Overview:
Orthopedic Shoulder Treatment
Shoulder pain is the third most common musculoskeletal condition that Americans seek treatment for.
It is estimated that shoulder injuries account for as much as 4.5 million doctor visits in the United States each year. With prevalence of this type of injury increasing with age, people 45 to 64 years old are most affected by this type of condition.
What are the common causes of shoulder pain?
The shoulder joint is flexible and made up of muscles, ligaments, and tendons that work together to support the joint. Shoulder pain is primarily attributed to the process of aging, but can also occur because of acute injuries to the rotator cuff, participation in impact and high-intensity sports, poor posture and/or workspace ergonomics. Repetitive shoulder activities can also lead to inflammation of the shoulder or shoulder impingement syndrome.
Shoulder pain can also occur due to medical issues in other parts of the body – known as “referred pain”.
The most common causes of shoulder pain include:
- Separation of the acromioclavicular joint that holds the shoulder and collarbone together
- Dislocation of the top of the arm from the socket
- Death of bone tissue or avascular necrosis
- Cartilage tear or labral injuries
- Fracture of the shoulder bone
- Rotator cuff tear or injury
- Shoulder impingement
- Rheumatoid arthritis
- Swimmer’s shoulder
- Frozen shoulder
- Tendinitis
- Bursitis
- Thoracic outlet syndrome
- Polymyalgia rheumatica
- Cervical radiculopathy
- Peripheral neuropathy
- Sprains and/or strains
- Brachial plexus injury
- Growth of bone spurs
- Disuse syndrome
- Septic arthritis
- Osteoarthritis
- Broken arm
What are the symptoms of shoulder pain?
The symptoms of shoulder pain are varied and often depend on the underlying cause(s) of the condition. Here are commonly experienced symptoms reported by patients who are experiencing shoulder pain:
- Feeling of the shoulder joint slipping out of the socket – often leading to dislocation
- Severe pain while moving the shoulder or lifting any weight
- Weakness of the upper arm and/or shoulder
- Reduced range of motion
- Sensation of pins and needles in the neck and shoulder area
- Severe pain in the front and back of the shoulder joint
- Inability to lift the arm
- Burning sensations
What are the risk factors associated with shoulder pain?
There are several risk factors that increase an individual’s tendency towards developing shoulder pain as a result of an acute injury or repetitive overuse. Some common risk factors for shoulder pain include:
- Participation in high impact and high-intensity sports, exercises, activities, and occupations
- Weakness of the rotator cuff or previous shoulder impingement
- Overuse of the shoulder and related structures
- Disuse of the shoulder and related structures
- Repetitive motions
- Chronic shoulder instability
- Poor workplace ergonomics
- Previous injuries
- Increasing age
- Poor posture
- Stress
When should I see a doctor for shoulder pain?
Apart from the symptoms mentioned above, the following signs could indicate a more serious condition and will require immediate medical attention:
- Warmth or sensation of burning around the joint
- Inability to lift the arm at the shoulder joint
- Inability to move the arm
- Severe and persistent pain
- Deformed shoulder joint
- Tenderness in the region
- Numbness
- Swelling
- Redness
How is shoulder pain diagnosed?
When you consult with your orthopedic specialist at Advanced Orthopedics, the first thing that they will work to determine is if the neck or the spine is being affected (which could lead to serious health concerns). This determination occurs through:
- Asking questions about the shoulder pain being experienced, symptoms, likely causes, and past medical history.
- Conducting a thorough physical examination and evaluation to check for range of motion, strength and flexibility of the shoulder joint, and load-bearing abilities.
By gathering this information, your orthopedic doctor works to isolate the possibilities that are causing the shoulder pain. This evaluation helps them understand what is causing the pain and what is required to resolve it.
If further investigation is necessary for a diagnosis, your orthopedic specialist may prescribe one or more of the following tests:
- X-rays — X-rays can indicate damage done to the bones and joints such as fractures, dislocations, spurs, and arthritis (although cannot specify issues with the soft tissue).
- CT scans and MRIs — These tests assess the extent of any damage caused in the shoulder. This assessment will assist in planning the shoulder pain treatment.
- Ultrasounds — These tests are useful to check for ruptures, tears, or inflammation in the surrounding soft tissue while providing an accurate picture of the shoulder and adjacent structures in the area.
- Electromyography — This procedure is conducted to check if there are issues in nerves in the shoulder region.
How is shoulder pain treated?
The first (and most critical) step towards recovery from shoulder pain is rest. As part of a self-care routine, your physician at Advanced Orthopedics may prescribe the following:
- Gentle stretches (such as the pendulum stretch and the crossover arm stretch)
- Over-the-counter pain relievers and anti-inflammation medicines
- Light forms of exercise as recommended by the physician
- Use of ice and hot packs
- Rest
In cases with more serious symptoms and signs, a more structured protocol for shoulder pain treatment may be advised.
Specific cases of shoulder pain will be treated with specific protocols. For example, with shoulder dislocations, An orthopedic surgeon will relocate the bone back into the socket.
In case of a shoulder impingement, an orthopedic doctor may also add on physical and/or occupational therapy to relieve the symptoms and prevent them from getting aggravated. Treatment of a fracture will involve the use of a sling or a shoulder immobilizer until the bone heals. In some cases, a fracture may need to be repaired surgically.
Depending on the cause and duration of the pain, physiotherapy can play a big part of the treatment and healing process after a shoulder condition develops. Physiotherapy can be advised as a part of a shoulder pain treatment process or to assist in the rehabilitation process (post surgery).
