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Subacromial Pain
This is one of the most common causes of shoulder pain. My patients describe a non-specific ache that spreads over the front and side of their shoulder, often down the front of their arm. It is often worse at night and exacerbated by overheard activities such as reaching for something off a high shelf.
It tends to be due to inflammation under the acromion, an arc of bone on the outside of the shoulder blade. It can be caused by a variety of issues such as repetitive strain or a tear to the tendons of the rotator cuff.
Ultrasound or MRI scans are very useful in diagnosis. A large amount of the time, a pain relieving injection alongside an effective course of physiotherapy is enough to cure the symptoms. Occasionally this wont have quite the desired effect and we may need to discuss keyhole surgery.
Common Shoulder Conditions
Rotator Cuff Tear
The rotator cuff is a set of four muscles that keep the shoulder joint centred and guide smooth and balanced movement. Tears to the tendons of these muscles are common, either because of an injury or attrition over time.
They can be completely asymptomatic. Many people go through life with a tear that they know nothing about. However they nay well cause the same type of symptoms as with subacromial pain (see above). They can also cause a type of shoulder arthritis.
Unfortunately these tears do not heal by themselves. Often patients may do well with symptom control treatments such as injections and physiotherapy however the only way to repair the tears is with surgery. I am almost always able to complete with keyhole techniques but sometimes they might require open surgery.
Shoulder Arthritis
Osteoarthritis of our shoulder, or "gleno-humeral" joint is less common than hip and knee arthritis but can be no less debilitating.
It occurs when the smooth cartilage that lines the joint wears, leaving rough surfaces that cause pain and stiffness when trying to move the shoulder. It may also be caused as a result of a rotator cuff tear that has been left untreated.
Beyond pain relieving medications there is unfortunately no medical treatment that has been shown to be effective. If the pain is severe enough I can offer shoulder replacement surgery. This is quite a major operation but can have huge beneficial quality-of-life impact after recovery.
Shoulder Trauma
Firstly for anything acute please go to your nearest Accident and Emergency Department or Urgent Care Centre.
If it is less urgent and you are able to wait to come and see me then I can take a look, get up to date investigations and together we can work on getting you better with pain-free function as soon as possible
Shoulder Instability
Our shoulder provides us with a huge range of motion but the cost of that is stability. It's far more unstable than almost all other joints which is why we hear about shoulder dislocations far more often than hip dislocations for example.
If you are unfortunate enough to have dislocated your shoulder please be reassured that the vast majority will recover very well with a focused course of physiotherapy.
Occasionally you may suffer several subsequent dislocations after the first and we may have to have a conversation about stabilisation surgery.
Frozen Shoulder
This is a condition where the normally elastic lining of the shoulder joint becomes thickened and less stretchy.
It can occur all by itself but is often associated with diabetes or can occur after some trauma.
People experience a period where the shoulder is quite painful and becomes less and less mobile. Eventually the shoulder is very stiff but less painful. This can significantly affect day to day life.
The good news is that this is a temporary condition. It will almost always resolve but this can take anywhere up to 3 years or so in rare cases.
There are several interventions that can speed up the recovery. From physiotherapy and injections to keyhole surgery in rare cases.
To Schedule An Appointment
Call 02082438598