What's Next In Health

Did you know the shoulder is one of the most complex joints in the body? That's because the shoulder is shaped quite differently from other body joints and relies greatly on its soft tissue envelope for stability. While most joints in the body are rounded, the shoulder joint is very flat, much resembling the shape of a golf tee.

For these reasons and as a result of the significant stresses placed on the shoulder during activity, the joint often becomes painful or dysfunctional. About four million people in the United States seek medical care for a shoulder problem each year.

If you have shoulder pain that won't go away, see your doctor immediately. The longer you wait, the harder it may become to move your shoulder and the longer the process of rehabilitation to return to your previous activity level.

There are three common problems associated with shoulder pain:

Instability/Subluxation
Instability is when the joint comes out of place completely; subluxation is when the joint partially comes out of place. These types of injuries oftem occur in active, younger patients as well as athletes.

The most common situations leading to a subluxation dislocation involve a fall with the arm up and away from the body.

Therapy is often the first course of treatment used to brind patients back to their previous levels of activity. When therapy alone does not work, surgery may be recommended.

Overuse
Also know as impingement, bursitis, rotator cuff tendonitis, and bicep tendonitis. This is a problem in which inflammation of the tissue surrounding the shoulder results from repetitive overuse or a mechanical problem with the shoulder.

This injury can occur in any person who performs a lot of overhead activity, from weekend athlete to assembly line worker.

Usually people suffering from this type of injury find relief when they are diagnosed early and discontinue or modify the injurious activity immediately. Those who wait to seek treatment may find relief with anti-inflammatory medication and activity modification.

Early recognition is key to avoiding a more significant problem, such as a rotator cuff tear. In cases where there is long-standing inflammation, a disruption of the muscles anaching the arm bone to the body canoccur. This is called a rotator cuff tear and typically requires surgery."

The treatment of rotator-cuff tears has certainly changed in the last decade. It used to be that patients would undergo a long operation and stay for several days following a cuff repair. Today, the repair is done through arthroscopic means (involving only three to four quarter-inch incisions) with the patient going home the same day and returning back to his or her daily routine within three to four days.

Arthritis and Degeneration
Most often this problem occurs in older adults. Sometimes a younger patient can develop significant arthritis from a previous, untreated shoulder injury that results in considerable degeneration of the joint.

Typically, patients complain of stiffness in the joint, pain with motion, and pain when attempting to go to sleep.

Often, a simple cortisone injection and physical therapy can improve the situation greatly. In more advanced cases, total shoulder replacement surgery is necessary to control the pain and stiffness. This too has really improved with respect to the severity of the procedure. Patients who underwent these kinds of operations used to stay in the hospital for eight to 10 days. Now patients go home the next day and in most cases stay only two nights.

Advancements in shoulder replacement surgery can be attributed to the new medicines that are now available to control inflammation and pain, the improvements in surgical approaches, and the type of components that are implanted.

These two books may help with the relieving chronic shoulder pain:

Shoulder Pain

Walk Yourself Well: Eliminate Back Pain, Neck, Shoulder, Knee, Hip and Other Structural Pain Forever-Without Surgery or Drugs