In some cases, conventional treatment options may not be sufficient to relieve the pain caused by this condition. Steroid injections may be prescribed directly into the joint to relieve the pain and inflammation. Hydrocortisone steroid injections are prescribed by physicians to treat painful or swollen shoulder joints. Used as an intra-articular injection, these steroids are injected directly into the joint to treat conditions such as tendinitis and bursitis. Available only through a doctor’s prescription, these injections help relieve pain and swelling for several months.
The most common types of injections administered are:
- Articular or joint injections
- Trigger point injections
- Epidural steroid injections
These steroid injections are almost always administered with a local anesthetic and may be performed under the guidance of ultrasound imaging to ensure accuracy in the delivery of the steroid.
When is surgery recommended for shoulder pain treatment?
Often, patients experience a remarkable improvement after a prescribed course of treatment, although in some cases, surgery may be required in the following scenarios:
- Severe damage to the shoulder joint as a result of arthritis or shoulder injuries
- Chronic form of rotator cuff tears
- Frequent or recurring dislocations causing chronic shoulder instability
- Frozen shoulder
- Acute form of rotator cuff tears
The most common shoulder surgeries performed are usually done with minimally invasive techniques and include the following:
- Shoulder arthroscopy
- Rotator cuff surgery
- Torn labrum surgery
- Surgery for arthritis
- Fracture repair
- Subacromial decompression
In some instances, more conventional open surgeries may be performed, which can include:
- Shoulder replacement surgery
- Reverse shoulder replacement
What is the post-surgery recovery like?
While postoperative rehabilitation is crucial for recovery, pre-surgery care and information are just as important. Physiotherapy and exercises are important to maintain muscle strength and range of motion which often ensures better success rates after a surgery.
Recovery after a minimally-invasive surgical procedure is usually faster than more invasive, replacement-type surgeries. The complete healing process may take a few weeks with the help of physiotherapy and exercise. In most cases, you will be discharged on the same day after the surgery with a set of clear, post-surgery care instructions. These instructions should include:
- When to begin the rehabilitation process
- Steps for surgical incision care
- Use of a sling for a few weeks
- Ice compression for 20 minutes every hour for the first week
- Pain medication
While shoulder surgeries do not usually lead to postoperative complications, your physician will discuss any potential complications with you at the time of discharge. If you are experiencing any of the following, contact your orthopedic doctor at Advanced Orthopedics immediately:
- Severe pain that is not responsive to medication
- Numbness or tingling on the operated side
- Persistent fever at 101 degrees or more
- Yellow discharge from the incision site
- Redness
How can I prevent shoulder pain?
Take the following precautions to prevent shoulder pain from occurring (especially if you have had previous injuries to the shoulder in the past):
If you are experiencing any pain in your shoulders, visit https://austinpaindoctor.com/ for further information on how the multidisciplinary team of doctors and surgeons at Advanced Orthopedics can assist you. You can also call us at 512-244-4272 to schedule a same or next day appointment with one of our orthopedic specialists.
FAQs
Q: What is the treatment for shoulder pain?
A: The first (and most critical) step towards recovery from shoulder pain is rest. As part of a self-care routine, your physician at Advanced Orthopedics may prescribe the following:
- Rest
- Over-the-counter pain relievers and anti-inflammation medicines
- Use of ice and hot packs
- Gentle stretches such as the pendulum stretch and the crossover arm stretch.
- Light form of exercises as recommended by the physician
In case of more serious symptoms and signs, a more intensive protocol for shoulder pain treatment may be advised. In some cases, conventional treatment options may not be sufficient to relieve the pain so steroid injections may then be prescribed directly into the joint to relieve the pain and inflammation. Often, patients find a remarkable improvement after the prescribed course of treatment. In some cases, however, surgery may be required.
Q: What is the best treatment for rotator cuff injury?
A: A rotator cuff injury may involve a variety of treatments – ranging from rest to surgery. Non-surgical treatment options include the following:
- Application of ice packs
- Strength and flexibility exercises
- Rest
- Over-the-counter pain relievers and anti-inflammation medications
- Steroid injections
In severe injuries or if there is no improvement in the condition despite conventional shoulder pain treatment, your physician may recommend surgery.
Q: Why does my shoulder hurt when I lift my arm?
A: Any swelling, damage, or changes to the bones in the shoulder can cause severe pain in the shoulder. The levels of pain being felt from this condition can increase when you try to move or lift your arm. The most common source of pain in the shoulder is the rotator cuff that enables the range of motion in the shoulder. Pain while lifting the arm can be due to factors such as tendinitis, bursitis, or shoulder impingement.
Q: How long will it take for my shoulder to heal?
A: The length of time needed for proper recovery will depend on the underlying cause and severity of the pain. A grade 1 sprain may heal within several weeks, while a dislocated or fractured shoulder can take up to 6 weeks to property heal. A shoulder impingement can take upwards of 6 months to heal.
If you are experiencing shoulder pain, Advanced Orthopedics is ready to help. Our teams of physicians and nurses have been treating Central Texans for decades and are ready to help treat your pain and get you back to feeling your best. We offer state-of-the-art surgical centers and the latest equipment and technology to support procedures and clinics in Austin, Amarillo and Waco. If you are in pain, there is no need to wait. Call us at 512-244-4272 or visit us online at www.austinpaindoctor.com to schedule a same or next day appointment.
