\/a><\/p>\n<p><strong>4.\u00a0 Epsom Salts<\/strong> (magnesium salts) in warm water.\u00a0 Helps relieve muscle and joint aches as the magnesium and warmth penetrate the skin and improve blood flow and muscle relaxation.\u00a0 Take a whole body soak in a Tub or use Epsom salts warm compresses for local area. \u00a0Pain relief and muscle relaxation short term. Use in addition to above options.<\/p>\n<p><strong>III. Oral Over-the-Counter Pain Relievers<\/strong><\/p>\n<p><strong>Even though these are OTC, they all have potential serious side effects used daily at higher doses, so you must use them with CAUTION.<\/strong> ORAL NSAID forms and Tylenol that can lead to increased BP, fluid retention, liver and kidney dysfunction at high doses every day.<\/p>\n<p><strong>1. I don\u2019t recommend Tylenol\/acetaminophen for arthritis pain<\/strong>!<br \/>\nMain reasons:\u00a0It is not a very effective pain reliever,\u00a0it has NO anti-inflammatory actions (needed for arthritis pain especially!), it blocks glutathione production, which means mitochondrial cellular energy production is impaired, and this leads to poor cellular oxygenation, oxidative stress, and MORE inflammation and pain!\u00a0<strong>But the BIGGEST REASON<\/strong>: there are serious potential adverse effects on liver and kidney function if dose not monitored closely.\u00a0 <strong>Tylenol (and other acetaminophen products) are the second leading cause of liver failure in the US! Sadly, such effective marketing of Tylenol as safe has covered up its serious risks and lack of much effectiveness for the inflammatory type of pain in arthritis.<\/strong><\/p>\n<p><strong>IMPORTANT: Read my Health Tip article on acetaminophen at <a href=\"http:\/\/www.TruthforHealth.org\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=http:\/\/www.TruthforHealth.org&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw3Nvckr0JhFfcfNxWzDOE9L\">www.TruthforHealth.org<\/a> website (<a href=\"https:\/\/www.truthforhealth.org\/es\/2025\/10\/dr-vliets-health-tip-acetaminophen-tylenol-risks-beyond-autismfor-all-of-us\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/www.truthforhealth.org\/2025\/10\/dr-vliets-health-tip-acetaminophen-tylenol-risks-beyond-autismfor-all-of-us\/&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw0L2_wtjKRX47dlJ9GWof2E\">here<\/a>) for more details on the risks and many adverse effects!\u00a0<\/strong>They are serious, especially as people get older. I NEVER recommend Tylenol or acetaminophen products for my patients for regular daily use.<\/p>\n<p><strong>2. \u00a0ORAL NSAIDS:<\/strong> <strong>OTC Aspirin, \u00a0Advil (ibuprofen), Aleve (naproxen)<\/strong> &#8211; I find that all are pretty much equal in effectiveness as a general rule, but for me personally, Aleve worked better than the others and didn\u2019t cause the tendency for bruising that daily ASPIRIN can cause as we get older. \u00a0Therapeutic doses of the OTC strengths are Advil-two pills THREE times a day, Aleve two pills two times a day, Aspirin 325 mg (enteric coated is safer) 2-3 times a day and watch for increase in bruising, and reduce dose if that happens. \u00a0Prescription doses of ibuprofen and naproxen are higher but need to be monitored by a health professional prescriber since they can lead to high BP, fluid retention, and adverse kidney effects over longer time at higher therapeutic doses.<\/p>\n<p><strong>IV<\/strong>. \u00a0<strong>Rx medicine:<\/strong> <strong>Hydroxychloroquine or HCQ<\/strong> (Rx in USA, may be OTC in Mexico).<br \/>\nThis is FDA-approved for Rheumatoid Arthritis. RA patients take it at fairly high dose it for years without major side effects. \u00a0HCQ is ALSO effective for Osteoarthritis although the company did not seek FDA-approval for this diagnosis. Usual dose: 200 mg twice a day for OA pain relief, up to total of 400-800 mg daily for RA. \u00a0I have a whole seminar on HCQ benefits in reducing inflammatory pain (such as arthritis), anti-viral effects, and benefits in diabetes and cancers. \u00a0 Seminar archived on our website <a href=\"http:\/\/www.TruthforHealth.org\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=http:\/\/www.TruthforHealth.org&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw3Nvckr0JhFfcfNxWzDOE9L\">www.TruthforHealth.org<\/a> and (<a href=\"https:\/\/www.truthforhealth.org\/es\/2023\/11\/faith-over-fear-11-28-23-turbo-cancer-pt-iii\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/www.truthforhealth.org\/2023\/11\/faith-over-fear-11-28-23-turbo-cancer-pt-iii\/&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw10D1k8nPdtGNtdKK55VvD7\">here<\/a>).