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How Shoulder Pain is Treated

The treatment of your shoulder injury is based on what is causing your shoulder problem. While the treatments vary, one technique that may be used often is shoulder arthroscopy.

There may be times when shoulder arthroscopy is not the right procedure. In these cases, traditional shoulder surgery may be performed by the physicians of The Shoulder Center, particularly in the area of shoulder replacement.

Injuries and Treatments
Bursitis --
For two thirds of the patients with bursitis, their symptoms can be treated without an operation. The three phases of recovery are inflammation control, range of motion restoration and strengthening. “Working through the pain” is usually not effective. Heat before exercise, gentle stretching, and ice afterwards often helps quiet down bursitis. Cortisone injections, and physical therapy may be used if home exercises aren’t effective.

Rotator Cuff Tears -- For those with a complete tear, coping may be an option. But many benefit from operative repair of the tendon back to the bone. This typically reduces pain, improves motion and frequently re-establishes power to the shoulder. For cases that fail non-operative treatment, arthroscopic subacromial decompression is very effective in reducing shoulder pain, and creating an improved healing environment.

Watch a 30-second video of a rotator cuff repair, featuring narration by Eric Olson, MD -- Quicktime version or Windows Media version.

DIAL-UP USERS: Please allow some extra time for the file to download.

Dislocations -- Treating a shoulder separation involves prompt reduction of the dislocation, immobilization of the arm in a sling for 1 to 3 weeks, and physical therapy. Arthroscopic repair of the ligaments torn during the dislocation can prevent the shoulder from dislocating again.

Frozen shoulder -- A stretching program is effective in gradually re-establishing motion over 3-6 months in two thirds of the people affected with frozen shoulder. Manipulation under anesthesia or arthroscopic capsular release of the tight capsule, can help re-establish motion in shoulders that fail to improve non-operatively.

Fractures --

Clavicle Fractures -- Most cases are treated with a sling, and require 6 weeks to heal. See our special page on the A/C joint.
 

Proximal Humerus Fractures -- Often, these fractures can be managed in a sling. If the fractured parts of the bone are very out of place, they may require an operation to restore improved position.
 

Greater tuberosity fractures -- The bone fragment that results from these fractures may need to be surgically repaired to reduce the risk of developing these problems.

Separations -- Severe separations may be treated with surgical reconstruction of the ligaments between the shoulder blade and the collarbone, but this is usually not needed. Most problems are managed initially with exercises, activity modification, medications and physical therapy. If non-operative methods are not successful, minimally-invasive surgical techniques are often helpful.

Degenerative arthritis -- If it involves the large ball-and-socket joint, replacing the worn shoulder joint with an artificial one (read Shoulder Replacement Surgery in Brief) can help reduce pain, and often improves motion. The painful degeneration of the AC joint, between the collarbone and the shoulder blade, may be treated with arthroscopic removal of the end of the clavicle, so that the two bones no longer bang into each other, and bone spurs from that joint no longer protrude down into the rotator cuff, which runs just beneath the joint.

SLAP lesions -- Physical examination and MRI tests may suggest a SLAP lesion. However, the diagnosis is frequently only confirmed and treated during arthroscopic examination. The rim of the saucer is sewn back down to the saucer to repair this injury.

Watch a 30-second narrated movie about repairing SLAP lesions, featuring
Eric Olson, MD  --
Quicktime version
or
Windows Media version.

DIAL-UP USERS: Please allow some extra time for these files to download.

Biceps tendonitis -- This injury may resolve with injections around the tendon to reduce inflammation. More severe cases may require operatively treating the worn tendon so it no longer slides through the groove.

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