Shoulder Problems and Treatments
Bursitis or Tendinitis can occur with overuse from repetitive activities such as swimming, painting or weight lifting. These activities cause rubbing or squeezing (impingement) of the rotator cuff under the acromion and in the acromioclavicular joint. Initially, these problems are treated by modifying the activity which causes the symptoms of pain and with a rehabilitation program for the shoulder.
Impingement and Partial Rotator Cuff Tears Partial thickness rotator cuff tears can be associated with chronic inflammation and the development of spurs on the underside of the acromion or the AC joint. The conservative non-operative treatment is modification of activity, light exercise and occasionally, a cortisone injection. Non-operative treatment is successful in a majority of cases, but if it is not successful, surgery often is needed to remove the spurs on the underside of the acromion and to repair the rotator cuff.
Full Thickness Rotator Cuff Tears are most often the result of impingement, partial thickness rotator cuff tears, heavy lifting or falls. Non-operative treatment with modification of activity is successful in a majority of cases. If you continue to have pain, surgery may be needed. Surgery may be necessary to repair full thickness rotator cuff tears. Arthroscopic techniques allow shaving of spurs, evaluation of the rotator cuff and repair of some tears. Both techniques require extensive rehabilitation to restore the function of the shoulder. Image of full thickness rotator cuff tears
Instability occurs when the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of sudden injury or from overuse of the shoulder ligaments.
The two basic forms of shoulder instability are subluxations and dislocations. A subluxation is a partial or incomplete dislocation. If your shoulder is partially out of the shoulder socket, it eventually may dislocate. Even a minor injury may push the arm bone out of its socket. A dislocation is when the head of the arm bone slips out of the shoulder socket. Some patients have chronic instability, shoulder dislocations occur repeatedly.
Patients with repeat dislocation usually require surgery. Open surgical repair may require a short stay in the hospital. Arthroscopic surgical repair is often done on an outpatient basis. Following either procedure, extensive rehabilitation, often including physical therapy, is necessary for healing.
Image of shoulder instability
Fractured Collarbone and AC Joint Separation are common injuries of children and others who fall on the side of their shoulder when playing. Most of these injuries are treated non-operatively with slings or splints. Severe displaced fractures or AC joint separation may require surgical repair.
Fractured Head of the Arm Bone is a common result of falls on an outstretched arm, particularly by older people with osteoporosis. If fragmented or displaced, it may require open surgical repair and possibly replacement with an artificial joint (prosthesis)
Osteoarthritis and Rheumatoid Arthritis can cause destruction of the shoulder joint and surrounding tissue, as well as degeneration and tearing of the capsule or the rotator cuff. Osteoarthritis occurs when the articular surface of the joint wears thin. Rheumatoid arthritis is associated with chronic inflammation of the synovium lining which can produce chemicals that eventually destroy the inner lining of the joint, including the articular surface.
Shoulder replacement is recommended for patients with painful shoulders and limited motion. The treatment options are either replacement of the head of the bone or replacement of the entire socket. Your orthopaedic surgeon will discuss with you the best option.