<\/p>\n<p>There are other oral Rx meds that are used for systemic chronic pain management, but these are not as effective and not as appropriate for localized inflammatory arthritis pain management as the ones I discussed above. This should be a good start for your self-help strategies!<\/p>\n<p><strong>Additional Self\u2011<\/strong><strong>Help Strategies<\/strong><strong> for Joint Pain<\/strong><\/p>\n<ul>\n<li>Activity modification, heat or ice, and short rest from provocative overhead or heavy\u2011load tasks are standard early steps for age\u2011related shoulder arthritis and tendinopathy.<\/li>\n<li>Myofascial release, Massage (Shiatsu, deep tissue, lymphatic and other types), cranial-sacral therapy, and physical therapy can all help with secondary muscle tension\/spasm and pain, in addition to specific modalities I discussed above for inflammatory and degenerative joint pain.<\/li>\n<li>Maintaining general strength, flexibility and aerobic movement conditioning also is helpful to improve mobility and decrease pain for older adults, particularly the many ways you can exercises of all kinds in WATER!<\/li>\n<li>Photobiomodulation (low-level red or infrared light therapy) can help chronic shoulder pain by reducing inflammation, improving local circulation, and stimulating cellular repair in tendons, joint capsule, and surrounding soft tissues, which in turn decreases pain and improves function. We have presented two seminars on LIGHT AS MEDICINE, so check our Faith Over Fear archives at <a href=\"http:\/\/www.TruthforHealth.org\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=http:\/\/www.TruthforHealth.org&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw3Nvckr0JhFfcfNxWzDOE9L\">www.TruthforHealth.org<\/a><\/li>\n<\/ul>\n<p>NOTE: It is beyond the scope of my \u201cSelf-Help Strategies\u201d Health Tip this week to get into a discussion of steroid injections, platelet-rich plasma (PRP) injections, Acupuncture, TENS, and other more complex approaches, including surgery, that all involve working with specialist medical professionals.<\/p>\n<p><strong>IN SUMMARY:\u00a0 Integrated Approach to Self-Help Pain Management<\/strong><\/p>\n<ul>\n<li>Identify with blood tests the nutritional deficiencies that contribute to joint pain, and correct these deficiencies to support muscle mass, mitochondrial function, reduce inflammation and aid healing.<\/li>\n<li>Seek to have lab tests to identify hormone factors contributing to joint pain and degenerative changes: decline in estradiol for women and testosterone for men.<\/li>\n<li>Protect sleep as much as possible, since sleep problems are common in older adults and worsen pain sensitivity and recovery.<\/li>\n<li>Address metabolic contributors such as prediabetes, diabetes, weight gain, and low physical activity, which are linked with higher shoulder pain and frozen shoulder risk.<\/li>\n<li>KEEP MOVING PHYSICALLY! Stay active with low-impact movement such as walking, swimming, yoga, or mobility work to maintain joint motion and whole-body conditioning, and include strength-training to maintain muscle mass to support your joints.<\/li>\n<li>Pay attention to posture and avoid long periods of desk work or being hunched over using mobile devices. All of these positions increase neck and shoulder muscle tension and aggravated shoulder joint pain.<\/li>\n<li>Keep your shoulders moving with gentle, regular range-of-motion, work such as shoulder rolls, rather than prolonged guarding or complete rest.\u00a0Get up from the computer or TV watching, move and stretch at least once an hour!<\/li>\n<li>Use heat for stiffness and cold for sharper inflammatory pain as needed.<\/li>\n<li>Seek medical evaluation if pain is lasting more than a few weeks, if the above strategies have not helped, or if you are experiencing more impairment of movement or function, such as shoulder motion decreasing, sleep disrupted, or there is nerve pain\/numbness\/tingling, or weakness.<\/li>\n<\/ul>\n<p>As you put all the pieces together that I have described today, I encourage you to consider our other natural medicines with our top quality, cGMP-compliant professional formulas:<strong><em> TruMitochondrial\u2122 Boost,\u00a0 TruNAC\u2122, Tru BioD3, Tru B\u2122 Complex Full Spectrum, TruZinc\u2122, TruC with BioFlavonoids\u00a0 <\/em>(Natural sourced Vitamin<em> C with complete Bioflavonoids), and TruProBiotic\u2122 Daily <\/em><\/strong>to replenish critical bifidobacteria depleted by COVID shots, viral illnesses, and antibiotic therapy.<\/p>\n<p>All Truth for Health Foundation Products Meet or Exceed cGMP Quality Standards, the highest quality standard for supplements sold in the USA. <strong><em>For more information, references from studies are listed in the Product Data Sheets for each product, available on our website.