Common Types of Shoulder Pain and Treatments
As a shoulder surgeon, the majority of what we do is see people and figure out how to relieve them of their shoulder pain. The two most common types of shoulder pain are something either caused from a tendon problem or a joint problem. Tendon issues in the shoulder are usually related the rotator cuff, which is a tendon that attaches to the top of the ball. It allows somebody to move their arm over their head. Sometimes this can fray or tear and become painful. We often we treat this with either an injection therapy or sometimes surgery to fix it. The other common cause of shoulder pain is arthritis, where the cartilage within the joint wears out. The shoulder can then grind and that’s when you hear the term “bone-on-bone arthritis.” We usually treat this similarly with injection or therapy. When when that doesn’t work, we can often replace the shoulder with a shoulder replacement.
Rotator Cuff Problems
The rotator cuff is the tendon that surrounds the shoulder joint that keeps the ball in the socket and allows the shoulder to move around and elevate one’s arm over their head. A rotator cuff tear occurs when the tendon tears off the bone. This can be very painful. Usually we treat that with surgery or arthroscopic surgery with a special camera to repair it.
There are several types of rotator cuff tears. Commonly we’ll see people with what we call an atraumatic tear or something that didn’t happen as a result from a single direct injury. Usually we can treat these with physical therapy, or sometimes injections, that can allow the tendon to heal itself and relieve the pain and inflammation in the shoulder. Traumatic tears, however, where somebody falls and then can’t elevate their arm over their head and the tendon is torn off the bone, are often fixed with arthroscopic surgery. This involves using a camera in the shoulder and repairing the tendon back down to the bone with a special anchor or screw with suture coming out of it.
There are several treatments for shoulder arthritis. Usually we start with physical therapy, anti-inflammatories, or sometimes an ultrasound-guided shoulder injection. However when that fails to work, we’ll do what’s called a shoulder replacement. This is where we replace the ball and socket with metal and plastic. We do a procedure where we bring you in overnight and then send you home the next day. Over the course of several weeks to months, the pain subsides and patients generally do very well.
Types of Shoulder Replacements
Standard shoulder replacement involves us replacing the ball and socket the way they were built, however, you need a rotator cuff at that’s functioning in order for us to do that surgery. For people with arthritis as well as a big rotator cuff tear, we cannot perform a regular shoulder replacement. In that case we perform what’s called a reverse shoulder replacement. It’s very similar in terms of the technique and the recovery and the outcome. The only difference is when we’re in there during surgery we’ll put the ball in the socket in the socket on the ball side with specialized implants. This allows us to treat pain patients with both shoulder arthritis and a rotator cuff tear, and it really does have excellent results.
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Dr. Matthew Dilisio is a fellowship trained orthopedic surgeon practicing in Omaha, Nebraska specializing in surgery of the shoulder. Dr. Dilisio has particular expertise in arthroscopic surgery to manage problems such as rotator cuff and labral tears, joint replacement surgery for arthritis such as total and reverse shoulder arthroplasty, revision shoulder surgery, latarjet reconstructions for chronic shoulder instability, and fracture care. He also practices sports medicine and surgery of the knee such as meniscus surgery, ACL reconstructions, and knee replacement surgery.