The shoulder is really several joints that combine with tendons and muscles to allow a wide range of motion to the arm—from scratching your back to throwing the perfect pitch. Mobility has its price, however, and may lead to increasing problems with instability or impingement of soft tissue, resulting in pain. You may feel pain only when the shoulder is moved, or all of the time. The pain may be temporary and disappear in a short time, or it may continue and require medical diagnosis and treatment.
Most problems in the shoulder involve the muscles, ligaments, and tendons, rather than the bones. Athletes are especially susceptible to shoulder problems. In athletes, shoulder problems can develop slowly through repetitive, intensive training routines,
Some people have a tendency to ignore the pain and “play through” a shoulder injury, which only aggravates the condition, and may possibly cause more problems. People also underestimate the extent of their injury because steady pain, weakness in the arm, or limitation of joint motion become almost second nature to them.
Rotator Cuff Injury
A rotator cuff injury is a common cause of shoulder pain. Although a rotator cuff injury is frequent among athletes, such an injury can also occur due to trauma and the “wear and tear” of the tendons over time.
A rotator cuff injury can lead to significant shoulder weakness, and treatment is necessary to correct this problem. Our orthopedic surgeons offer both surgical and nonsurgical treatment options for a rotator cuff injury.
Shoulder arthritis (also known as shoulder osteoarthritis or glenohumeral osteoarthritis) is a degenerative condition that involves changes to the cartilage and other structures of the shoulder joint. The gradual loss of cartilage eventually causes the two shoulder bones to grind against each other, which can cause pain, stiffness, and inflammation in the joint. The condition is progressive and can often become debilitating. While the degenerative changes cannot be reversed, there are a variety of treatments used to control pain and slow the progression of the disease.
When you experience a flare-up of shoulder arthritis, the shoulder may become inflamed and painful. Using your arm to lift or push is difficult when the rotation of the shoulder is inhibited. These flare-ups may result from overuse, progressive wear and tear and even changes in the weather.
If you have severe arthritis or a fracture in your shoulder joint, you may need a shoulder replacement. Shoulder replacement surgery replaces the worn parts of your shoulder joint with artificial parts. It is a complex procedure performed to relieve pain and improve mobility.
Anyone who has had shoulder joint trauma, a broken bone, dislocation (when the humeral head pops out of its socket), or other serious injury or surgery is at risk for developing shoulder osteoarthritis many years after the initial trauma. Trauma to the shoulder joint eventually leads to shoulder osteoarthritis.
Other persons who are risk are those whose jobs or recreational activities have required a lot of time lifting objects overhead, throwing, or doing high-impact activities such as chopping wood or using an air hammer. These repetitive motions over time cause wear and tear of the shoulder joint, causing the cartilage to thin and become less flexible.
Other risk factors include:
- Congenital defect or illness
- Family history
- Gender (glenohumeral arthritis is more common in women)
- Advanced age
Common symptoms of shoulder arthritis include:
- Mild to moderate stiffness
- Pain with movement
- Limited range of motion
- Episodes of inflammation (swelling)
- Grinding sound with movement
Your orthopedic surgeon will perform a comprehensive clinical examination to determine whether or not you have shoulder arthritis. This may include other tests such as X-rays or an MRI.
Medical History. Your doctor will ask you questions about your medical and family history and about any medications you may be taking. This information will help guide further treatment options.
Patient Interview. Your doctor will ask you about your work and lifestyle activities, and whether or not you have had any previous shoulder injuries. You will also be asked to describe your pain–the pattern, any limitations to range of motion–all vital information to rule out other potential sources of pain such as shoulder bursitis, shoulder impingement, rotator cuff tears or other common shoulder problems.
X-Rays. Digital imaging is ordered to arrive at clinical diagnosis–verifying whether or not there are significant signs of shoulder osteoarthritis.
MRI. Your doctor may order an MRI (magnetic resonance imaging) for you if x-rays of the shoulder are inconclusive or if it is suspected that your pain is due to damage to the shoulder’s labrum or rotator cuff. An MRI provides more detailed images of the soft tissue (ligaments, tendons, and muscles) and bone.
Lab Tests. Lab tests may be ordered to rule out other causes of shoulder pain, such as infection or gout.
Physical Exam. Your doctor will examine your shoulder for signs of a previous injury, tenderness, pain points, range of motion, and muscle weakness. Other joints may be examined as well to determine if you have any other joint problems that may indicate an inflammatory condition such as rheumatoid arthritis or gout.
There are both nonsurgical and surgical treatment options available for the treatment of shoulder arthritis. Conservative treatment may provide pain relief and reduce episodes of inflammation. In combination with beneficial lifestyle changes, your doctor can provide you with a treatment plan that can significantly improve the range of movement in the shoulder. Effective treatment and physical therapy can help manage your inflammation and slow down the progression of the disease.
Nonsurgical Treatment Options
Nonsurgical treatment options may provide pain relief and reduce episodes of inflammation. Such options may include:
Activity Modification. Modifying your daily activities and exercise will help to avoid pain, especially activities that involve intense shoulder activity like weight lifting or chopping wood.
Periodic Rest. When patients experience extreme bone-on-bone pain, they need to rest the joint and should not ignore it. Your body is telling you to take it easy, so listen.
Warm or Cold Compress. Warm or cold compresses applied to the joint can decrease swelling and provide some immediate pain relief.
Physical Therapy. Stretching and muscle strengthening exercises help to maintain the shoulder’s range of motion; however, they should not be too aggressive and patients should proceed slowly for the most benefit.
Injections. Steroid injections can help to alleviate severe pain from shoulder arthritis.
Surgical Treatment Options
Surgical treatment options to relieve symptoms of osteoarthritis, such as the following, may be necessary if patients don’t respond to conservative treatment:
Shoulder Arthroscopy. This is a minimally invasive procedure that is done to remove loose pieces of damaged cartilage.
Shoulder Osteotomy. This procedure is done to shave off osteophytes (bone spurs) and reduce friction between bones.
Shoulder Arthroplasty. This is a total joint replacement done to replace the ball and socket glenohumeral joint with an artificial one made of metal and plastic.
Hemiarthroplasty. This is a partial joint replacement where one half of the shoulder joint, the humeral head, is replaced with a prosthesis and the glenoid (socket) is left intact.
At Go To Ortho, we collectively have over 100 years of combined experience dealing with trauma injuries in the Portland area. Let Go To Ortho be your go-to place for quick-care orthopedic injury treatment. Walk-in appointments are welcomed or you may call us at (503) 850-9950.