<\/em><\/strong>\u00a0 Check us out at <a href=\"http:\/\/www.TruthforHealth.org\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=http:\/\/www.TruthforHealth.org&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw3Nvckr0JhFfcfNxWzDOE9L\">www.TruthforHealth.org<\/a> Click on tab for Store.\u00a0 OR <a href=\"http:\/\/www.shopTruthforHealth.com\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=http:\/\/www.shopTruthforHealth.com&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw28u3s8ZZjX8otK9OybPciY\">www.shopTruthforHealth.com<\/a><\/p>\n<p><strong>CAUTION:<\/strong> As always, we urge you to avoid supplements without checking knowledgeable sources to evaluate your medical situation, proper lab tests to verify what is needed, and to make sure to avoid adverse interactions with prescription medicines and other supplements you take.\u00a0 Under medical practice regulations, we are unable to answer individual medical questions or make specific individual supplement recommendations for people who are not established patients of Dr. Vliet\u2019s independent medical practice (<a href=\"http:\/\/www.ViveLifeCenter.com\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=http:\/\/www.ViveLifeCenter.com&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw03-X0Z9ufHq2_sykXdYPFk\">www.ViveLifeCenter.com<\/a>).<\/p>\n<p><strong>To Your good health and improving resilience!<\/strong><br \/>\n<strong>Elizabeth Lee Vliet, MD<\/strong><\/p>\n<p><strong>More Resources:<\/strong><br \/>\n<a href=\"https:\/\/www.truthforhealth.org\/es\/2026\/04\/dr-vliets-health-tip-from-stiff-to-strong-regenerate-your-joints-with-green-lipped-mussels-red-light-hormones\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/www.truthforhealth.org\/2026\/04\/dr-vliets-health-tip-from-stiff-to-strong-regenerate-your-joints-with-green-lipped-mussels-red-light-hormones\/&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw1cN5kYGLkG_0XIkS4jTdag\"><strong>Dr. Vliet\u2019s Health Tip: \u201cFrom Stiff to Strong: Regenerate Your Joints with Green-lipped Mussels, Red Light, &amp; Hormones\u201d<\/strong><\/a><br \/>\n<a href=\"https:\/\/www.truthforhealth.org\/es\/2024\/03\/health-tip-from-dr-vliet-truamino-complex\/\" data-saferedirecturl=\"https:\/\/www.google.com\/url?hl=en&amp;q=https:\/\/www.truthforhealth.org\/2024\/03\/health-tip-from-dr-vliet-truamino-complex\/&amp;source=gmail&amp;ust=1777244706577000&amp;usg=AOvVaw3D1BkC4TI3Q-jwyIjSXTGq\"><strong>Dr. Vliet\u2019s HEALTH TIP \u2013 TruAmino\u2122 Complex<\/strong><\/a><br \/>\n<a href=\"https:\/\/www.truthforhealth.org\/es\/2025\/11\/dr-vliets-health-tip-covid-brain-fog-fix-rescue-your-mitochondrial-energy-engines\/\"><strong>TruMitochondrial\u2122 Boost \u2013Dr. Vliet\u2019s earlier Health Tip<\/strong><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><a href=\"https:\/\/www.truthforhealth.org\/es\/category\/health-tips\/\"><u><strong>C<\/strong><em><strong>lick here to read Dr. Vliet\u2019s Health Tips<br \/>\non these and more products.<\/strong><\/em><\/u><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>","protected":false},"excerpt":{"rendered":"<p>\u00a9 by Elizabeth Lee Vliet MD and Kathy Kresnik I often have patients tell me \u201cI have this shoulder pain that affects my sleep.\u00a0 Do you think I need to &hellip; <\/p>","protected":false},"author":21,"featured_media":10701,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[222],"tags":[],"class_list":["post-10700","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-tips","fadeIn","image-hover-transition-effect","latest_post"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Dr. Vliet\u2019s Health Tip: Midlife Shoulder Pain: Inevitable Aging? or Fixable? - Truth for Health Foundation<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.truthforhealth.org\/es\/2026\/05\/dr-vliets-health-tip-midlife-shoulder-pain-inevitable-aging-or-fixable\/\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Dr. Vliet\u2019s Health Tip: Midlife Shoulder Pain: Inevitable Aging? or Fixable? - Truth for Health Foundation\" \/>\n<meta property=\"og:description\" content=\"\u00a9 by Elizabeth Lee Vliet MD and Kathy Kresnik I often have patients tell me \u201cI have this shoulder pain that affects my sleep.\u00a0 Do you think I need to &hellip;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.truthforhealth.org\/es\/2026\/05\/dr-vliets-health-tip-midlife-shoulder-pain-inevitable-aging-or-fixable\/\" 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