Shoulder Injury

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Not all shoulder pain requires shoulder surgery, hopefully via nonoperative means Dr. Schwartz can resolve your symptoms

Not all shoulder injuries require shoulder surgery, hopefully via nonoperative means Dr. Schwartz can resolve your symptoms

Shoulder injuries or shoulder problems are more than just a pain (albeit sometimes very painful pain!) They can cause limited movement, extreme discomfort often leading to sleepless nights and sometimes life changing problems until the issue has been resolved. For the majority of people shoulder injury symptoms are overlooked until the pain or discomfort is unbearable and the patient finally turns to their shoulder doctor for help. But when do you know if that pain is serious enough to need attention or not? Will a few days’ rest resolve the problem, or is it a serious enough problem to merit a visit to the A&E department?

While friends and family might be able to offer advice; you may still be left asking “What shoulder injury do I have?” Here are some of the signs you should look out for and common shoulder injuries and symptoms that might warrant attention:

Shoulder Instability

The shoulder joint is the most flexible joint in the human body allowing for a range of movements and flexibility that no other joint can provide. There are three bones in the the shoulder which are the humerus, which is the upper arm bone, the scapula, the shoulder blade and the clavicle, the collarbone. At the head of the humerus bone the shape is that of a ball which fits into the socket of the clavicle. This ball and socket type joint is what allows such freedom of movement, however, it is exactly for this reason that it can also easily cause problems. When the ball part of the joint is not moving freely or is in some way restricted this is known as shoulder instability.

Sometimes the patient will feel a weakness in the shoulder, usually when lifting the arm. A tingling sensation is sometimes present and often popping or clicking noises come from the shoulder.

Shoulder Dislocation

Closely linked to shoulder instability because it is what happens when the ball part of the humerus actually comes out of the clavicle (socket). Possibly one of the most painful types of shoulder injuries, shoulder dislocation requires immediate medical attention.

This kind of shoulder issue is usually caused by a blunt impact to the area including:

  • A fall onto a hard surface
  • Being hit with force in the shoulder – often seen in impact sports like rugby or football
  • Breaking a fall by putting out your hand

Because of the nature of this injury, no time should be spared in seeking medical attention. You will need a medical professional to put the bone back into the socket. Until this is done the joint will continue to swell and will be extremely painful. Thankfully as soon as the bone is re-placed into the socket, a lot of the pain goes away.

Rotator Cuff Injuries

Possibly one of the most common shoulder injuries, rotator cuff injuries can be seen in patients who have jobs where they perform overhead movements with their arm, for example, painters and decorators and carpenters, but it is also an injury seen in sports people, most commonly in baseball and tennis players. The initial pain felt will be a dull ache which will be worse when the patient tries to lie on the affected shoulder leading to sleepless nights . Rotator cuff injuries need to be carefully diagnosed as tears can be quite common, to varying degrees, and need to be treated accordingly. This type of shoulder injury is age related and by the age of 60 more than half the population will have a tear, mostly caused by wear, tear and overuse. The tears do not heal by themselves and need medical intervention to keep the situation under control and pain-free.

Strengthening exercises which improve flexibility and mobility can often be enough to help in recovery. However if a tear in the rotator cuff is discovered, immediate action is required as the extent of the tear may result in surgery being needed.

Frozen Shoulder

Frozen shoulder can be described as a pain and stiffness of the shoulder joint that gradually gets worse over time – sometimes taking up to a few years. One of the more common shoulder injuries, frozen shoulder involves the tissue which surrounds the shoulder joint, known as the shoulder capsule, becomes thick and as a result makes movement within the joint difficult. The synovial fluid, the liquid within the joint which helps easy movement of the joint, decreases and movement becomes difficult and painful.

Pain and discomfort can interfere with sleep as the pain usually gets worse at night. Your doctor will most likely be able to diagnose frozen shoulder from the symptoms alone but sometimes he might request imagine tests like X-rays or MRI scans just to rule out other issues.

A general way to think about pain generators in the shoulder.

A general way to think about pain generators in the shoulder.

Treatment for Shoulder Joint Injuries

For most shoulder injuries the RICE principles can be applied; Rest, Ice, Compression and Elevate. Reducing the movement for a few days with rest and regular ice packs is an easy, self-help way to reduce inflammation and pain. The use of compression and elevation can help alleviate swelling reducing the discomfort felt by the patient.

Upon the advice and guidance of a competent shoulder surgeon you will be able to carry out simple, easy exercises by yourself which should slowly build up strength of the muscles in the shoulder.

Slings are sometimes used to immobilize the injured shoulder allowing muscles and tendons to heal.

Non steroidal anti-inflammatory medication may be administered to help with pain relief and to reduce swelling.

If the injury does not appear to be healing, your shoulder surgeon my administer a corticosteroid by means of injection.

Finally, when a tear is diagnosed and depending on the severity of the tear, surgery may be required to get the patient back on their feet again.  The advice of a specialised, competent shoulder specialist who has knowledge and experience in dealing with shoulder injuries and surgery should be sought. They will guide you through the pros and cons of surgery and help you make the best decision for you.

Does your Shoulder Pain need Shoulder Surgery?

Call 206-860-5578 and ask for an appointment with Seattle’s Premier Shoulder Specialist, Dr. Daniel Grant Schwartz to find out; or contact us for more information.