shoulder pain

Millions of Americans suffer from shoulder pain, due to injuries or other causes. When physical therapy and medication fail to relieve the discomfort and restore shoulder function, surgery is often recommended.
At Orthopedic Surgery San Diego, patients are evaluated to determine their best options. Types of shoulder operations include closed procedures and arthroscopic surgery.The shoulder consists of several joints, as well as tendons and muscles, that allow a variety of movements. The joint features three bones: the humerus, in the upper arm; the scapula, also known as the shoulder blade; and the clavicle, or collarbone. The humerus extends into the glenoid, a socket in the scapula. The muscles and tendons that hold the humerus in place make up the rotator cuff.
Some people feel pain only when they make certain movements, while others experience discomfort even while the shoulder is not being used. Sometimes, the joint heals and the pain goes away. In other cases, patients must obtain treatment to find relief.
The major reasons for shoulder pain are tendon inflammation due to bursitis or tendonitis, tendon tears (most common being the rotator cuff), instability, arthritis and broken bones (fractures). Less common causes include tumors, infections and nerve problems, according to the American Academy of Orthopaedic Surgeons.
Overuse of the shoulder, which occurs while playing sports or performing certain physical tasks, can lead to inflammation of the bursae (sacs of fluid that cushion the bones and tissues in joints). This condition is diagnosed as bursitis.
When the swelling is between the rotator cuff and the acromion (the top of the shoulder blade), it is classified as subacromial bursitis. This frequently afflicts people who also have rotator-cuff tendonitis, which results from long-term deterioration of a tendon.
Tendonitis is either acute, due to an injury from excessive throwing or other overhead activities; or chronic, a degenerative disease that gets worse with age. Most of the time, shoulder tendonitis occurs in one of the four rotator-cuff tendons or in a biceps tendon.
A tendon tear also can result from either an acute injury or degenerative effects. It can be a partial tear, or a severing of the tendon. A complete tear entails a tendon being pulled apart from a bone. Injuries to the rotator cuff and biceps tendons are most often responsible for tears.
When the acromion exerts too much pressure on underlying soft tissues while the arm is lifted away from the body, impingement (or rubbing) can occur. That can cause bursitis, tendonitis and even rotator-cuff tears.
Shoulder instability involves the head of the upper arm bone being forced out of the shoulder socket, because of injury or overuse. Such dislocations can be partial or complete. Some patients suffer multiple recurrences, as shoulder ligaments, tendons and muscles become loose and more vulnerable to instability. The more times it happens, the greater the odds of arthritis developing.
The most common type of shoulder arthritis, osteoarthritis, is characterized by pain, inflammation and stiffness that generally starts in middle age. The condition gradually worsens, due to wear and tear of the joint over the years. Athletes, as well as workers who repeatedly reach above their heads, are particularly susceptible to osteoarthritis.
Other kinds of shoulder arthritis result from rotator-cuff tears, infections and inflammation of the joint lining.
An injury can break the clavicle, humerus or scapula. For seniors, falling is the typical cause of a shoulder fracture. Younger people are more likely to be injured in a traffic accident or while playing sports. Patients with broken shouder bones experience severe pain, swelling and bruising.
Orthopedists employ a variety of diagnostic tests to identify the cause of shoulder pain. They usually advise patients to rest the joint, and reduce or alter activities. However, inactivity may lead to stiffness, pain and lost range of motion. Doctors typically recommend physical therapy, and prescribe anti-inflammatory medication.
In about 10 percent of cases, surgery is required to relieve symptoms and restore shoulder function. Operations often are performed arthroscopically, a minimally invasive technique that involves only small incisions. For shoulder reconstruction or replacement, open surgery is conducted.
If you are experiencing shoulder pain, it is necessary to pinpoint its cause to determine the appropriate and effective treatment. Schedule an appointment for an evaluation by the nationally renowned sports medicine surgeons at Orthopedic Surgery San Diego to learn about ways to relieve the discomfort and regain full use of your shoulder.