Shoulder Treatments & Procedures

The Shoulder joint is one of the largest and most complex joint in the Human Body formed by the Humerus(upper-arm bone) and the Scapula(shoulder blade), like a ball and socket. With an extensive use case, over time, with regular wear & tear, some of the most common types of troubles / injuries that your may face with your shoulder include:

AC JOINTS

What Is Ac Joint injury?

The acromioclavicular (AC) joint is the joint composed by the clavicle (collarbone) and the highest point of the acromion (shoulder blade). The AC joint is held closely together by multiple ligaments (one in the front, one in the back, one on top and one in the bottom). Additionally, there are two ligaments connected to another bone called the coracoid (conoid and trapezoid) that keep the clavicle in place.

 

What causes AC Joint injury?

An AC joint injury is a common shoulder condition generally caused by a hard fall or blunt force to the joint. A sports medicine orthopaedic surgeon can help alleviate acromioclavicular joint pain and deformity after an injury and return patients to an active, healthy lifestyle. The most common cause of an AC joint injury is a direct contact force impacting the top of the shoulder. The fall can cause the joint to experience a mild sprain or, in cases of a particularly forceful impact, a complete shoulder separation. An AC joint injury is measured in multiple grades, spanning from Grade 1 as a mild sprain up to Grade 6 as a debilitating and complete disruption resulting in a total AC joint separation.

 

How Ac Joint Injury is Diagnosed?

A comprehensive physical examination of the shoulder along with a detailed history and a series of x-rays will lead to a confirmed AC joint injury diagnosis. An x-ray can also help rule out any additional injuries to the bone, such as a fracture of the end of the collarbone. In addition to x-ray, an MRI scan to determine the injury grade and assess injury of surrounding ligaments to arrive at an effective and individualized treatment plan.

 

How Ac joint Injury is Treated?

Depending on the pain and the function, options range from conservative treatment to surgical options. These options should be tailored to each patient’s needs. Injury grade can help determine which is the best option. A surgical procedure may be recommended by doctor in higher grade injuries or when non operative treatments have failed.

FROZEN SHOULDER

What is frozen shoulder?
Adhesive capsulitis, also commonly referred to as frozen shoulder, is a condition that results in significant pain and limited range of motion of the shoulder. It can be very painful, and the loss of motion can impact an individual’s ability to perform their daily activities.

What Causes Frozen Shoulder?
Frozen shoulder is the result of thickened and tightened scar tissue surrounding the shoulder joint, or what your surgeon may described as adhesions within the shoulder capsule. This thickened and tightened tissue limits the ability of the shoulder joint to move normally, and can be quite painful. In addition, there is also less synovial fluid, which is the normal lubricating liquid within the joint that helps it move smoothly.

How frozen shoulder is Diagnosed?
The diagnosis of frozen shoulder is largely based on patient symptoms and physical exam. One of the characteristics of frozen shoulder that is different from other painful conditions of the shoulder, is the limited passive range of motion. Meaning, that when the doctor or therapist attempts to move your shoulder, the range of motion is also limited.
If needed, a variety of imaging techniques can be used to help make the diagnosis. Techniques such as magnetic resonance imaging (MRI) and ultrasound can help your doctor see the tissue surrounding the shoulder joint to help make the diagnosis.

How Frozen Shoulder is treated?
Treatments typically begin with medications and physical therapy. Commonly, over-the-counter-medications such as non-steroidal anti-inflammatory drugs (NSAIDs) are used. If needed, more powerful anti-inflammatory medications can be prescribed, such as steroids, either taken orally or injected directly into the joint.
If these treatment options do not work, there are other more aggressive options including manipulation under anesthesia, during which the patient is put to sleep and the doctor moves the shoulder through a complete range of motion, in attempts to stretch out and break up the tight scar tissue around the joint. Lastly, in very severe cases, there are surgical procedures that can be performed to cut and remove the tight scar tissue.


SHOULDER DISLOCATION / INSTABILITY

What is shoulder Dislocation or instability?
The shoulder joint is made up of a ball (humeral head) and a shallow flat socket (glenoid). The labrum is a thin piece of tissue that lines the rim of the glenoid that helps keep the ball in the socket through a large range of motion. However, because of the incredible mobility, the shoulder is at higher risk of dislocation compared to other joints, such as the hip, where the socket is much deeper.

What causes Shoulder Dislocation or instability?
Dislocations of the shoulder most frequently occur in the setting of traumatic injury such as a fall, or participation in contact sports, including football or hockey.

How is Shoulder dislocation or instability diagnosed?
If the shoulder remains dislocated, you should seek immediate treatment to have your shoulder relocated. However, even if the shoulder goes back into place by itself, there may be damage to the surrounding structures that need treatment.

Imaging including x-rays and MRI (magnetic resonance imaging) are frequently used as well. X-rays can help make sure that the shoulder is located within the socket, and evaluate for any fractures. MRI can be used to determine if there are any injuries to the soft-tissues surrounding the shoulder, including the labrum. Based on all of the information gathered from the history, physical exam, and imaging, Doctor can discuss treatment options based on your goals and activity level.

How is Shoulder dislocation or instability Treated?
For the treatment of shoulder instability and dislocations, there are both non-surgical and surgical options. Much of this is determined by your specific injury, age, activity level, and future goals.

Non-surgical options typically include a period of rest and immobilization using a sling. Medications can also be used for a brief period of time to help relieve pain. This is then followed by physical therapy to help regain strength and range of motion.

Surgical options are typically used in cases where patients have had multiple dislocations or instability events, or there are injuries to the tissues surrounding the shoulder that require surgery. Most commonly, these are injuries to the labrum.


SHOULDER OSTEOARTHRITIS

What is Shoulder Osteoarthritis?
Shoulder osteoarthritis, also known as degenerative joint disease of the shoulder, is the gradual “wear and tear” of cartilage in the shoulder. Shoulder osteoarthritis affects up to 33% of patients over the age of 60. This condition is often painful and limits patient’s range of motion and ability to comfortably move their shoulder.

What causes Shoulder Osteoarthritis?
Shoulder osteoarthritis most often occurs in people who are over 50 years old. However, shoulder osteoarthritis can be seen in younger people due to an injury or trauma, such as a fracture or dislocated shoulder. Osteoarthritis can also run in families.

How is Shoulder Osteoarthritis diagnosed?
To diagnose shoulder osteoarthritis, a thorough history and physical exam is completed by your doctor to assess for pain, tenderness, and loss of motion. Your doctor may also ask questions about how long your symptoms have been occurring, and any history of recent shoulder injuries or trauma.

Medical imaging can also be done to look at the severity of the shoulder arthritis and rule out other possible causes of pain. An X-ray of your shoulder can show if there is a loss of space between the shoulder head and the glenoid, or “socket.” A loss of joint space means there is a loss of cartilage. If X-rays do not give a clear cause, an MRI can also be done.

How is Shoulder Osteoarthritis Treated?
Unfortunately, there is no cure for shoulder osteoarthritis. But there are treatments that can help manage symptoms and keep people as active as possible. Physical therapy is a great way to stretch and strengthen the muscles that support your shoulder. Pain reliever medications like acetaminophen and anti-inflammatories (NSAIDs) can also be used to ease pain.