Shoulder pain can be successfully treated with physical therapy to strengthen the supporting muscles; however, some cases require surgery for relief and repair. The shoulder joint has the greatest range of motion and is at risk for injuries. Age, overuse, trauma and daily strain all contribute to pain; common shoulder conditions also responsible for pain include tendinitis, rotator cuff tear, arthritis and joint instability.
Determine the Source of the Pain
After a family history is acquired, the shoulder's range of motion, joint stability and strength is measured through a physical examination. The doctor tries to locate the exact area of pain; depending upon the findings, additional tests such as a shoulder X-ray shoulder, CT scan or MRI may be required. An arthogram may also be ordered, wherein dye is injected into the shoulder joint prior to the X-ray;ultrasounds can also be used. A diagnosis of inflammatory arthritis requires blood tests and joint fluid analysis.
Arthroscopic Surgery
Shoulder pain resulting from rough bone surfaces often need outpatient arthroscopic surgery. A series of tiny incisions is made and the surgeon inserts a pencil-thin arthroscope outfitted with a light and lens into the openings; the shoulder joint is viewable on a monitor, and repairs are made. Arthroscopic surgery is usually done to smooth rough bone surfaces and repair joint instability and rotator cuff tears.
Open Surgery
Open surgery is required when replacing the shoulder joint or repairing more serious rotator cuff tears. A large incision is made to reveal the joint area, and the surgeon makes repairs through this opening.
Worn out shoulder joints can be replaced depending upon the extent of joint damage, which determines whether a partial or total shoulder replacement, involving the ball and socket portions, is necessary. Replacement parts, or prostheses, are made of metal alloys or plastics; once cemented into place, bone grows around them.
Recovery
Typically, recovery can take up to 6 months, but this time frame depends upon the extent of the repairs, general health and the patient's compliance with a physical therapy routine. Simpler arthroscopic procedures such as smoothing bones recover in as short as 2 months. Rotator cuff tears require healing time for tendons regardless of the type of the surgical procedure. In general, recovery from arthroscopic procedures is easier due to the smaller incisions.
Critical aspects of surgical recovery include rehabilitation and physical therapy. Therapists develop programs specifically geared towards shoulder rehabilitation. Following the prescribed routine manages stiffness and maintain the shoulder's maximum, capable range of motion. Strengthening, range of motion and stretching exercises are significant in restoring the shoulder.
Frozen Shoulder
Frozen shoulder, or adhesive capsulitis, is inflammation in the shoulder's connective tissue. This condition affects women more often than men---approximately 70 percent of patients with frozen shoulder are female. Symptoms tend to appear after age 40. The shoulder joint's capsule becomes stiff with progressive symptoms of aching or burning pain, and due to this pain, the shoulder's range of motion is compromised. The condition resolves itself through physical therapy, usually within a year; persistent pain is treated with acetaminophen or other over-the-counter, non-steroidal anti-inflammatory drugs (NSAIDs). Corticosteroids may also be injected into the joint for further relief. Arthroscopic surgery to break up scar tissue contributing to unresolved pain may be required.
Tags: range motion, shoulder joint, physical therapy, cuff tears, rotator cuff, arthroscopic procedures, bone surfaces