You don’t have to live with it. Most shoulder injuries can be easily treated by medication, physiotherapy and surgery.
Do you feel a twinge in your shoulder when you lift up your arm? Or find that you are having trouble stretching your arms backwards? You may be suffering from a shoulder joint injury.
The shoulder joint is made up of three bones – the upper arm bone, shoulder blade and collarbone – along with a combination of muscles and tendons called the rotator cuff.
The joint is one of the most mobile in the human body and prone to injury because of the heavy use of the arm and shoulder.
There are three main causes of shoulder pain:
- Rotator Cuff Injuries
- Dislocated Shoulder
- Frozen Shoulder
Rotator Cuff Injuries
Rotator cuff injuries can range from less severe inflammation or partial tears of the cuff, to a complete tear. This can be caused by wear and tear, which is why the Chinese call this type of injury the “50-year shoulder”. People most affected are those who have to constantly life their arms over 90 degrees. Larger tears are also caused by trauma, such as in sports accidents or when you use your arms to break a fall.
Inflammation and smaller tears sometimes heal by themselves without surgery, and treatment for such conditions include non-steroidal anti-inflammatory drugs to bring down the swelling and ease the pain, combines with physiotherapy to strengthen the other rotator cuff muscles. Another option is an injection of anaesthetic into the area, which gives pain relief and brings down inflammation for up to six months. Activity modification is also important in treatment and prevention. This may include physical exercise to strengthen the rotator cuff, and changing the patient’s posture during everyday activities. A cycle of non-operative treatment usually lasts about three to six months.
In more serious tears, or when non-operative treatment is ineffective, surgeries are usually performed using the keyhole procedure, and will attempt to repair any damage to the rotator cuff. “Results are usually very good and most of our patients are able to return their sport in six to seven months.”
A dislocated shoulder happens when your upper arm bone pops out of the socket in the shoulder that it should fit in. Patients with dislocated shoulder will be in a lot of pain and unable to move the arm. The shoulder joint will also look deformed. After reducing the dislocation, one of the first steps of diagnosis is to undergo X-rays and a scan to find out why the dislocation happened, because in young patients, the chance of it happening again is very high. “We also conduct tests to find out how ‘loose’ the joint is as that will tell us how likely another dislocation is, even if the patient undergoes surgery.”
Not getting proper treatment could lead to more serious consequences. If a dislocated shoulder is not treated properly, the bone that is left out of the joint could damage the surrounding cartilage. Bone loss can occur because of the friction between the joint and the surrounding bone. Once that happens, it will be difficult to fix the problem with just keyhole surgery. Because of this, our orthopaedic specialist, Dr. Kevin Yip encourages seeking treatment from an orthopaedic specialist for all dislocations.
Just like its description, a frozen shoulder occurs when a patient cannot move his shoulder in any direction. This is caused by the thickening of the capsule of connective tissue that surrounds the shoulder joint.
There are three phases:
The first phase is when the range of motion of your shoulder becomes limited and pain arises when you try to move it. In the frozen stage, the shoulder becomes stiffer but the pain decreases, while the thawing stage is when the patient slowly regains the range of motion. The thawing process can take over a year, which is when it becomes disruptive to daily life. Treatment options include physiotherapy, injections and moving the shoulder joint to the full range of motion while you are in anaesthesia to break up the scar tissue and speed up recovery, and keyhole surgery to release the thickened capsule.
Keep Your Shoulders Safe
Shoulder conditions can have a considerable impact on your everyday life, and it is possible to lessen your risk of developing them. Our best piece of advice for protecting your shoulders would be to know your limits. If you know that a certain action is causing damage to your shoulders or making them hurt, stop doing it – activity modification is very important. And for sports enthusiasts, our advice is something we tell the guys we work out with – keep your ego at home when you exercise.
And more importantly, if you are already having shoulder pain, do not ignore it. See a doctor if you have any pain in the shoulder that persists beyond two weeks. There is treatment that can help relieve the pain and prevent it from coming back again. Remember – you don’t have to live with shoulder pain!