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To Your Health: Treatment can bring shoulder pain relief

Dr. Phillip Nigro

Dr. Phillip Nigro

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Updated: June 2, 2013 6:09AM



If you’re looking for relief from shoulder pain, you’re not alone.

Nearly 7 million Americans suffer from some form of shoulder pain every year, and experts estimate Americans spend more than $1 billion on shoulder treatment annually.

What most people call the shoulder is really several joints that combine with tendons and muscles to allow a wide range of motion in the arm.

Mobility has its price, however. As the most movable joint in the body, the shoulder also is one of the most potentially unstable.

As a result, it is the site of many common problems — including instability of the soft tissue or bony structures in your shoulder, which can result in pain.

Shoulder injuries are frequently caused by athletic activities that involve excessive, repetitive, overhead motion such as swimming, tennis, pitching and weightlifting. Injuries also can occur during everyday activities such as washing walls and gardening.

The shoulder is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula) and the collarbone (clavicle).

The head of the upper arm bone fits into a rounded socket in the shoulder blade called the glenoid. A combination of muscles and tendons keeps the arm bone centered in the shoulder socket. These tissues are called the rotator cuff. They cover the head of the upper arm bone and attach it to the shoulder blade. As we age, joints and tissues degenerate, tear and begin to hurt.

If you are experiencing pain in your shoulder, ask yourself these questions: Is the shoulder stiff? Can you rotate your arm in all the normal positions? Does it feel like your shoulder could pop out or slide out of the socket? Do you lack the strength in your shoulder to carry out your daily activities?

If you answered “yes” to any of these questions, consult an orthopedic surgeon to determine the severity of the problem.

The most common source of shoulder pain is when rotator cuff tendons become trapped under the bony area in the shoulder. The tendons become inflamed or damaged, resulting in a condition called rotator cuff impingement.

Sports or occupations requiring repetitive overhead motion or heavy lifting can place a significant strain on rotator cuff muscles and tendons. This can lead to bursitis, an inflammation of the fluid-filled sac that normally protects the joint and helps it move smoothly.

Reducing the inflammation with nonsteroidal anti-inflammatory medications, such as aspirin or ibuprofen, and rest is the first step in treating bursitis. After the pain is gone, simple exercises or physical therapy may help you return to normal, pain-free activities.

If symptoms don’t subside, the next step is usually a cortisone injection, or steroid shot, to reduce the pain-causing inflammation. I use ultrasound-guided injections that pinpoint the precise location of the pain and bring the most effective results.

Over time, tendons become weaker and degenerate. Eventually, this degeneration can lead to complete tears of both muscles and tendons, known as a rotator cuff tear.

Physical therapy and cortisone injections may reduce pain from this condition. In patients with a complete tear of the rotator cuff, shoulder arthroscopy to reattach the tendon to the head of the humerus may be the best option.

Arthritis of the shoulder is another common complaint. Arthritis is a degenerative disease caused by either wear and tear of the cartilage or an inflammation of one or more joints. As with other arthritic conditions, initial treatment is nonsurgical and usually involves rest or avoiding activities that provoke shoulder pain, physical therapy to improve range of motion, nonsteroidal anti-inflammatory medications to reduce inflammation and pain, ultrasound-guided cortisone injections in the shoulder joint to reduce swelling and pain or applying ice or moist heat.

If these treatment options aren’t effective, joint replacement surgery should be considered.

Orthopedic surgeons at the Advanced Orthopedic Institute at Ingalls treat joints with some of the latest technology available, including computer-assisted navigation to place new joints with pinpoint accuracy.

More information is at (708) 915-7246.

Nigro is an orthopedic surgeon, sports medicine specialist and shoulder and elbow surgeon with the Advanced Orthopedic Institute at Ingalls.



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