• Bone and Joint Health
• Health Topics
• Joint Conditions/Injuries/Treatment
• Joint Pain/Pain Management
• Shoulder

How To Shoulder Less Pain

Over time, repetitive motion of the shoulder joint and the breakdown of soft tissue in and around the shoulder can lead to chronic pain, involving any of the components that make up the shoulder – bones, muscles, tendons, and ligaments.

Other common causes include injury to the tendon or rotator cuff and arthritis in the shoulder joint. Shoulder conditions fall into four main categories, according to the American Academy of Orthopaedic Surgeons (AAOS):

• Arthritis
• Fracture
• Instability
• Tendon inflammation (bursitis or tendinitis) or tendon tear

Rare causes of shoulder pain include tumors, infection, and nerve-related problems.

Types Of Shoulder Arthritis

Arthritis in the shoulder can limit mobility and cause pain, swelling, and stiffness. Four types of arthritis can affect the shoulder:

• Osteoarthritis. The most common form of arthritis, it wears away the cartilage from the ends of bones that form joints, causing the bones to grind together.
• Posttraumatic arthritis. This develops after an injury such as dislocation of the shoulder.
• Rheumatoid arthritis. An autoimmune disorder that causes your immune system to attack your body, rheumatoid arthritis causes swelling and pain in joint linings.
• Rotator cuff tear arthritis. This develops in the shoulder joint, over time, after a rotator cuff tear goes untreated.

Tests For Shoulder Pain

A thorough physical examination by your doctor is the most reliable and comprehensive test for diagnosing shoulder pain. During the exam, your doctor may test you for:

• Deformity or muscle weakness
• Physical abnormalities
• Range of motion and strength
• Swelling
• Tenderness

Your doctor may follow up with an X-ray or ultrasound.

Nonsurgical Shoulder Pain Treatments

Some over-the-counter medications can alleviate the pain and stiffness of shoulder arthritis. Medications can also slow bone loss or alter the course of an inflammatory disease causing the pain, the Arthritis Foundation says.

Physical therapy and exercise are also effective noninvasive treatment options. Other nonsurgical treatments to control pain and inflammation include:

• Corticosteroid injections in the shoulder
• Dietary supplements, such as glucosamine and chondroitin sulfate
• Icing the shoulder for 20 to 30 minutes two or three times a day
• Moist heat
• Rest or change in activities

Types Of Shoulder Surgery

Surgery may become necessary if an injury, or a disease like arthritis, does not respond to nonsurgical forms of treatment. Untreated, arthritis will progressively worsen and diminish the functionality of your shoulder joint, your ability to perform daily activities, and your quality of life.

Total shoulder replacement and reverse shoulder replacement are common procedures. Total shoulder replacement involves replacing the ball of the shoulder joint with a prosthesis and placing the artificial ball in the natural socket of the joint.

Reverse shoulder replacement is effective for treating conditions like a torn rotator cuff. In this procedure, the ball and socket of the shoulder are replaced. A prosthetic ball is attached to the shoulder bone, and a prosthetic socket is attached to the arm bone.

Arthroscopic shoulder surgery is a minimally invasive procedure in which the surgeon makes  small incisions for inserting a tiny camera and surgical instruments to treat bone spurs, a torn rotator cuff, or impingement syndrome, which occurs when inflammation, bone spurs, or fluid buildup cause a rotator cuff tendon to be squeezed and rub against a bone.

Arthroscopic surgery, which can also be used for removing scar tissue or repairing damaged, worn, or injured tissue, results in shorter recovery times and less pain following surgery than conventional open surgical procedures.

Reverse Vs. Conventional Total Shoulder Replacement

Conventional total shoulder replacement is the best option if you have osteoarthritis, live an active lifestyle, and have a functional or reparable rotator cuff. This procedure is effective in relieving pain and restoring mobility.

Reverse total shoulder replacement surgery is an effective choice if you’re less active than you used to be and have a torn rotator cuff that is not reparable or was previously torn and repaired. The procedure is appropriate in these cases because it relies on different muscles to move the arm.

Shoulder Surgery Recovery

Recovery and return to normal activity after shoulder replacement surgery varies from one patient to another. Factors such as age, medical condition, and history, as well as the type of procedure performed all play a role.

Generally, conventional shoulder replacement surgery involves one night in the hospital following surgery, wearing a sling after surgery, start of physical therapy – to regain motion and strength – a couple of weeks after surgery, and return to normal activity six to eight weeks after the operation.

Recovery from reverse shoulder replacement surgery is similar to that for conventional surgery. Exercise and physical therapy differ some, as they are tailored to the surgery.

Typically shoulder replacement surgery significantly reduces pain, but it may not go away entirely, and you may still have some stiffness.

Shoulder replacement procedures and the technology involved are continually being updated to improve patient outcomes and reduce recovery time.

Source: American Academy of Orthopaedic Surgeons; American Academy of Family Physicians; American Academy of Physical Medicine and Rehabilitation; Arthritis Foundation